|
|
 |
   |
 |
|
GreatSkin® skin care Clinics |
|
The Epidermis itself consists of four layers: Stratum Corneum – the top layer of flat, hard, dried scale like dead skin cells that are continually shed and replaced. Granular Layer – protein fibers called keratin. Spiny Layer – keratinocytes in their earliest form; constitutes 95% of the epidermis. Basal Layer – bottom “living” cell layer, responsible for the growth of the epidermis. Basal cells called keratinocytes produce a protein called keratin. Cells divide to produce upper cell layers. Fibrous bands keep this layer anchored to the dermis. This basal layer also contains melanocytes, specialized cells that produce melanin pigment which protects the sensitive cells below from the destructive effects of excessive UV rays of the sun. Melanocytes transfer pigment to the keratinocytes to give the skin most of its color. Melanocytes and how prone a person is to hyperpigmentation are related to the amount of melanin in one’s epidermis. Melanin determines a person’s skin color. The quantity of melanin in a person’s melanocytes is determined by genetics. Melanin helps protect the skin from sunburn. For instance, pale skinned or fair persons have little melanin and dark skinned persons have quite a bit of melanin. Please see the Fitzpatrick Scale below.
See our Skintype Regimens page for up to 20% savings on our best recommendations for skin types I-VI!
|
|
||||||||||||
Dr. Mark says:“Do you have hyperpigmentation of the face from excessive sun exposure, oral contraceptive use, recent pregnancy, or race-related skin types of Fitzpatrick 3-6 skin coloration? Then take a look at our extensive line of products to help you. If you are still confused about which products would be best for you…take our online skin analysis and mention your problems with pigmentation. We can achieve marvelous results with product selection alone!” |
The Fitzpatrick Skin Classification System allows physicians to predict “pigmentary responsiveness” of the skin to chemical insult (as in the various types of chemical peeling agents), mechanical insult (as in dermabrasion and microdermabrasion), and thermal insult (as in laser surgery or laser resurfacing). We must always judge our potential patient in terms of our ability to have a good to excellent outcome in cosmetic dermatology, and closely adhere to that ancient Greek addage, “Primum Non Nocere,” … “above all else, do no harm.”
When asked to evaluate clients about pigmentary disorders, I always look first to establish their Fitzpatrick type. Most patients with splotchy facial pigmentation will be Fitzpatrick 3 or more. However, certain ethnic rules also apply. For instance, in Asian patients, no pigmentation at all may be present, yet a strong thermal or chemical insult can result in marked skin reactivity and splotchy hyperpigmentation, and thus a poor cosmetic result. When asked to evaluate patients who desire wrinkle reduction, my first observation is their Fitzpatrick classification, as this will guide me in what technique for wrinkle reduction I might choose. The Blond hair, blue eyed Fitzpatrick 1 will respond much better in terms of pigmentary outcome to laser resurfacing than the Fitzpatrick 4 client, unless I have prepared the Fitzpatrick 4 to withstand the chemical or thermal injury I am using to treat wrinkle reduction.
Since the production of melanin is a tyrosinase based enzyme pathway, I can pre-treat potential clients who might otherwise respond with aggressive pigmentation to thermal or mechanical insult with Hydroquinone or Kojic Acid derivatives. These products can be applied to the skin for a minimum of six weeks prior to therapy. They are “tyrosinase inhibitors,” meaning they block the melanocyte’s ability to produce melanin, thus allowing the physician to complete his procedure without significant risk of hyperpigmentation.
Hydroquinone is the most commonly used tyrosinase inhibitor, with Kojic acid running second and certain natural substances like bilberry extract and others next.
Caution must be used with the bleaching agent hydroquinone, as prolonged use of high concentrations may produce paradoxical excessive pigmentation in Fitzpatrick 4-6 skin types.
In summary, the treating physician who wishes to effect a positive response in his patient should always evaluate first, that patients likelihood of pigmentation in response to epidermal/dermal injury through the various techniques we use to rejuvenate skin, and prepare that patient accordingly.
|
Not responsible for typographical errors. Prices subject to change. Return to the skin care News E-Zine index page
|
|
