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Handling Post-inflammatory hyperpigmentation, alpha hydroxy acids, Asian, Native American, ethnic, hypopigmentation

By: Christine Heathman
Posted: September 28, 2012, from the October 2012 issue of Skin Inc. magazine.

page 3 of 4

The basis of pigmentation morbidity can occur as the result of cumulative exposure to UV light, making it a major culprit in melasma, solar lentigines and ephelides. Many medications, cosmetics and inflammatory skin diseases, in addition to adverse reactions to chemical peels, ingredients, pesticides, chemicals, detergents, heat, laser resurfacing, laser assisted hair removal and skin injuries can also be a source of pigmentation disorders.

PIH is caused by one of two mechanisms that result in either epidermal melanosis or dermal melanosis. These constituents of inflammation alter the activity of both immune cells and melanocytes. Specifically, these inflammatory components stimulate epidermal melanocytes, causing them to increase the synthesis of melanin and subsequently to increase the transfer of pigment to surrounding keratinocytes. This increased stimulation and transfer of melanin granules results in epidermal hypermelanosis.

Dermal melanosis occurs when inflammation disrupts the basal cell layer, causing melanin pigment to be released and subsequently trapped by macrophages in the papillary dermis, also known as pigmentary incontinence.

Accept the challenge

PIH is a universal response of the skin and can occur in lighter global skin categories, but is more common in the darker global skin types. This condition can occur at any age and takes place in both females and males. Inflammation is the trip wire to hyperpigmentation, and the skin you treat can have many levels of damage that require assessment to determine how you manage pigmentation disorders according to the information brought to light during the client’s skin history consultation.

Are you prepared to accept the challenges of working with skin of color? Beautiful skin, sex appeal, sophistication and good looks have always been a desire of all cultures. Always assess individual ethnic variability when developing a personal home care program and clinical treatment plan.

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