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How to Handle a Product Reaction

This is a pustular reaction to an aggressive superficial peel of 30% salicylic acid after microdermabrasion.

By: Carl Thornfeldt, MD
Posted: February 28, 2011, from the March 2011 issue of Skin Inc. magazine.

My patient left me a voice mail and her voice sounded concerned. “Dr. Carl,” she said. “I think something is wrong. I had a chemical peel three days ago, but instead of my skin being a reddish color with flakiness, I have lots of small pimples and it feels very itchy. Could you please call me?”

Sometimes unplanned reactions can occur in a medical spa or esthetic medicine practice. A spa professional must know how to handle unwanted, adverse reactions in a systematic way, but diagnosis must be determined by a medical professional.

It starts with prevention

Make sure you have recommended the right products for your client. It sounds fairly simple, but let’s review the basics. During the first appointment, thoroughly complete a consultation form and medical history. This helps to clearly identify the client’s concerns, allergies, medical history and current medications. Whenever possible, carefully analyze your client’s freshly cleansed skin with good lighting and a magnifying glass or loupe to identify areas of concern. A Wood’s lamp may also be added to identify ultraviolet (UV) damage that isn’t visible with regular light.

Go beyond your client’s skin type. There might be a difference in what she thinks her skin type is and what it actually is. Start with a treatment plan that fits your client’s needs, and then follow up. Call within three to five days of starting a new regimen and again at 14 days to check her progress, answer any questions and review instructions. Are any adjustments necessary to the existing regimen? What can be disconcerting is that sometimes clients who experiences negative responses or adverse reactions to products you recommend or procedures you perform won’t tell you. Either you never see them again, or they just don’t come back to purchase recommended products. A spa professional wants clients to have the best results and experience, so close follow-up is essential. Moreover, it is documented that the chance of being sued if a bad result occurs decreases when the professional is frequently communicating to try to solve the problem, referring to a dermatologist when necessary.

Don your detective hat

If your client experiences unusual reactions to the products you have recommended or to a procedure you performed, become an investigator to find out as many details as youcan to confidently solve the problem. The No. 1goal is to prevent permanent abnormalities, such as scarring or stretch marks. One of the most common causes of scarring is a secondary infection, usually to bacteria but also yeast, and viruses such as herpes simplex. Another common cause is performing a procedure or applying a chemical peeling agent that is too aggressive.