When people are experiencing issues with skin nonconformities, they often seek treatments from their medical provider. If you’re looking for treatment ideas you can offer your patients to help with these concerns, this article is here to guide you. Continue reading to discover the most popular concerns patients seek to treat with specific aesthetic services, plus the leading services that address these concerns.

Acne and Acne Scarring

What is it? 

While acne is caused by an overgrowth of bacteria, acne scars are usually the result of inflamed blemishes from pores being engorged with excess oil, dead skin cells, and bacteria. Once the pores become inflamed, they can go on to cause breaks and lesions in their follicle walls. These are normally superficial and fully heal. In the case of deeper tears, infected material can start to spread into surrounding tissues, leaving the tears to continue to become even deeper. The skin forms new collagen fibers to help repair itself, but sometimes these repairs don’t leave the skin’s surface as smooth as it once was, and scars are still visible. In other cases, the skin’s healing process is disrupted, triggering an excess increase in collagen production. This can result in raised hypertrophic or keloid scars.

Many patients look for treatments to clear their visible acne and acne scars. Thankfully, the following solutions have been proven to target acne and diminish scars.

Recommended Treatments 

Patients experiencing acne can benefit from using certain topical antibiotics regularly. If, after a few weeks, there is no improvement, an oral antibiotic may be helpful to see better results. These patients should also work with their providers to develop a great skincare regimen, including a good face wash that will leave them on the dry side. For any large cystic acne breakouts, cortisone injections directly into the breakout could be helpful. 

As far as in-office treatments go, the following provide great results against acne and acne scarring: 

Microneedling

Microneedling is one of the most sought-after treatments for smoothing a rough skin texture and healing residual acne scars. When scarring occurs, the skin undergoes fibrosis, which pulls the skin down and results in noticeable irregularities on the skin’s surface. This treatment uses small needles to poke at the skin, making it feel like it’s under attack so that its healing responses will begin to repair and correct the skin’s remaining scars, bumps, and impurities. 

Portrait Provider Juli Bromley, RN, BSN, explains that “Microneedling helps produce new collagen and reduces superficial acne scarring.” Microneedling induces the skin’s natural healing response in as little as a single treatment session. The patient’s skin will react to the micro-needling procedure almost immediately as it works to heal itself against the micro-wounds. 

Even though results are visible after one session, microneedling typically requires nine months, or three to six sessions, to treat deeper scars. Each session should be spaced out every two to six weeks to achieve complete results. The exact number of treatments needed will vary on the individual’s unique severity of concerns.

Microneedling can also be combined with PRF, which can enhance the results of this treatment. To learn more about this treatment, check out our recent blog post. 

Intense Pulse Light (IPL) Therapy

Intense pulsed light (IPL) therapy, aka a photo facial, is another treatment that works to even a patient’s skin’s tone and texture. Besides acne scars, IPL also works to correct visible damage caused by photoaging (sun exposure). When the skin is heated, the body gets rid of the unwanted cells, which help the patient’s cells produce new, fresh skin. Unlike lasers, an IPL device sends out more than one wavelength of pulsating light, which can address several skin conditions at once.

Chemical Peels

Chemical peels are special acid solutions applied to the face that can help reduce acne and even diminish deep acne scars. It’s also commonly used to help patients looking to address hyperpigmentation, melasma, enlarged pores, fine lines and wrinkles, a dull complexion, or rough skin texture. 

​​There are three different types of peels you can perform on a patient. The first is a superficial peel which targets the top layer or epidermis. These peels are often called a “lunchtime peel” as they involve minimal downtime and take just a few minutes for the skin to bounce back. These are ideal for minor acne issues.

The next type of chemical peel is the medium-depth peel. The medium-depth chemical peel goes deeper into the epidermis and also reaches a part of the dermis. This peel is ideal for patients with deeper scarring.

Lastly, a deep chemical peel is reserved for more severe skin concerns as it impacts the deeper parts of the dermis, requires the patient to be under anesthesia, and involves a lengthier downtime. 

You could also use different types of acids at different concentrations for each session as you best see fit for the client. For the best results on acne-scarred skin, it’s recommended to perform several light or medium peels over the course of a few months. The deep chemical peels are performed in a single session and are meant to be administered less often. Once the chemical peel treatments are completed, damaged skin is removed, acne is cleared, scarring is smoothed out, and the patient’s complexion is enhanced. 

Portrait provider Crystal Coatney, PA-C, who specializes in dermatology and aesthetics, often uses chemical peels for her patients struggling with acne. Crystal mentions, “I love doing light chemical peels, even on teenagers. It's very safe and works really well to help dry their skin out and fade those little reminder marks that pop up. Once the acne is gone, if they have remaining pigmentation issues, you can then transition into the topical and in-office protocol with them.” 

Hyperpigmentation

What is it?

Hyperpigmentation is a term that refers to patches of skin that become darker and more pigmented than surrounding areas of skin. There are several types of hyperpigmentation, including age spots and melasma, that can contribute to a visibly uneven skin tone. This condition can be caused by liver issues, sun exposure, aging, and poor lifestyle habits.

Recommended Treatments

Patients experiencing hyperpigmentation can benefit from implementing a skin lightening regime at home. Two great products for this are the Lytera® 2.0 Pigment Correcting Serum by SkinMedica® and medical-grade Hydroquinone®. Providers should also remind patients not to scrub the skin and to avoid high estrogen birth control, which can contribute to hyperpigmentation issues. These patients must also be using an effective sunscreen regularly. 

As far as in-office treatments go, the following provide great results against hyperpigmentation: 

Chemical Peels

A chemical peel is a facial treatment that uses acids at high concentrations to treat skin concerns like hyperpigmentation. They work to reduce the appearance of highly pigmented skin by removing the epidermis. Depending on the severity, there are more superficial and deeper versions that can even penetrate the dermis to produce more dramatic results.

Chemical peels can help patients with types of hyperpigmentation like age spots, sun spots, melasma, or generally uneven, blotchy skin. This treatment is widely trusted to produce the best results on those with fairer skin tones, although darker skin types may also use a chemical peel.

Intense Pulse Light (IPL) Therapy

Medical practitioners may offer IPL to treat hyperpigmented skin. IPL works with quick and powerful flashes of light that reach below the skin's surface to break down and remove unwanted pigment. As it’s a milder alternative to intensive laser treatments, IPL is ideal for younger patients with fairer skin who are starting to see pigmentation on their skin. It can also help with minor wrinkling, acne, and an uneven skin tone.

Once broken down, the pigment particles naturally either rise to the skin's surface as scabs that go away in about a week, or in some cases, get carried away by the body's lymphatic system. Typically, three to five sessions are recommended with sessions being one month apart. Afterward, maintenance visits are suggested twice a year.

Microneedling

Microneedling is a minimally invasive procedure that aims to improve the appearance and texture of the skin. The treatment involves the insertion of very fine and short sterilized needles into the skin, creating microscopic punctures. The small wounds result in the body producing more collagen and elastin, which heal the skin and create new, healthy cells that translate to a soft, firm, and even-toned complexion. 

For the most effective results, microneedling is recommended on a two-month cadence. The results can be enhanced by alternating between a chemical peel and a microneedling session. To learn more about microneedling, check out our blog. 

Rosacea

What Is It?

Rosacea is a common skin condition that causes anything from blushing to excessive redness, visible blood vessels, or even small, pus-filled bumps around the face. These symptoms can flare up for weeks to months and then disappear and go into remission for different amounts of time. Rosacea is sometimes confused for other skin concerns like acne or just redness.

Crystal Coatney shares information about this skin nonconformity: 

“The root cause of rosacea is typically the overproduction of oil combined with a higher number of Demodex mites. Every human being has Demodex, or a little mite, that lives in their hair follicles. We are colonized with this as soon as we are born. Patients with rosacea tend to have a higher number of Demodex — usually related to the kind of oil they have going on there.”

Recommended Treatments 

Patients with rosacea can explore great skincare products to supplement the in-office treatments mentioned below. Portrait provider Jolene Retaskie, RN, BSN, loves recommending the ZO® Skin Health products to those with rosacea. These patients should use products that are generally soothing on the skin, avoiding anything that could cause a harsh reaction. In fact, retinol is not recommended for people with rosacea; instead, they should try Finacea® Azealic Acid. Prescription medications, such as MetroGel, that help with the mites mentioned above may also be beneficial. 

As far as in-office treatments go, the following are provide great results against hyperpigmentation: 

Intense Pulse Light (IPL) Therapy

IPL is known as a gentle yet effective solution for improving rosacea. Intense pulsed light (IPL) therapy, also known as a photo facial, is a treatment that works to even a patient’s skin’s tone and texture. What’s more, IPL harnesses the power of the intense pulsed light to soothe skin redness and inflammation while diminishing skin spots caused by rosacea. 

When the skin is heated, the body gets rid of the unwanted cells to improve the skin and target the patient’s skin concerns. Unlike lasers, an IPL device sends out more than one wavelength of pulsating light. It can treat a range of skin conditions at the same time.

Most patients complete their rosacea IPL treatment after one to three sessions, depending on the severity.

Trichloroacetic (TCA) Peels

A TCA peel is a medium-strength chemical peel used to treat a wide range of skin concerns. Derived from acetic acid, TCA is available in concentrations ranging from 10% to 100%. The peel chemically exfoliates the skin and removes the top layer of skin from the face, neck, hands, or other parts of the body. TCA breaks up keratin, a protein found in the skin, which causes it to stop functioning properly, lighten in color, and peel away from the skin over the course of several days. Healthier, smoother skin is revealed beneath as a result of this treatment. 

These chemical peels can be used to lighten all types of hyperpigmentation, including freckles, age spots, dark patches, and melasma. 

Conclusion 

As a medical aesthetic provider, each of your patients has a unique set of needs. Some of the more common skin issues seen are acne and acne scarring, hyperpigmentation, and rosacea. We hope the information in this article will help expand your knowledge on how to deal with these different skin types' nonconformities. To learn more about how you can incorporate these types of treatments into your own studio, speak to a Portrait specialist today.