Skincare Case 102

Age: 35 years old
Gender: Female
Fitzpatrick: 3
Skin type: Combination
Main Concern: Some pimples on the chin, with some raised inflammation and redness in the same area

History: The client has regular menstrual cycles and gets pimples around the time of her period, as well as when she’s experiencing emotional stress or anxiety. She’s within a normal weight range for her age and has some fine lines on her forehead, as well as crow’s feet on the corners of both eyes. Due to the nature of her job, she must wear heavy makeup daily.

Home care routine: She uses micellar water to remove her makeup, washes her face and body with pink Dove soap, uses a rejuvenation cream every night, and uses vitamin C serum. She doesn’t use sunscreen because her job is indoors.

Findings: She has some papules on her chin that she’s picked at, which is why they’re inflamed and irritated. Under Wood’s lamp, you can see numerous dark spots on her chin and a few on her cheeks.

Skincare Exams 102
Case Discussion (Please click here)

This patient is a 35-year-old female with Fitzpatrick skin type 3 and combination skin. Her main concern is pimples on the chin area, which become inflamed and red, particularly around the time of her menstrual cycle or during periods of emotional stress. She also has some fine lines on her forehead and crow’s feet. Her job requires her to wear heavy makeup daily. Her skincare routine includes makeup removal with micellar water, cleansing with pink Dove soap, nightly application of rejuvenation cream, and usage of vitamin C serum. She does not use sunscreen due to her indoor job.

The pimples on her chin are likely related to hormonal changes during her menstrual cycle and possibly exacerbated by stress. The presence of fine lines and crow’s feet suggests the onset of age-related skin changes. The dark spots observed under Wood’s lamp could suggest post-inflammatory hyperpigmentation (PIH) or sun damage.

Causes

The causes of her skin conditions can be attributed to several factors:

  1. Hormonal fluctuations: Hormonal changes during her menstrual cycle can stimulate sebaceous glands, leading to excess oil production and acne.
  2. Emotional stress: Stress can also trigger acne breakouts.
  3. Aging: The fine lines and crow’s feet are natural aging signs due to decreased collagen and elastin production.
  4. Heavy makeup: Daily use of heavy makeup can clog pores and contribute to acne.
  5. Sun exposure: The dark spots may be due to sun exposure or PIH from past acne.

What was Done Wrong

  1. Lack of sunscreen: Regardless of working indoors, UVA rays can penetrate window glass and contribute to aging and pigmentation.
  2. Inadequate cleansing: While micellar water can help remove makeup, a second cleanse with a dedicated facial cleanser may be needed, especially with heavy makeup use.
  3. Picking at acne: This can lead to inflammation, scarring, and PIH.
  4. Use of bar soap: Bar soaps, even gentle ones like Dove, can disrupt the skin’s pH balance and strip natural oils, potentially exacerbating acne and aging.

Office and Home Treatment Options

Office treatment options may include:

  1. Topical treatments: Prescription creams, gels, or lotions with retinoids, or a combination of topical antibiotics and benzoyl peroxide.
  2. Hormonal therapy: If her acne is primarily hormonal, birth control pills or spironolactone might be considered.
  3. Procedures: Chemical peels, microdermabrasion, or laser treatments for aging signs and hyperpigmentation.
  4. Mental health support: Stress management techniques or mental health counseling may be beneficial if stress is a significant acne trigger.

Home care options may include:

  1. Over-the-counter treatments: Non-prescription creams and ointments containing benzoyl peroxide, salicylic acid, or retinol.
  2. Gentle cleansing: Washing the face twice daily with a gentle, non-abrasive facial cleanser.
  3. Consistent moisturizing: Using a non-comedogenic moisturizer to prevent skin dryness.
  4. Regular sun protection: Applying sunscreen daily.

Prevention

  1. Regular skincare routine: Washing the face twice daily, moisturizing, and applying sunscreen.
  2. Avoid harsh skincare products: Some products can irritate the skin and exacerbate acne.
  3. Regular exercise and a healthy diet: These can help manage stress and support overall skin health.
  4. Regular medical follow-ups: Regular check-ups with a healthcare provider can help monitor the condition and adjust treatment as necessary.
  5. Avoid picking at the skin: This can prevent scarring and further inflammation.
  6. Use non-comedogenic makeup: This type of makeup is designed not to clog pores

Home Care Daily Routine

A suggested daily routine for this patient could look like this:

Morning:

  1. Cleanse the face using a gentle, non-comedogenic facial cleanser.
  2. Apply a vitamin C serum to promote collagen production and to help with hyperpigmentation.
  3. Use a non-comedogenic moisturizer to keep the skin hydrated.
  4. Apply a broad-spectrum sunscreen (at least SPF 30) to protect the skin from harmful UV rays, even if indoors.

Evening:

  1. Use micellar water to remove makeup.
  2. Perform a second cleanse with a gentle, non-comedogenic facial cleanser to ensure all makeup and daily grime are removed.
  3. Apply a rejuvenation cream as a night moisturizer to help with the fine lines and crow’s feet.
  4. If prescribed, apply topical acne treatment. Start with a lower frequency and increase as tolerated.

General Tips:

  1. Don’t pick or pop pimples to reduce the risk of scarring, inflammation, and hyperpigmentation.
  2. Regularly clean items that touch your face, like your phone and makeup brushes.
  3. Try to maintain a balanced diet, focusing on fruits, vegetables, lean proteins, and whole grains.
  4. Regular exercise and stress management techniques can help manage hormonal fluctuations and reduce acne breakouts.
  5. Get adequate sleep to help the body and skin rejuvenate.
  6. Consider switching to non-comedogenic makeup products that won’t clog pores.

As always, it’s important to remember that everyone’s skin is different, and what works for one person may not work for another. The patient should consider consulting with a dermatologist or healthcare provider to discuss these symptoms and potential treatments further.