Skincare Case 114

Age: 24 years old
Gender: Female
Fitzpatrick: 2
Skin type: Oily
Main concern: Dark pinpoint spots on the nose
History: Pinpoint spots on the nose on her pale skin color are not sightly. With the impression of blackhead comedone, an esthetician extracted some of the dark spots that were very uncomfortable.
She used Biore Nose Strips a few times that looked good, but the dark spots returned in a couple of weeks.

Skincare Exams 114-1
Homecare routine:
Findings: The nose and area around the nose show many orange spots when illuminated under a Wood’s lamp. Even after cleansing with a gel cleanser, some of the orangish spots are still there, indicating that the cleanser wasn’t able to remove all of the oil from the skin.

Skincare Exams Case 114
Case Discussion (Please click here)

This case involves a 24-year-old female with Fitzpatrick skin type II and oily skin, who presents with the main concern of dark pinpoint spots on her nose. The spots, initially mistaken for blackhead comedones, were unsuccessfully extracted by an esthetician. The use of Biore Nose Strips provided temporary relief but the spots returned in a couple of weeks. Under a Wood’s lamp, many orange spots appear on and around her nose, persisting even after cleansing with a gel cleanser.

Causes

The dark pinpoint spots on the patient’s nose are likely sebaceous filaments, which are natural parts of the skin’s follicles that help to channel the flow of sebum along the lining of the pore. In people with oily skin, sebaceous filaments can become more visible and may be mistaken for blackheads.

What is Done Wrong

  1. Misidentification of the issue: The patient’s sebaceous filaments were mistaken for blackheads, leading to inappropriate treatment.
  2. Over-extraction: The extraction by an esthetician was not only uncomfortable but could also potentially damage the skin and exacerbate oil production.
  3. Use of pore strips: Biore Nose Strips can provide temporary improvement in the appearance of the nose by removing sebaceous filaments, but they do not address the underlying issue of excess oil production. In addition, frequent use can damage the skin and lead to larger, more visible pores.

Office and Home Treatment Options

Office treatments:

  1. Regular facials: Professional deep cleansing can help manage excess oil and improve the appearance of sebaceous filaments.

Home treatments:

  1. Regular cleansing: A gentle, oil-controlling cleanser can help manage oil production.
  2. Use of a salicylic acid product: Salicylic acid is a beta hydroxy acid (BHA) that can penetrate the oil in the pores and help to dissolve the sebum that contributes to sebaceous filaments.
  3. Oil-free moisturizers: These can help to hydrate the skin without contributing to oiliness.
  4. Retinoids: These can help to reduce the size of the pores and the amount of oil they produce.

Preventions

  1. Regular and appropriate skincare: Keeping the skin clean, using oil-control products, and maintaining adequate hydration can help manage oil production and prevent the over-visibility of sebaceous filaments.
  2. Avoid pore strips and over-extraction: These can damage the skin and exacerbate the problem.

Home Care Daily Routine

Morning:

  1. Cleanse with a gentle, oil-controlling cleanser.
  2. Apply a salicylic acid product to the nose and any other oil-prone areas.
  3. Apply an oil-free moisturizer to the entire face.
  4. Apply a broad-spectrum sunscreen with an SPF of at least 30.

Evening:

  1. Remove makeup with a gentle makeup remover.
  2. Cleanse with a gentle, oil-controlling cleanser.
  3. Apply a retinoid product (start with a lower concentration and increase gradually as tolerated).
  4. Apply an oil-free moisturizer to the entire face.

The patient should understand that while the appearance of sebaceous filaments can be minimized with proper skincare, they cannot be completely eliminated as they are a natural part of the skin’s structure. Regular follow-ups with a dermatologist or skincare specialist can help monitor progress and make any necessary adjustments to the treatment plan.