In the treatment room, skin care providers will often encounter hypopigmentation, post-inflammatory hyperpigmentation (PIH), and post-inflammatory erythema (PIE). These pigmentary concerns stem from various inflammatory processes affecting skin, posing both clinical and psychological challenges for the client. It is crucial for aestheticians and medical providers to understand why this might occur, the clinical symptoms that will present, and effective management approaches for these conditions to deliver top-notch care and attain positive results for their clients. 

Skin pigmentation refers to the natural coloration of an individual’s skin. In instances of illness or injury, changes can occur to skin resulting in lightening (hypopigmentation), darkening of pigment (hyperpigmentation), or areas of redness (post–inflammatory erythema). 

HYPOPIGMENTATION CAUSES & CHARACTERISTICS

Hypopigmentation, a condition characterized by reduced skin pigmentation, can manifest from birth, or develop later in life due to illness, injury, or specific medications. The condition features patches of skin lighter than the surrounding area. This results from inadequate production of melanin, the pigment responsible for skin darkening due to malfunctioning melanocytes.

Furthermore, vitiligo, an autoimmune disorder, arises when the immune system attacks melanocytes, leading to smooth, white patches on various body parts such as the face, chest, hands, or legs. It can stem from genetic predisposition, other autoimmune conditions, medications, or cancer. Stress, severe trauma, or exposure to chemicals and lasers can also trigger vitiligo to spread or become worse. Specialized treatment protocols are crucial for individuals with vitiligo, avoiding hydroquinone, phenol, or high doses of acids are essential to prevent exacerbation. Vitiligo on the face may, in some instances, be misdiagnosed as melasma so it is important to consult with clients regarding any knowledge of autoimmunity or patches on other parts of the body.

When working with clients with hypopigmentation, it is important to be cautious with homecare by avoiding too many exfoliants. In the treatment room, chemical and physical exfoliation should be limited, as the act of peeling or bringing too much heat into skin can be damaging and cause more white patches to appear.

For hypopigmentation unrelated to vitiligo, traumatic inflammation from factors like sunburn, blisters, burns, acne, eczema, psoriasis, surgery, topical steroids, or excessive hydroquinone usage can stimulate hypopigmentation. During summer months, the pigment difference may appear even more noticeable as skin around it gets darker.

Holly Sheppard has been involved in the medical field for over 13 years – five of those years as a licensed aesthetician and laser technician. She also holds certifications in oncology aesthetics and eyelash lift services. She enjoys continuously expanding her knowledge and skills with advanced training. Sheppard takes pride in creating unique customized treatments with the latest technology that are both corrective and relaxing. She sees beauty in every individual and believes that taking the time to invest in skin is a decision that lasts a lifetime. Sheppard performs various aesthetics treatments, including intense pulsed light (IPL) therapy, laser resurfacing, chemical peels, facials, microneedling, body toning, and more.