Essentials for Aesthetic Dermatology in Ethnic Skin Practice and Procedure 1st Edition by Mukta Sachdev, Niti Khunger, Ninon Patrao ISBN 9780429243769 0429243766

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ISBN 10: 0429243766
ISBN 13: 9780429243769
Author: Mukta Sachdev, Niti Khunger, Ninon Patrao

Essentials for Aesthetic Dermatology in Ethnic Skin Practice and Procedure 1st Edition Table of contents:

Part I: Fundamentals in Understanding Ethnic Skin/Skin of Color

1 Introduction

2 Anatomy: Skin, Hair, Nails

3 Factors Affecting Skin Integrity

3.1 Introduction

3.2 Microbiome

3.3 Endocrine

3.4 Climate

3.4.1 Sunlight and Humidity

3.4.2 Cold and Dry

3.5 Allergens and Irritants

3.5.1 Skin

3.5.2 Hair

3.5.3 Genetic

3.5.4 Cultural Practices

3.5.5 Aging

3.6 Conclusion

4 Geo-Ethnic Variations in Skin

4.1 Introduction

4.2 The Origin of Humans

4.3 Differences in Skin Coloration

4.4 Racial Differences in Stratum Corneum Structure

4.5 Racial Differences in Epidermal-Dermal Function

4.6 Racial Differences in Cutaneous Appendages: Eccrine, Apocrine, and Apoeccrine Sweat Glands

4.7 Sebaceous Glands

4.8 Cutaneous Irritation in Different Racial Groups

4.9 Clinically Relevant Structural and Functional Differences

4.10 Complications

Part II: Cases Encountered in Cosmetic Dermatology Practice

5 Sensitive Skin

5.1 Definition

5.2 Introduction

5.2.1 Key Considerations before Moving Forward with Cosmetic Procedures

5.3 Aesthetic Procedures and Considerations in Skin of Color

5.3.1 Chemical Peels

5.3.2 Lasers

5.3.3 Hair Removal

5.3.4 Injectables

5.3.5 Microdermabrasion (MDA)

5.3.6 Hair Transplantation

5.3.7 Other Considerations: Keloids and Hypertrophic Scars

5.4 Conclusion

6 Acne Vulgaris

6.1 Introduction

6.2 Classification

6.2.1 Mild Acne Vulgaris

6.2.2 Moderate to Severe Acne Vulgaris

6.3 Epidemiological and Etiological Aspects

6.3.1 Acne Grading System

6.4 Investigations

6.5 Management/Approach to Ethnic Skin

6.6 Clinical Pearls in Treating Skin of Color

6.7 Conclusion

7 Rosacea

7.1 Introduction

7.2 Epidemiology

7.3 Pathophysiology of Rosacea in Skin of Color

7.4 Clinical Features and Subtypes of Rosacea

7.5 Differential Diagnoses to Be Considered in Patients with Skin of Color

7.6 Treatment of Rosacea

7.7 General Measures/Non-Pharmacologic Treatments

7.7a Patient Education

7.7b Photoprotection/Sunscreens

7.7c Facial Cleansers

7.7d Facial Moisturizers

7.8 Conclusion

8 Pigmentary Disorders

8.1 Introduction

8.2 Hyperpigmentation

8.2a Acquired Diffuse Hyperpigmentation

8.2b Hyperpigmentation of Genetic/Nevoid Origin

8.2c Acquired Localized Hyperpigmentation

8.2d Drug-Induced Hyperpigmentation

8.2e Reticulate Pigmentary Disorders

8.2f Hyperpigmentation Affecting Flexures

8.2g Pigmented Lesions in Oral Mucosa

8.2h Pigmented Lesions of the Vulva

8.3 Hypopigmentation Disorders

8.3a Piebaldism

8.3b Waardenburg Syndrome

8.3c Albinism

8.3d Griscelli Syndrome

8.3e Ash Leaf Macules

8.3f Nevus Anemicus

8.3g Nevus Depigmentosus

8.3h Hypomelanosis of Ito

8.3i Idiopathic Guttate Hypomelanosis

8.3j Vitiligo

8.3k Other Hypopigmentation Disorders

8.4 Conclusion

9 Contact Dermatitis

9.1 Introduction

9.2 Allergic Contact Dermatitis

9.2.1 Epidemiology

9.3 Risk Factors

9.4 Ethnicity

9.5 Pathogenesis

9.6 Sensitization Phase

9.7 Elicitation Phase

9.8 Clinical Presentation

9.8.1 Localized ACD

9.8.2 Systemic/Generalized CD

9.8.3 Non-Eczematous ACD

9.8.4 Allergic Contact Urticaria (ACU)

9.8.5 Diagnosis

9.9 Patch Test

9.9.1 Types

9.10 Conclusion

10 Keloids and Hypertrophic Scars

10.1 Introduction

10.1.1 Etiology

10.1.2 Psychological Impact

10.1.3 Case

10.1.4 Standard Guidelines of Care for Keloids and Hypertrophic Scars

10.2 Conclusion

11 Hirsutism

11.1 Introduction

11.2 Epidemiology

11.3 Pathophysiology

11.3.1 Types of Hair

11.3.2 Normal Enzymatic Activity of the Skin

11.3.3 Androgens and Hair Growth

11.3.4 Insulin Resistance and Hirsutism

11.4 Etiology

11.5 Clinical Features

11.6 Classification of Severity

11.7 Approach to a Hirsute Patient

11.8 Management

11.9 Conclusion

12 Hair Loss and Hair Disorders

12.1 Introduction

12.2 Diffuse Non-Scarring Hair Loss

12.2a Androgenetic Alopecia

12.2b Telogen Effluvium

12.2c Loose Anagen Hair Syndrome

12.3 Patchy Non-Scarring Alopecia

12.3a Alopecia Areata

12.3b Traction Alopecia

12.3c Pressure Alopecia

12.3d Trichotillomania

12.3e Tinea Capitis

12.4 Cicatricial Alopecia

12.4a Central Centrifugal Cicatricial Alopecia

12.4b Lichen Planopilaris

12.4c Frontal Fibrosing Alopecia

12.4d Chronic Cutaneous Lupus Erythematosus

12.4e Folliculitis Decalvans

12.5 Hair Shaft Disorder

12.5a Chemotherapy-Induced Hair Loss

12.6 Conclusion

13 Periorbital Conditions in Ethnic Skin

13.1 Introduction

13.2 Functional Periorbital Anatomy

13.3 Periocular Wrinkles

13.3.1 Crow’s Feet

13.3.2 Horizontal Forehead Lines

13.3.3 Glabellar Frown Lines

13.3.4 Brow Contouring

13.4 Periocular Hills and Valleys

13.4.1 The Valleys

13.4.2 The Hills

13.5 The Dark Circles (Periocular Hyperpigmentation)

13.6 Dermatochalasis and Blepharochalasis

13.6.1 Preoperative Evaluation

13.6.2 Blepharoplasty Surgery

13.7 Transcutaneous Lower-Lid Blepharoplasty

13.8 Conclusion

14 Psychological Concerns in Ethnic Skin

14.1 Disorders of Pigmentation

14.1.1 Vitiligo

14.1.2 Melasma

14.1.3 Acne and Post-Inflammatory Hyperpigmentation

14.2 Hair/Scalp

14.2.1 Alopecia

14.2.2 Pseudofolliculitis Barbae (Razorbump)

14.2.3 Perifolliculitis Capitis Abscedens et Suffodiens (Dissecting Cellulitis)

14.3 Others

14.3.1 Keloids

14.3.2 Sarcoidosis

14.3.3 Eczema

14.3.4 Psoriasis

14.4 Conclusion

Part III: Cosmeceuticals

15 Physical Photoprotection, Cosmetic Camouflage, and Sunscreens

15.1 Introduction

15.2 Sunlight

15.2.1 Physical Means of Photoprotection

15.2.2 The UPF of a Fabric Depends Upon

15.3 Sunscreens

15.3.1 Primary Photoprotection

15.3.2 Secondary Photoprotection

15.4 Characteristics of a Perfect Sunscreen

15.5 Sunscreen Labels

15.6 Application and Reapplication

15.7 Quantity

15.8 Shelf Life

15.9 Advice for Children

15.10 Safety

15.11 Adverse Reactions

15.12 Contraindications

15.13 Precautions

15.14 Sunscreen for Lips and Eyes

15.15 Sunscreen and Pollution

15.16 Controversies

15.17 Sunscreen and Its Effect on Vitamin D (“Sunshine Vitamin”)

15.18 Effect on Ecosystems

15.19 Oral Photoprotection

15.20 Sunscreen and Insect Repellents

15.21 Camouflage and Cosmetics

15.22 Skin of Color and Use of Sunscreen

15.23 Conclusion

16 Cleansers and Moisturizers

16.1 Introduction

16.2 Cleansers

16.3 Additional Considerations

16.3.1 Acid-Base Balance

16.3.2 Bar versus Liquid

16.3.3 Preservatives

16.3.4 Enhancers

16.3.5 Choosing a Product

16.4 Moisturizers

16.4.1 Occlusives

16.4.2 Humectants

16.4.3 Emollients

16.4.4 Preservatives

16.4.5 Enhancers

16.4.6 Choosing a Product

16.4.7 Clinical Pearls in Treating Skin of Color

16.5 Conclusion

17 Topical Anti-Acne Agents

17.1 Introduction

17.2 Treatment of Acne

17.2.1 Do Topicals Work in the Treatment of Acne?

17.3 Classification of Anti-Acne Agents

17.3.1 Antimicrobial Agents

17.3.2 How to Choose an Anti-Acne Agent

17.3.3 Side Effects of Antibacterials and Their Management

17.4 Hydroxyl Acid

17.5 Topical Retinoids

17.6 Combination Therapies

17.7 Anti-Acne Agents in Special Categories

17.7.1 Children

17.7.2 Pregnancy

17.8 Novel Approaches in the Treatment of Acne

17.8.1 Liposomal Formulation of Retinoids

17.8.2 Microsponges

17.8.3 Microspheres

17.8.4 Mechanical Treatments

17.9 Procedural Therapies in Acne

17.10 Newer/Emerging Topical Anti-Acne Agents

17.11 Conclusion

18 Lightening Formulations

18.1 Introduction

18.2 Indications

18.3 Classification

18.3.1 Lightening Formulations That Regulate Melanocyte Activation

18.3.2 Lightening Formulations That Reduce Melanogenesis

18.3.3 Lightening Formulations That Inhibit Melanosome Transfer to Keratinocytes

18.3.4 Lightening Formulations That Remove Epidermal Pigment

18.4 Clinical Pearls in Treating Ethnic Skin/Skin of Color

19 Anti-Aging Agents for Ethnic Skin

19.1 Introduction

19.2 Classification

19.2.1 Sunscreens

19.2.2 Retinoids

19.2.3 Alpha- and Beta-Hydroxy Acids

19.2.4 Antioxidants

19.2.5 Polyphenol/Flavonoid Antioxidants

19.2.6 Hormonal Agents

19.2.7 Growth Factors

19.2.8 Peptides

19.2.9 Anti-Aging Minerals

19.2.10 Nutraceuticals Targeting Advanced Glycation End Products

19.3 Clinical Pearls in Treating Ethnic Skin

19.4 Indications for Agents

19.5 How to Use and Dosage

19.6 Side Effects

19.7 Choosing a Product

19.8 Conclusion

20 Cosmeceuticals in Hair Care

20.1 Background

20.2 How Do They Differ from Cosmetics and Drugs?

20.3 Other Cosmeceuticals Available for Hair Care

20.3.1 Decoding the Cosmeceuticals Available in the Market

20.4 Where Do Cosmeceuticals Score in Hair Care

20.4.1 Clinical Situations Frequently Encountered in Day-to-Day Practice

20.5 How to Increase the Efficiency of Peptide Penetration

20.6 Tests for Efficacy

20.6.1 Physical Examination of the Scalp

20.7 Conclusion

21 Lip, Nail, and Eye Care

21.1 Introduction

21.2 Lip Care

21.2.1 Specific Anatomical Considerations

21.2.2 Why Do Our Lips Need Separate Care?

21.2.3 Examination of the Lips

21.2.4 Lip-Licking Dermatitis

21.2.5 Lip Balms

21.2.6 Recent Advances and Lip Fillers

21.3 Nail Care

21.4 Nail Cosmetics

21.5 Eye Care

21.5.1 Eye Health

21.5.2 Special Eye Care Measures

21.6 Conclusion

22 Vitamins, Antioxidants, and Proteins

22.1 The Role of Nutrients in Skin Health

22.2 Vitamins

22.2.1 Vitamin A

22.2.2 Vitamin C

22.2.3 Vitamin E

22.2.4 Vitamin D

22.2.5 The B Vitamins

22.2.6 Vitamin K

22.3 Antioxidants

22.4 Proteins and Amino Acids

22.5 Oral Nutraceuticals

22.6 Conclusion

23 Cosmeceutical-Related Dermatitis and Allergies

23.1 Introduction

23.2 Classification

23.3 Epidemiology

23.4 Common Cosmeceutical Allergens

23.4.1 Fragrance

23.4.2 Preservatives

23.4.3 Vitamins

23.4.4 Hydroxy Acids

23.4.5 Botanicals

23.5 Investigation

23.5.1 History and Physical Exam

23.5.2 Patch Testing

23.6 Management

23.6.1 Post-Inflammatory Hyperpigmentation

Part IV: Procedural Considerations for a Patient with Ethnic Skin

24 Evaluation and Assessment for Ethnic Skin

24.1 Introduction

24.2 What Are Consumers Looking For?

24.3 Differences in Intrinsic Aging across Ethnicities

24.3.1 Evaluation of Asian Skin

24.3.2 Evaluation of Southeast Asian Skin

24.3.3 Evaluation of Middle Eastern Skin

24.3.4 Evaluation of African Skin

24.3.5 Evaluation of Hispanic Skin

24.4 Conclusion

25 Aging in Middle Eastern Skin

25.1 Introduction

25.2 Stress and Aging Skin

25.3 Cutaneous Anatomical Features and Aging Skin

25.4 Pigmentary Disorders

25.5 Consultation for the Aging Face

25.6 Case 1

25.7 Cases 2 and 3

25.8 Case 4

25.9 Case 5

25.10 Case 6

25.11 Cases 7, 8, and 9

26 Minimizing Complications in Skin of Color

26.1 General Pre-Treatment Care for Chemical Peels, Microneedling, Microneedling Radiofrequency (MNRF), Platelet-Rich Plasma, and Laser and Light Devices

26.1.1 Pre-Treatment Priming

26.2 Special Considerations While Doing Chemical Peels: Step-by-Step, Shehnaz in Aesthetic Derm

26.3 Special Considerations While Doing Laser Treatments

26.4 Points to Remember before Any Laser Treatment

26.5 Points to Remember Pertaining to Specific Lasers

26.6 Hair Removal Lasers

26.7 Special Considerations While Doing Injectables

27 SOP for an Aesthetic Dermatology Clinic

27.1 Introduction

27.2 What Does Aesthetic Dermatology Comprise?

27.3 The State of Aesthetic Healthcare Practice

27.4 Infrastructure

27.5 Physician Qualifications and Staff Requirements

27.6 Equipment

27.7 Pre-Procedure Checklist

27.8 Procedures That Can Be Performed

27.9 Post-Procedure Care

27.10 Pharmacy and Dispensing

27.11 Telemedicine and Virtual Consultation

27.12 Publicity and Promotion

27.13 The Ethical Issues of Cosmetic Procedures

27.14 Conclusion

Part V: Procedures

28 Chemical Peels

28.1 Introduction

28.2 Indications

28.2.1 Contraindications

28.3 Patient Workup and Counseling

28.3.1 History

28.3.2 Examination

28.3.3 Photographic Documents

28.3.4 Patient Selection

28.3.5 Test Spot Testing

28.4 Pre-Procedure Care

28.5 Procedure

28.5.1 Peeling Technique

28.5.2 Reagents

28.5.2a Tretinoin Peel

28.5.2b Salicylic Acid (SA)

28.5.2c Trichloroacetic Acid

28.5.2d Glycolic Peel

28.5.2e Jessner’s and Modified Jessner’s Solution

28.5.2f Phenol Peel

28.5.3 Procedure

28.6 Post-Procedure Care

28.7 Side Effects and Their Management

28.8 Clinical Pearls in Treating Ethnic Skin/Skin of Color

28.9 Conclusion

29 Microdermabrasion

29.1 Introduction

29.2 Type of Devices

29.2.1 Crystal-Containing MDA

29.2.2 Non-Crystal-Containing MDA

29.2.3 Oxygen MDA (Oxybrasion)

29.3 Mechanism of Action

29.4 Histological Evaluation

29.5 Transdermal Drug Delivery

29.6 The Effect of Skin Barrier Function

29.6.1 Sebum

29.6.2 Skin Hydration

29.6.3 Transepidermal Water Loss (TEWL)

29.6.4 Skin pH

29.6.5 The Effect of Skin Pigmentation

29.6.6 Indications

29.7 Patient Workup/Counseling

29.8 Pre-Procedure Care

29.9 Procedure

29.9.1 Patient Preparation

29.9.2 Device and Equipment Preparation

29.9.3 Operator Preparation

29.9.4 Steps of Treatment

29.10 Post-Procedure Care

29.11 Side Effects and Their Management

29.12 Clinical Pearls in Treating Ethnic Skin

29.13 Special Precautions—Do’s and Don’ts

30 Microneedling

30.1 Introduction

30.2 Mechanisms of Action

30.3 Devices

30.4 Roller MN

30.5 Stamp MN

30.6 Pen MN

30.7 Other Variations in MN Devices

30.8 Patient Considerations and Clinical Assessment

30.9 Operative Techniques

30.10 Post-Procedure Care

30.11 Number and Frequency of Treatments

30.12 Side Effects and Their Management

30.13 Special Precautions

30.14 Conclusion

31 Lasers and Lights

31.1 Introduction

31.2 Biological Characteristics and Classification of Skin of Color

31.3 Lasers in Skin of Color: General Considerations and Precautions

31.4 Laser Hair Removal

31.5 Skin Rejuvenation and Resurfacing

31.6 Endogenous Epidermal and Dermal Pigmented Lesions

31.6.1 Melasma

31.6.2 Ephelides, Lentigines, and Dermal Melanocytosis

31.7 Conclusion

32 Non-Light Energy-Based Devices

32.1 Introduction

32.2 Classification

32.3 Indications

32.4 Radiofrequency

32.5 Nonablative Radiofrequency Skin Tightening

32.6 Classification of Radiofrequency

32.7 Fractional Sublative Radiofrequency

32.8 Nano-Fractional Radiofrequency

32.9 Fractional Microneedling Radiofrequency

32.10 High-Intensity Focused Ultrasound

32.11 Cryolipolysis

32.12 Conclusion

33 Injectables: Toxins—Intrinsic Aspects and Special Precautions

33.1 Introduction

33.2 Botulinum Toxin for Glabella and Forehead

33.3 Treating Lateral Canthal Lines with Botulinum Toxin

33.4 Nasal Tip Elevation with Botulinum Toxin

33.5 Botulinum Toxin Treatment for Perioral Lines

33.6 Botulinum Toxin A Treatment of Masseter

33.7 Botulinum Toxin A for Parotid Gland

33.8 Botulinum Toxin for Chin (Mentalis)

33.9 Botulinum Toxin Treatment for the Neck and Jawline

33.10 Side Effects of Botulinum Toxin Treatment

33.11 Conclusion

33.12 The Future of Botulinum Toxin

33.13 Botulinum Toxin in Times of the Pandemic

34 Injectables: Fillers—Intrinsic Aspects and Special Precautions

34.1 Introduction

34.2 Structural and Functional Differences of Ethnic Skin

34.3 Skin Aging Assessment in Ethnic Skin

34.4 Indications

34.5 Patient Workup/Counseling

34.6 Pre-Procedure Care

34.7 Procedure

34.8 Post-Procedure Care for Ethnic Skin

34.9 Side Effects and Their Management

34.10 Clinical Pearls in Treating Ethnic Skin or Skin of Color

34.11 Special Precautions Do’s and Don’ts

34.12 Precautions during COVID-19 Times for Dermal Fillers, Especially in India

34.13 CK2 Point in Indian Men beyond 40 Years and Bony Resorption

34.14 Conclusion

35A Emerging Techniques: Platelet-Rich Plasma Therapy

35A.1 Introduction

35A.2 Indications

35A.3 Patient Workup/Counseling

35A.4 Pre-Procedure Care

35A.5 Procedure

35A.6 Post-Procedure Care

35A.7 Contraindications

35A.8 Side Effects and Their Management

35A.9 Clinical Pearls in Treating Ethnic Skin/Skin of Color

35A.10 Special Precautions

35B Non-FDA Skin-Lightening Procedures

35C Non-Surgical Thread Lifts

35C.1 Introduction

35C.2 Indications

35C.3 Types of Threads

35C.4 Mechanism of Action

35C.5 Patient Workup/Counseling

35C.6 Pre-Procedure Care

35C.7 Procedure

35C.8 Post-Procedure Care

35C.9 Contraindications

35C.10 Side Effects and Their Management

35C.11 Clinical Pearls in Treating Ethnic Skin/Skin of Color

35C.11.1 Combination Treatments

36 Home-Use Devices: An Overview and Regulatory Aspects

36.1 Introduction

36.2 Hair Reduction

36.2.1 Mode of Action

36.2.2 Clinical Efficacy and Safety

36.2.3 Side Effects and Adverse Incidents

36.3 Skin Rejuvenation

36.3.1 Mode of Action—Thermally Based Technology

36.3.2 Mode of Action—Non-Thermal Technology

36.3.3 Clinical Efficacy and Safety

36.3.4 Side Effects and Adverse Incidents

36.4 Hair Growth Stimulation

36.4.1 Mode of Action

36.4.2 Clinical Efficacy and Safety

36.4.3 Side Effects and Adverse Incidents

36.5 Medical Use of Huds

36.5.1 Mode of Action

36.5.2 Clinical Efficacy and Safety

36.5.3 Side Effects and Adverse Incidents

36.6 Standards

36.6.1 Embedded Lasers—Class 1C

36.7 Regulatory Aspects

36.7.1 General

36.7.2 Regulations outside the European Union and the United States

36.8 Where Does This Leave the Professional Practitioner and the Client?

36.9 Conclusion

Part VI

37 Digital Marketing and Social Media Branding

37.1 Dermatology Trends on Social Media

37.2 More Dermatologists Turn to Social Media to Communicate with Patients

37.3 Increasing Your Brand Awareness

37.4 Five Core Benefits of Social Media Marketing for Dermatologists

37.5 Best Practices for Creating Compelling Content

37.6 Monitoring Your Online Reputation

37.7 Conclusion

Part VII: The Future

38 Newer Cosmeceuticals

38.1 Introduction

38.2 Peptide-Containing Cosmeceuticals

38.2.1 Carrier Peptides

38.2.2 Signal Peptides

38.2.3 Neurotransmitter Peptides

38.3 Platelet-Rich Plasma Cosmeceuticals

38.4 Prebiotic, Probiotic, and Postbiotic Cosmeceuticals

38.5 Conclusion

39 New Devices for Treating Darker Skin Types

39.1 Introduction

39.2 Ethnic Population

39.3 Laser Tissue Interactions

39.4 Anti-Aging Treatments

39.5 Lasers

39.6 Radiofrequency

39.7 Microfocused Ultrasound

39.8 Toxins and Fillers

39.9 Skin Tone and Pigmentation Disorders

39.10 Acne and Other Scarring

39.11 Facial Photodamage and Rejuvenation

39.12 Benign Cutaneous Tumors

39.13 Hair Disorders

39.13.1 Acne Keloidalis Nuchae

39.13.2 Hypertrichosis

39.14 Conclusion

Part VIII

40 Post-COVID-19: Where Are We Headed?

Index

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Tags: Mukta Sachdev, Niti Khunger, Ninon Patrao, Aesthetic Dermatology, Ethnic Skin