Skin Care for the O to D Parameter in Visual Studio .NET

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Skin Care for the O to D Parameter
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Oily skin types are difficult to treat because there are no effective topical agents that significantly reduce sebum
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BOX 9-1
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Types of Sensitive Skin
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S1 Acne S2 Rosacea S3 Burning and stinging S4 Susceptibility to contact and irritant dermatitis
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Skin Care for the S to R Parameter
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Individuals with resistant R skin can use most skin care products without fear of incurring adverse reactions (eg, acne, rashes, or a stinging response) On the other hand, the same qualities that protect resistant skin from most formulations also render many products ineffective because these patients exhibit an exceedingly high threshold for product ingredient penetration In other words, resistant types have a strong skin barrier Therefore, people with resistant skin may not benefit from weaker products, which are unable to penetrate the SC of such individuals to deliver the intended results Resistant patients are the ones who should be treated with higher levels of glycolic acid and will require longer incubation periods with Levulan prior to photodynamic therapy They are less likely to develop allergic reactions to skin care products that sensitive types cannot tolerate Individuals with sensitive skin share one quality in common: inflammation Treatment is geared toward preventing
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CHAPTER 9 THE BAUMANN SKIN TYPING SYSTEM
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FIGURE 9-2 This OS1,2 PT patient has a history of facial ushing, redness, and acne (S1 and S2 refers to the fact that she has acne and rosacea-sensitive skin types 1 and 2) She tries to avoid sun but lives in Miami and sunscreens usually make her sting or breakout Her skin regimen should consist of a salicylic acid or selenium sul de cleanser, a serum with anti-in ammatory ingredients, a topical antibiotic, and a sunscreen with micronized zinc oxide and titanium dioxide Intense Pulsed Light treatments will improve her solar lentigos and facial redness Antioxidant supplements such as vitamin C 500 mg twice a day and Pycnogenol 50 mg every day may help decrease the in ammation she experiences Mild salicylic acid chemical peels are an option as well determine what skin treatments are necessary and which to avoid Resistant skin is characterized by a robust stratum corneum (SC) that strongly protects the skin from allergens, other environmental irritants, and water loss Individuals with resistant skin rarely experience erythema or acne (Fig 9-5) In general, they can be treated with stronger skin care products and in-office procedures, such as chemical peels, than can those with sensitive skin (Box 9-1)
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Parameter
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Oily or Dry
Sensitive or Resistant
Pigmented or Nonpigmented
Wrinkled or Tight
Spectrum
Very dry Slightly dry Combination Slightly oily Very Oily
Very sensitive Somewhat sensitive Somewhat resistant Very resistant
Pigmented Nonpigmented
Wrinkled Tight
Scores between 7 and 28, determine severity with low scores being very dry and high scores being very oily
Designation
Oily (O)
Baumann Skin Type Indicator (BSTI) evaluation algorithm for an oily (O) skin type FIGURE 9-3 Algorithm for assessing oily skin according to the BSTI
with a history or current presentation of pigmentary alterations that can be prevented or improved with skin care products as well as dermatologic procedures, and includes conditions such as ephelides, melasma, postinflammatory hyperpigmentation, and solar lentigos (Fig 9-7) Skin lesions that require excision or treatment beyond skin care (eg, congenital nevi and seborrheic keratoses) fall beyond the scope of the BSTS An individual with a propensity to develop unwanted pigmentary changes is classified as having the P skin type in the BSTS system; a person not exhibiting this tendency has type N skin (Fig 9-8) Knowing the P score of a patient will help alert the physician to the change of hyperpigmentation, and chemical peel strengths and laser settings can be adjusted accordingly to prevent postinflammatory hyperpigmentation in those with high P scores Patients with the N skin type often have light skin and an inability to tan; however, individuals with red hair, who have a tendency to freckle, are designated as P skin types FIGURE 9-4 Oily skin types often show a light re ection or facial shine in photographs People with these skin types should use serums and gels rather than creams If skin is combination (oily in the T zone), then lotions are a good choice Retinoids in the gel form are a good option for oily skin types
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