Post Inflammatory Erythema

by Kara McLucas Mark

If you have ever had the misfortune to experience acne and have inflamed pustules you know the literal mark it leaves. We call it “post-inflammatory erythema”; flat discolorations that are dark pink or even purple in color. These can bring more self-esteem issues than acne itself. Diagnosing and treating post-inflammatory erythema can help acne sufferers move past the breakout and help create a clear complexion. But how does post-inflammatory erythema happen?

One of the main symptoms of acne is inflammation – the devil of the skin. (Nothing good ever comes from lasting inflammation). When an acne flare-up occurs the skin becomes hyper-focused on isolating and killing off P. Bacteria. One of the ways it does this is by creating a higher concentration of circulation within the afflicted area. This causes redness around the papules and/or pustules during and after the flare. This redness can worsen if the area is treated improperly or subject to additional trauma by picking at the pustules. Once the infection is irradicated it can take some time for the redness to subside – but there are treatments to help speed that process along.

One of the first things to mention is the prevention of acne that can become inflamed. Instructing clients on how to minimize bacteria on the skin while keeping the skin barrier intact is key in prevention. Using a combination of salicylic acid and benzoyl peroxide can help loosen dirt in clogged pores as well as keep bacteria at bay. Staying away from harsh products that will leave the skin vulnerable to inflammation and keeping the skin moisturized will do wonders to prevent PIE from even occurring. However, if your advice is not heeded or they are coming after the fact there are treatment options.

One of the easiest at-home treatments is the topical application of brightening agents. Vitamin C is the first to appear at the top of the list – is there anything this powerhouse can’t do? Vitamin C assists in reducing inflammation, healing, and preventing tyrosinase from creating more pigment. Another powerhouse is Niacinamide- which is a form of B3. Commonly used in eczema treatments this B vitamin variant can help lighten PIE (post-inflammatory erythema) by soothing the skin and helping it to retain moisture and maintain the skin barrier function, preventing any more flare-ups.

Another is tretinoin – a vitamin A derivative that is known for cell turnover and collagen synthesis. Tretinoin can help as a preventative method or “after the fact” treatment. Increasing cell turnover can help reduce the chances of inflammation occurring but also help the skin to shed its discoloration by exfoliating. With daily use of any of these topicals, it can take two to three weeks to start seeing results. If the PIE is unresponsive or the client wants faster results, there are advanced options.

Medical grade lasers are a treatment option for PIE as well as the treatment of acne. IPL( intense pulsed light) or pulsed dye laser can be used to treat the underlying vascularity of the postinflammatory erythema. These lasers work by isolating the damaged blood vessels and irradicating them. This gets rid of the discoloration as well as prevents it from coming back. It can take one to three treatments to see results. Another great treatment option is microneedling. Microneedling helps PIE by breaking up scar tissue that may have formed and encouraging a wound healing response. Microneedling can also be used in conjunction with topical treatments to help speed along the process.

As previously stated, post-inflammatory erythema can be just as damaging as acne itself however there is hope in treatment options. Keeping ourselves informed as skincare professionals, and teaching our clients how to care for their skin is the greatest weapon in our arsenal. By preventing inflammation, we do not have to treat the aftereffects and can help our clients achieve and maintain clear skin.

Kara McLucas-Mark is a licensed esthetician with a medical focus. She has worked with multiple modalities including non-ablative lasers, microcurrent, ultrasound skin tightening, and radiofrequency machines. She lives with her husband and two dogs outside of Annapolis, MD. She loves learning about new skin developments, her LED light, and jade roller!

by Rachael Pontillo, M.Msc, CIHC, CNAP, LE

Have you ever had a client that for some reason, just doesn’t respond to the products and treatments you offer, even though they were supposed to be right for their skin type?

Though this scenario might not happen all the time, it certainly does happen; and it is both confusing and upsetting for both the client and the aesthetician when it does happen. The simple reason why this happens is that for whatever reason, the skincare products chosen for that client were not the right ingredients for that particular client’s unique skin.

If the product does not contain the right ingredients for the person using it, its efficacy will be extremely limited at best, and problematic at worst.

This is where the Skin Sequencing® Method comes in.

The Skin Sequencing® Method is a proprietary method developed and tested by Rachael Pontillo, in a 2-year, informal study called the Skin Sequencing® Project, in conjunction with Toolbox Genomics. The Skin Sequencing® Method utilizes both science and traditional herbal wisdom to systematically narrow down ingredient choices using ancestry and nutrigenomics. This will help skin care professionals make the most targeted ingredient selections possible for individual clients.

This study was conducted on a small group of students and graduates of the Create Your Skincare Pro professional skincare formulation course; 60% of whom are licensed aestheticians. Participants ranged in age, ethnicity, skin type/condition, health history, and other demographic factors. Their only common thread is that they were all skincare formulators, who learned skincare formulation from the Create Your Skincare Pro online training.

After completing an intake form, and undergoing both nutrigenomic (via Toolbox Genomics) and ancestry DNA testing (via Toolbox Genomics, AncestryDNA, or 23andMe), each participant was given a list of custom skincare formulations for a cleanser, toner, and moisturizer. The participants were instructed to create the products, use those products exclusively for three months, and complete periodic questionnaires to report their progress. Eleven of the participants completed the project and submitted their required surveys.

Initial findings identified that two of the participants experienced adverse reactions to specific ingredients. Fortunately, their nutrigenomic test results explained why–those participants both had genetic variants that inhibited their body’s ability to absorb and utilize those specific ingredients.

These participants’ formulations were re-formulated minus the problematic ingredients. The participants created the new formulations. After one month of use, reported no adverse reactions, AND overall improvement in the overall appearance of their skin.

At the end of three months of consistent use of the “Skin Sequenced” products, all participants reported an improvement in the appearance and condition of their skin over whatever previous products they had been using prior to participating in The Skin Sequencing® Project.

The Skin Sequencing® Method works because it is based on bio-individuality. Bio-individuality is the concept that one person’s food (or skincare ingredient, in this case) is another person’s poison through ancient healing systems such as East Asian Medicine and Ayurveda. Modern interpretations such as the Metabolic Typing Diet and the Blood Type Diet, also carry this theory true–we see it through all these dietary theories that aim to “type” people.

Bio-individuality is based on both genetics (ancestry, ethnicity, nutrigenomics–a person’s genetic predispositions towards certain foods, nutrients, deficiencies, and disorders) and epigenetics (lifestyle factors independent of ancestry/passed down genetic predispositions such as diet, exercise, stress, water quality, pollution, medication, exposure to toxicants, etc).

The fact that both modern science and ancient wisdom support the idea that humans achieve the best possible health outcomes by following an individualized, ancestral diet also supports that humans achieve the best possible SKIN outcomes with an individualized, ancestral topical skincare regimen.

By utilizing the Skin Sequencing® Method, aestheticians and other skin care professionals will have the ability to understand exactly what nutrients a person is genetically pre-disposed to need, as well as what the best source of those nutrients are based on their ancestry.

The Skin Sequencing® Method can be used by those who offer premium, custom formulation services to their clients. It can also be used by aestheticians who are not skincare formulators to identify which products contain the ingredients the client either needs OR might react to (and therefore should avoid) due to allergies or genetic variants. This way, aestheticians and other skin care professionals can help even the most reactive clients, as well as the clients that have seemingly tried everything, but nothing works.

Rachael Pontillo is a holistic skincare formulator, educator, conscious beauty brand and marketing consultant, healthy skin media expert, and licensed aesthetician. She teaches skincare makers, founders, and practitioners to create innovative plant-based formulations, develop launch + growth solutions, and supports their continuing education in plant-based skincare formulation, and authentic online business and marketing with the Create Your Skincare Pro online courses and in her consultancy.