Reviewed by Varnada Karriem-Norwood on May 05, 2012
Robert Kotler, MD, FACS Cosmetic and Plastic Surgeon of the Face and Neck Clinical instructor, Division of Head & Neck Surgery, UCLA Medical School.
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Robert Kotler, MD: The question of the medium complected person, the olive skinned patient that has perhaps brown eyes. What do we do for them, because I’ve stated that they are not the perfect candidate. Well, there are people who kind of fall into you’re probably okay type department.
Robert Kotler, MD (cont.): What we do there is, rather than guess what the result would be, we do what we call a patch test, or a demo. We take a little bit of the chemical, we put it on the skin of the forehead, usually under where the hair would conceal it, and we test the skin, kind of like paint companies test paint, put it out in the sun for a few months.
Robert Kotler, MD (cont.): We’re going to see how that skin behaves, and we’re going to see what the end color is. Now, we may have to wait 3 to 6 months. It may take that long for the pink color to fade and for the skin to get to the ultimate color it’s going to be. Most of the time, it’ll be lighter, but in some people, it could be darker, and we’d like to know that. Now, it’s a color issue for these people. It’s not an issue of a greater chance of other serious complications like scarring or the white bumps. It’s strictly the color.
Robert Kotler, MD (cont.): But that is important, because people would like to have uniform color and natural look. But we also have to remind that patient that since most people’s skin will lighten up a little bit if they have a reasonable amount of pigment, then there’s a potential color difference between the treated face and the untreated neck.
Robert Kotler, MD (cont.): Now that can be concealed with makeup and not necessarily heavy makeup, but the patient needs to know that going in, because there are some women for example who say, but I don’t ever wear makeup, and I don’t want to wear makeup and if I’m going to look like I’ve got a color difference, then maybe this isn’t for me. And I agree, it isn’t for them. But if we can show them by the patch test, the sample test, the demo, what the outcome will be, then they can make a better decision.
Robert Kotler, MD (cont.): We still have to deal with the patient who has some darkness and increased darkness from sun damage and there are less intense ways to deal with that including bleach creams. Even if a patient does develop pigmentation because perhaps they went out in the sun a little too soon, or perhaps they went water skiing and washed off their sunscreen, we do have bleach creams that are very effective within 4 to 6 weeks when applied once a day will bleach out that pigment.