Fitzpatrick Skin Type IV

Fitzpatrick Skin Type IV People with skin type IV have dark hair and light Mediterranean, olive looking skin – beige with light brown tint. They typically tan with ease and seldom get burned. Their risk to develop skin cancer is less that those with skin types I-III, but still present. They should therefore still take care, use sunscreen and protect themselves from harmful UV rays as extreme sun exposure can result in serious damage, uneven skin tone, premature ageing and possible skin cancers.

Skin type IV -can be prone to an overactive production of melanin following sun exposure which can result in the uneven pigmentation of melasma especially if they are on hormonal therapy such as the oral contraceptive or during pregnancy.

Those with a higher level of skin type such as skin type IV -can be prone to an overactive production of melanin following certain light and laser skin rejuvenation treatments or laser hair removal and thus proper preparation of the skin and sun avoidance is recommended prior to aesthetic treatments such as laser / light and peels. This can help prevent permanent discoloration or scarring of the skin.

Best skin care practices for Skin Type IV

• Minimise sun damage - Individuals with this skin type should stay out of the sun during the peak hours of 10am - 4pm, and wear a SPF 15 sunscreen every day. Products with titanium dioxide or zinc oxide or Avobenzonw provide protection against both UVA and UVB rays. Whenever you are out in the sun , wear a high SPF of 50 , wear protective clothing, wide brimmed hats, sunglasses, etc. and reapply a SPF of 50 every 90 minutes. Wear sunglasses that provide UVA protection as UVA exposure can cause cataracts. For Internal Skin Protection oral supplements such as Polypodium leucotomas (Heliocare) and Pycnogenol ® (Ovelle) that offer sun protection and increase resistance against the pigmentation effects of the sun should be considered. Try to avoid tanning beds and booth as they have a high intensity of UV output , many times stronger than the midday summer sun in most countries
• Even out pigmentation - The new pigmentation peptides such as Oligopeptide-34, Oligopeptide-51, Oligopeptide-53, Pentapeptide-15, together with Arbutin, Kojic acid block melanin production. If pigmentation fails to respond to topical depigmenting agents then it may be necessary to have treatment with laser technology.
• Reverse some pre-existing age related changes such as wrinkles - Once the signs of ageing such as wrinkles appear on the facial skin, it is time to initiate the most powerful corrective treatments such as growth factors , peptides , PHAs to improve collagen content and wrinkling.
• Check your skin head-to-toe each month, paying careful attention to any suspicious growths - An annual consultation by a dermatologist is advised to exclude any dermal pathology such as melanoma and skin cancers especially if there is a family history of cancer or if the person has a history of any serious sunburn exposure.

In office aesthetic treatments for Fitzpatrick Skin Type IV

Most aesthetic skin treatments can safely be done in Skin Type IV individuals without adverse side effects such as hyper or hypopigmentation occurring, provided that it is done by professionals who are experiences in treating Skin Type IV . Most experts agree that people with this type of skin should receive pretreatment of their skin prior to aggressive lasers a or chemical peels applied, to avoid hyper- or hypopigmentation, a common problem resulting form the inflammation that follows one of these treatments. In these patients, the risks are weighed against potential benefits, and other treatments (e.g. nonablative Laser Genesis rejuvenation with the long pulsed Nd YAG) may be considered.

Other factors to be considered include the following:

Age of the patient Area of skin to be treated History of previous sun exposure especially before treatments Level of skin damage (e.g., mild, moderate, severe; often caused by sun exposure) Treatment goals (e.g., reduce fine lines, wrinkles, skin discoloration) Nonablative laser rejuvenation with a long pulsed Nd YAG (such as Laser Genesis procedure ) can improve the texture and appearance of the skin and reduce uneven skin tone, without damaging the outer layer of the skin (epidermis). These nonablative lasers and infra red light spectrum of the Titan bypass the epidermis and deliver energy to the underlying layers of skin (dermis), stimulating collagen growth and skin tightening. These procedures can be used in patients with all skin types, and may be better choices for patients who have skin types IV–VI. Nonablative resurfacing may cause fewer side effects and result in faster recovery times.

In general, skin types IV have a medium risk for problems (e.g. skin discoloration, blotchiness, darkening or lightening of the skin, burns, scarring) following aesthetic treatments and therefore any of the following treatments can be done in a clinic experienced in treating skin type IV:

The following treatments can be performed on Fitzpatrick Skin Type IV

• Botox and fillers work well on this skin type
• Microdermabrasion and all types of chemical peels including Chemibrasion by Nimue and mid dermal peels such as Mela M and TCA can be done safely sLaser & Light such as Titan, Laser Genesis skin treatments can be safely used on skin type IV with no pain and no downtime or side effects – provided that it is performed in a clinic experienced in treating skin type IV IPL/ Lime
• Light skin rejuvenation treatments can be done, but at a reduced fluence /joules to prevent side effects such as hypo- and hyperpigmentation Radiofrequency such as Accent and TriPollar radiofrequency procedures can be safely used on skin type IV with no pain and no downtime or side effects
• Mesotherapy and transdermal mesotherapy can be safely used on skin type IV with no pain and no downtime or side effects
• Carboxytherapy can be safely used on skin type IV with minimal pain and no downtime or side effects
• Dermaroller skin needling can be safely used on skin type IV with minimal downtime or side effects

Skin Care Regimen for Skin Type IV

1. CLEANSE AND EXFOLIATE
2. CORRECTIVES FOR SKIN PROBLEMS
3. FEED
4. HYDRATE
5. PROTECT

1. CLEANSE AND EXFOLIATE:

• Clean skin twice a day. If you have dry or sensitive skin , use a gentle creamy cleanser that does not contain sulphate. Oily or acne prone skin should cleanse with a salicylic acid cleanser Exfoliate twice a week if you have normal or oily skin.
• Exfoliate once a week if you have sensitive skin or active acne.

2. CORRECTIVES FOR SKIN PROBLEMS :

Wrinkles:

Once the signs of ageing such as wrinkles appear on the facial skin, it is time to initiate the most powerful corrective treatments such as growth factors and peptides to improve collagen content and wrinkling. Topical products to improve wrinkles and collagen: Growth Factors and Peptides found in Dermaheal offer the ultimate in anti-ageing and laser-free skin remodelling products. Set out to be the most powerful, corrective product on the market and is available at all Skin Renewal clinics.

Retinoic Acid /Retinaldehyde binds to receptors in the skin cells. Regular treatment over several months can lead to partial reversal of extrinsic photo-aging. Retinoic Acid such as Retin A should not be used during pregnancy because it is potentially teratogenic. It is only available on prescription . Renewal cream by Neostrata contains a less irritating form called Retinol and is available at all Skin Renewal clinics.

Alpha hydroxyl acids (AHAs) and Polyhydroxy acids (PHAs) such as glycolic acid, lactic acid and gluconolactone are primarily used as chemical exfoliants. Long-term use of these leads to increased collagen and elastin synthesis, and increased glycosaminoglycan concentration in the dermis. Clinically, concentrations less than 10% improve skin texture and pigmentation, while higher concentrations lead to improvement in fine wrinkling. AHAs and PHAs are considered safe in pregnancy and cause less skin irritation than retinoic acid and are available in Neostrata products at all Skin Renewal clinics.

Additional Skin Care ingredients to improve wrinkles in Skin Type IV:Copper peptide, Epidermal growth factor, Insulin growth factor, Fibroblast growth factor, Vit C, Oligopeptide - 34, Oligopeptide - 51, Oligopeptide-53 and Pentapeptide – 15.

Pigmentation

Topical products with active ingredients to even out pigmentation Skin Type IV The following is a list of skin care ingredients to USE if one has pigmentation. Oligopeptide-34, Oligopeptide-51, Oligopeptide-53, Pentapeptide-15, arbutin, bearberry, cucumber extract, hydroquinone, kojic acid, liquorice extract, magnesium ascorbyl phosphate, mulberry extract, niacinamide, retinol, resorcinol, beta hydroxyl acid, vitamin c

The following is a list of skin care ingredients to AVOID because it might enhance dark spots. Oestradiol, oestrogen, genistein, black cohosh, chasteberry, hops, red clever, soy and wild yams.

Skin Care ingredients to use if you have dark spots Arbutin, Cucumber extract, Hydroquinone, Kojic acid, Licorice extract, Oligopeptide 34, Magnesium ascorbyl phosphate, Mulberry extract, Pentapeptide 14, 51 and 53

Acne:

Topical products with active ingredients to avoid if you have acne in Skin Type IV: Cinnamon oil, Cocoa butter, Cocus nucifera, Isoprpopyl isostearate, Isopropyl myristate, Isopropyl myristate, Butyl stearate, Isostearyl neopentanoate, Myristyl myristate, Octyl palmitate, Isocetyl srearate, Propylene glycol 2, Myristyl propionate, Lanolin, Peppermint oil, Decyl Oleate, Octyl stearate.

Redness and Rosacea:

Topical products with active ingredients to avoid if you have redness and rosacea in Skin Type IV: Alpha Lipoic Acid, AHAs, PHA, Retinol, Retinaldehyde, Retinyl palmitate, Vitamin C, Benzoyl Peroxide, Gluconolactone, Phytic acid, Acetic acid, Allantoin, Balsam of peru, Benzoic acid, Camphor, Cinnamic acid, Cinnamon oil, Cocoa butter, coconut oil, DMAE, Isopropyl isostearate, Isopropyl myrisstate, Lactic acid, Menthol, Parabens, Peppermint oil and Quarternium.

3. FEED:

These are ingredients/nutrients that feed the skin which you may not get from your diet. These can be applied topically to fight free radicals damage and to calm, soothe and heal skin.

• Vitamin C can be used for pigmentation issues and healthier looking skin.
• Vitamin E protects against sun damage
• Alpha Lipoic Acid fights a range of free radicals, promotes energy in living ells and helps promote a healthy glow.
• Green Tea extract soothes irritated skin and can help with rosacea, inflammation and mild acne.
• Aloe Vera has powerful soothing and moisturising properties and is great for oily skin , eczema and rosacea.
• Botanical extracts such as Camellia sinensis, rosemary extract etc provide an alternative to chemically manufactured products

4. HYDRATE:

Keep skin well hydrated and moisturised as well hydrated cells are healthier and look and function better. Dehydrated skin cells are prone to sensitivity and infection.

• Humectants attract water to the skin cell and thus plump up fine lines and wrinkles giving your skin a smooth, youthful glow. These humectants include hyaluronic acid, sodium hyaluronate, glycerine, glycerides, propylene glycol, sorbitol urea, colloidal oatmeal .
• Occlusives bind water to your skin and slow the loss of water by forming a barrier on the skin’s surface . These include beeswax, lecithin, dimethicone, ceramides, cetyl alcohol and grapeseed oil
• Emollients are lipids that add lubrication to the surface of the skin by binding water and preventing evaporation and include hea butter, avocado, acai, passion fruit, mango, coconut, olive oil, rosehip oil, evening primrose oil, GLA and squalane
• Additional Skin Care ingredients to moisturise and hydrate Skin type IV:ajuga turkestanica, aloe vera, apricot kernel oil, borage seed oil, canola oil, , cholestrol, dexpanthenol, Jjojoba oil, macadamia nut oil, safflower oil,

5. PROTECT

• Minimise sun damage. Individuals with this Skin type IV should stay out of the sun during the peak hours of 10am - 4pm, wear a high SPF 30 sunscreen every day, wear protective clothing, wide brimmed hats, sunglasses, etc.
• External Skin Protection: Products with titanium dioxide or zinc oxide or Avobenzone provide protection against both UVA and UVB rays. Micronised Zinc oxide is recommended for sensitive skins and avoid avobenzone , PABA, Benzophenone, Butyl methoxydibenzoylmethane, Octyl methoxycinnamate, Methylbenzylidene camphor, Phenylbenzimidazole sulfonic acid if you have sensitive skin
• Internal Skin Protection: Oral supplements such as Polypodium leucotomas (Heliocare) and Pycnogenol ® (Ovelle) that offer sun protection and increase resistance against the damaging effects of the sun should be considered.