A thorough skin assessment is essential prior to considering using skin products that may interact with healthy skin. This is even more important when considering skin with underlying skin conditions such as rash, dermatitis, eczema, psoriasis or cellulitis. Using any product that is either acidic or alkaline can alter the pH and bacterial flora on the skin which may increase the likelihood of pathogenic organism colonisation. The recovery of skin pH after cosmeceutical exposure in healthy skin may take 48 hours and inflamed or damaged skin takes even longer.
Determining a person’s skin colour using the Fitzpatrick scale would be a useful tool as it estimates the skin’s response to different skin products. The Fitzpatrick scale initially estimates a person’s response to UV rays. This can inform advice as to sunscreen protection and which other products containing sunscreen to use. For example, a Fitzpatrick type 1 who is very pale may need to be assessed head to toe for skin lesions as they have a high risk of skin cancer if exposed to a lot of UV radiation and would need to use sunscreen most of the time outdoors. Those with Fitzpatrick types 1, 2 and 3 usually react well to aesthetic procedures such as botulinum toxin and micro needling as well as products such as chemical peels. However, for Fitzpatrick types 4, 5 and 6 they may hyper or hypo-pigment due to melanocyte concentration in the skin and may be less suitable to certain treatments and products, or certainly caution would be required to avoid Post Inflammatory Hyperpigmentation (PIH). They may also be at greater risk of keloid scarring due to activity of fibroblasts post minimally invasive treatment.
Being able to recognise those who are at risk of skin breakdown is an essential part of preventing any injury to the patient’s skin. It would also be important to check any wounds or abnormal lesions. Classifying facial wrinkles based on a skin assessment such as the appearance of static or dynamic rhytides or using a tool such as The Wrinkle Assessment Scale may also inform which aesthetic products and procedures a patient is suitable for.