Generational and Cosmetic Dermatology, Rancho Mirage, CA
A 58-year-old African American female, Fitzpatrick skin type
5 (Roberts Skin Type F5/H3/G3/S2), who presented with complaints
of darkening skin globally but reporting she felt
“especially tired around the eyes”. Her occupation was in school
transportation and she was outside every day with no sun protection.
She also reported 5 hrs or less of sleep per night. On
physical examination she had severe mid facial descent also
with a significant tear trough deformity and suborbital shadowing.
Though this patient would be an excellent candidate for mid
face filling she was not amenable to this and just wanted to look more refreshed until the school year was out. Her first line treatment
was microdermabrasion that gave her no downtime and
did not pose a risk for her daily exposure to sun. She was also
started on a routine daily SPF 30, foundation mineral makeup
and counseled to get more sleep. At 2 months she noted an
increased luminosity and eveness to her skin with decreased
pigmentation of her face globally which included the undereye
area. This case demonstrates how simple counseling in skin
care may improve the appearance of some cases of POH.
A 27-year-old African American Male, Fitzpatrick skin type 5
(Roberts Skin Type F5/ H 1/ G1/ S3) presents with an unknown
history of increasing hyperpigmentation of the right suborbital
area. He had a positive history for atopy and had used
a variety of unknown products to treat the hyperpigmenta-
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