GlyMed's Director of Education, Sarah Robbins, interview with Jean McKoy for the Skin Deep podcast on pigmentation in Fitzpatricks IV, V, and VI. Jean McKoy is a Licensed Master Esthetician located in Sacramento, California, and has been an account with GlyMed Plus for more than eight years.
Feb 2, 2022 2:14:01 PM / by The Institute of Skin Science
Interview with Former UAC Member Jean McKoy
GlyMed's Director of Education, Sarah Robbins, interviewed Jean McKoy for the Skin-Deep podcast and had an excellent discussion on Fitzpatricks IV, V, and VI. If you'd like to listen to the full podcast, click here or search for Skin Deep by GlyMed Plus on any podcast network.
Jean McKoy is a Licensed Master Esthetician located in Sacramento, California, and has been an account with GlyMed Plus for more than eight years. GlyMed is also privileged to have her be a part of our Unity Advisory Committee, which exists to help influence the direction and voice of the esthetician and shape the future of esthetics.
This text was transcribed from her interview with GlyMed. Some edits have been made for readability.
About Jean McKoy
Skin has always been a passion of mine as a little girl and through adolescence in high school. In 2008, I retired from corporate structure, went to skin school, became an esthetician, and I've been practicing since 2008. I opened my business in 2014 and wanted to specialize in clinical skincare and focus more on skin nutrition and chemical peels. While I was in school, I was introduced to GlyMed Plus. Our class was the first to utilize GlyMed Plus, and I just fell in love with it because of the active ingredients.
Fast forward from 2014 to current, I have a client base of about 3000. Every month, I see about 175 to 200 clients pre-covid.
My business primarily carries GlyMed. I use a couple of other things, but I'm really 100% GlyMed, and that's simply because of the relationship I've built over the years. There's a lot of consistency in education and knowledge within the GlyMed family. On top of the fact that the products work and are effective. And my clients love it.
Melasma and Its Triggers
Melasma is an overproduction of the melanocytes or overproduction of colour in the skin, which can come from many things. Pregnancy is one of the big ones. Certain things can trigger it, including your diet, thyroid issues, hormonal changes, pharmaceutical products, and medications, but they vary by person. Fitzpatricks IV, V, and VI typically develop some type of pigmentation while pregnant, and it usually starts at the chest line up to the neck and onto the face.
Melasma is most concentrated, usually along the jawline, the cheeks—because that's the fattiest part of our face—usually followed by the bridge of the nose. It could be on the upper and bottom lip, the chin area, but mostly the jawline is what I deal with a lot. The difference in the type of melasma depends on how deep it is. So, the darker the melasma becomes, the deeper in the epidermis.
Some medications that can trigger overproduction are blood pressure medicine, thyroid medication, and birth control pills. Those are the three main ones that I see a lot that are the root cause. You must be careful with the types of meds you're taking, but the moment you start to see a change in your skin, that's a great time to seek out an esthetician or even a dermatologist.
I remember growing up watching pregnant women in the African-American community and listening to my elders saying, "Oh, she has the mother's mask," which usually presents itself around month seven of pregnancy. When I became pregnant, I developed the mother's mask on my chest and neck. Nine times out of 10, after you deliver, it goes away, but I do have clients where it didn't completely disappear, so it's not a 100% guarantee that it will. So again, that's something to be mindful of while you're pregnant. For my pregnant clients, I place them on either Living Cell Clarifier or Derma Pigment Skin Brightener and some other products while they're pregnant.
I suffer from light pigmentation on my cheeks. It became more prominent after I did a Vitamin A peel about four years ago. I keep it at bay with Derma Pigment Skin Brightener and chemical peels. If I don't use my tyrosinase inhibitor, after about four or five days, I start to see the shadowing of it coming back in, so it is not something that will go away.
SPF and Darker Fitzpatricks
People think, especially Fitzpatrick types V and VI, that sunscreen is unnecessary. Sunscreen is for everybody, and the sun is no respecter of skin tone. The sun's rays can produce melasma if they don't protect their skin, and I often stress that to my clients, regardless of colour. We all need to wear sunscreen.
Melasma and Who It Affects
Statistically, about 10% of the male population fits the hyperpigmentation category and has some overproduction of colour. About 90% of the statistics show that women are more susceptible to overproduction of pigment in their skin.
Teenagers are not excluded from the development of melasma in the skin, and a lot of times, I find in teens that it's hereditary. It's essential to get them on a good regimen and stress the importance of protecting their skin, especially those still in school.
Body temperature, increased heart rate, and inflammation trigger pigmentation. We often hear about melasma and think of older individuals because it’s more common in ages 35 to 50, but it does show up in younger skin.
Deep Pigmentation
It's challenging to differentiate between hyperpigmentation and melasma, and I always tell clients to look for patterns. If you start to see the dots of pigmentation connecting, becoming denser in the skin, and spreading, the chances are that's melasma and not hyperpigmentation. There's a distinctive pattern with melasma.
In my consultations, I'm usually looking at the density of the melasma. If it's dense, I typically recommend consulting with their doctor before they go through the chemical peel process. I advise them to talk with their doctor about getting on hydroquinone to help with the process of prepping the skin for chemical peeling as well as the reduction or slowing down of the melanocytes. That has worked well for some of my clients who've had that higher density of pigmentation in the skin, and then I set them up with a chemical peel process. I start with gentle chemical peels to begin slowing down the production of colour in the skin and then gradually take them up each session to a different level.
Treating Pigmentation
Usually, when I'm seeing a client for the first time, I start with something superficial, just to get the skin accustomed to the acids and make sure that there's no reaction. Then I put them on a pre-treatment or home care regimen and bring them back within four to six weeks. That’s when I step it up a notch or two. Sometimes my chemical series can take four to six months because I take my time, and I want to make sure that the skin is healing well before applying another chemical peel. Don't rush it.
When you're getting into the more aggressive peels, your aftercare instructions are very important for your clients throughout the process. I don't allow my clients to perspire after an aggressive peel for three to four days; do not work out, don't sweat, and avoid the sun at any cost. Perspiration can cause bacteria on the skin and cause them to break out. On top of the chemical peel acids, now you're adding more acid from the salt to the skin, which will be an irritant, so your home care is important, but your aftercare is even more important.
Homecare is Key
I educate my clients all the time about the difference between over-the-counter products versus active ingredients, which is what I use on them and what I'm recommending for them at home; there is a huge variance between the two. I ask them not to use home care that they purchased over the counter or in a department store while using the products that I have them on. Most of them comply with that because they want to get a true result. If you're not using the correct products, I can't guarantee anything.
If you have a client that's not going to commit to home care, then it's not even a path you want to travel down performing chemical peels. It also shows that you don't want them as a client because they're not willing to trust you and the advice, you're giving them.
I have turned people away if they’re not buying products from me. I've had people say they found a product on Amazon instead, or what have you. No, no, no, no, no, I don't know what that product is. I don't know what's in that product. If you're not buying it from me, I will not peel you because it's not about the money, it's about my reputation and your results, so if you're not going to comply, I can't serve you. And it's okay to do that.
Written by The Institute of Skin Science
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