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Summary of “Emotional Benefit of Cosmetic Camouflage in the Treatment of Facial Skin Conditions: Personal Experiences and Review”

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Recent studies highlighting the psychological benefits of medical treatment for dermatological skin conditions have demonstrated a clear role for medical therapy in psychological health. Skin conditions, particularly those that are overtly visible, such as those located on the face, neck, and hands, often have a profound effect on the daily functioning of those affected. The literature documents significant emotional benefits using medical therapy in conditions such as acne, psoriasis, vitiligo, and rosacea, but there is little evidence documenting similar results with the use of cosmetic camouflage.

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Visible skin conditions are often a source of emotional concern for patients. Perseverance with treatment regimens is required in order to see noticeable improvements; however, many patients desire an immediate effect. Cosmetic camouflage is an easy to teach and learn technique that utilizes makeup to disguise skin lesions. Following application of specialized products, an immediate improvement in skin appearance and patient contentment is often appreciated. Currently, there is a paucity of studies documenting the benefits and efficacy of cosmetic camouflage for patients with disfiguring skin lesions. We see immediate and satisfying results with the use of camouflage in our patients. Dermatological conditions, particularly those located on the face, such as acne, psoriasis, vitiligo, and rosacea, can be emotionally and psychologically disfiguring

Patients with acne are more likely to experience depression, anxiety, decreased self-esteem, and have suicidal ideation.This is especially important during the formidable years of adolescence, where psychological distress can cause significant social problems. Psoriasis, a common autoimmune inflammatory skin disease, decreases the QoL of those affected and is also a notable risk factor for suicide. Additionally, patients with rosacea and vitiligo, and other dermatological conditions that manifest on the face, also experience significant psychological distress and impaired self-esteem leading to a decreased QoL. Mealsma, characterized by hyperpigmented macules/patches in sun-exposed areas (particularly on the face), is another skin condition with known significant psychological effects, such as feelings of embarrassment, anxiety, depression, and social isolation. After an extensive literature review seeking information regarding the impact of melasma on health-related QoL in affected patients, it was determined that there was a deleterious impact on social life, emotional well-being, physical health, and financial status in Hispanic women.

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AV is a chronic inflammatory disease of the pilosebaceous unit. It is a distressing condition among adolescents and young adults because it can lead not only to physical complications, such as permanent scarring but also to long-lasting psychosocial effects. The conventional model of AV pathogenesis begins with follicular hyperkeratinization, followed by sebum accumulation leading to comedone formation. Inflammation was believed to be secondary following these steps. However, subclinical inflammation has been found to occur even without preceding microcomedone formation, and it takes place early during the emergence of visible lesions, through progression, and even during resolution when the scars are forming.Thus, AV pathogenesis is currently believed to be caused not only by Propionibacterium acnes proliferation, but also by inflammatory mechanisms due to factors such as genetic predisposition, diet, sebaceous gland activity, inflammatory mediators, and their target receptors. P. acnes resistance has been found to be progressing at an alarming rate due to continued irrational antibiotic use. Changing patterns of antibiotic susceptibility have led to significant alterations in prescribing patterns as well as the widespread recognition of the need for alternative nonantibiotic treatment for AV (Pawin H, Beylot C, 2009)

Throughout the decades, AV therapy has remained largely the same: Comedolytics, antimicrobials, anti-inflammatory substances, and isotretinoin. The current advances in the understanding of normal skin physiology and the pathophysiologic mechanisms leading to acne have allowed for the development of other therapies that have a wide spectrum of treatment targets. Cosmetics were initially intended to enhance esthetic appearance. Nonmedicinal raw materials are incorporated into these products to have functional effects on the skin (Thiboutot D, 2009). These are then used as supplementary agents in the treatment of dermatologic conditions such as AV. These cosmetics are referred to as “cosmeceuticals.”

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After all, camouflage makeup was able to conceal almost all skin changes, improving QoL scores regardless of age, diagnosis, and site of skin changes. Use frequency was significantly higher in patients with skin changes on exposed sites compared with patients with unexposed sites.

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Thiboutot D, Gollnick H, Bettoli V, Dréno B, Kang S, Leyden JJ, et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol. 2009;60(5 Suppl):S1–50.

Dréno B, Thiboutot D, Gollnick H, Finlay AY, Layton A, Leyden JJ, et al. Large-scale worldwide observational study of adherence with acne therapy. Int J Dermatol. 2010;49:448–56

Pawin H, Beylot C, Chivot M, Faure M, Poli F, Revuz J, et al. Creation of a tool to assess adherence to treatments for acne. Dermatology. 2009;218:26–32.

Suh DH, Shin JW, Min SU, Lee DH, Yoon MY, Kim NI, et al. Treatment-seeking behaviors and related epidemiological features in Korean acne patients. J Korean Med Sci. 2008;23:969–74.

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