ANAHEIM, CALIF. An in-office camouflage makeup expert can help mask postoperative bruising, swelling, or redness, which can make the difference to patients who feel injured or disfigured, said Howard Steinman, M.D., at a cosmetic dermatology seminar sponsored by the Skin Disease Education Foundation.
It's not uncommon for dermatologists to simply give patients a list of a few paramedical products and send them on their way, without considering that most patients will not want to be seen in public, even by strangers, immediately after the procedure. "You may see a normal postop resultbruising, redness, or asymmetryand you think it looks like a normal, great result, but the patient probably doesn't see it that way," said Dr. Steinman, a dermatologist in private practice in Chula Vista, Calif.
The last thing a patient likely wants to do is go to a cosmetic counter with an unsightly face when the salespeople look like models, he added. "Having to buy the products outside the office is simply not a viable option for cosmetic patients."
The difficulties of using past-generation paramedical products turned many practitioners away from offering in-house camouflage makeup services.
But mineral makeup has changed all that. Newer products are much easier for staff people to use and for patients to learn to apply themselves. The products can be highly effective in normalizing or almost normalizing regular bruising, covering redness, and masking pigmentary changes.
The makeup helps cover expected discoloration caused by everything from ablative procedures, deeper peels, and S-lifts to blepharoplasty, Mohs surgery, and even botulinum type A injections.
The products are formulated for postsurgical use, are waterproof, have an SPF, and are easy to apply and remove, Dr. Steinman said. The paramedical products he uses include Youngblood Mineral Makeup, DermaColor Camouflage, and Lycogel. He said he does not have financial ties to any of the manufacturers.
There are some limitationsthe makeup usually won't cover three-dimensional conditions, for instance. And it often can't cover very dark bruising or a lack of texture, he noted.
The staff person in charge of applying the camouflage makeup can offer an added level of care and understanding that boosts patient satisfaction.
"If you use someone who's experienced in paramedical camouflage makeup, they understand the psyche of the postop patient, the procedures, and they have great credibility in your office." In Dr. Steinman's practice, the makeup expert is his wife, Diedre, but estheticians or other staff members with experience in paramedical camouflage makeup can take on the role.
To allow adequate time and planning for makeup application and training, the service is best offered as a postsurgical session, arranged along with the other procedures, Dr. Steinman recommended.
Makeup should be matched to patients' facial skin prior to laser or chemical peels to ensure the appropriate color will be available postoperatively, and patients should be told to bring in their own makeup to help them feel as "normal" as possible when they leave.
Considering the low cost and risk of camouflage makeup, the minimal office space required, and the high level of patient satisfaction, the inclusion of such services is very worthwhile, Dr. Steinman said.
"When this is incorporated in your office, the fear we all have of doing procedures that have downtime can be ameliorated," he said. "With something like CO2 laser resurfacing, for instance, I have no concerns about downtime."
"If you're not offering camouflage makeup, then you're missing the boat, because this really completes the whole package for the patient and makes you, the physician, feel much more secure," he added.
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