Ped derm patients embrace cosmetic camouflage

COEUR D’ALENE, IDAHO – The impaired quality of life so common among children and teens with visible skin disorders is significantly improved through instruction in the use of cosmetic camouflage, according to data from a 6-month prospective study.

"We believe cosmetic camouflage may allow patients a protective window of time in order to adapt to or accept a new visible skin condition," Dr. Michele Ramien said at the annual meeting of the Society for Pediatric Dermatology.

"Visible skin conditions are a source of emotional and psychologic stress," she added. "Amongst children, differences are quickly identified and questioned by peers. The pediatric burn literature shows that visible scarring results in an array of negative responses: Stares, avoidance, teasing, bullying."

Dr. Ramien reported data from 38 patients aged 5-18 years with vascular or pigmentary disorders visible while wearing a T-shirt and pants. Two-thirds of the individuals were light skinned, and two-thirds of the skin disorders were facial. All but three of the patients were female. They were taught to use cosmetic camouflage by hospital-based cosmeticians, and they received a free 6-month supply of the products.

Mean scores on the Children's Dermatology Life Quality Index improved from 5.1 (out of a theoretically possible 30) at baseline to 2.1 at 6 months. The scores of children with pigmentary conditions improved from a mean of 6.2 to 3.2, while the scores of patients with vascular anomalies improved from 4.1 at baseline to 1.0 at 6 months.

The quality-of-life improvement was comparable in dark- and light-skinned patients, according to Dr. Ramien of the University of Montreal.

Patient surveys at 1 and 6 months showed cosmetic camouflage was well tolerated and used by the majority of patients. Indeed, all but one tried the prescribed regimen during the first month. The majority of subjects used cosmetic camouflage on a daily to once-weekly basis. At the 6-month mark, all but seven patients continued to use cosmetic camouflage.

Cosmetic camouflage entails the skillful application of specialized, commercially available products that are waterproof, are opaque, adhere to damaged skin, and will last for 8-16 hours. There is ample published evidence of the quality-of-life benefits of cosmetic camouflage in adults with disfiguring skin conditions, but little evidence of effectiveness in children until recently, Dr. Ramien observed.

"The proposed drawbacks of cosmetic camouflage that you may come across in the older literature – poor coverage of textural differences and shame related to concealing one’s true identity – those are not supported in the newer literature," she said.

Physicians without ready access to a hospital-based cosmetician have several other options.

"We realized that community dermatologists are really going to be the introduction point for the majority of pediatric patients with visible skin anomalies who might benefit from cosmetic camouflage," Dr. Ramien said. "Anyone who is interested in becoming further informed can contact representatives of the various companies that market the products, or networks of cosmeticians and aestheticians in your area who are interested in developing these services for your patients. Even the online websites of many of the cosmetic camouflage producers can be very useful in learning more about what’s available," she emphasized.

Dr. Ramien reported having no financial conflicts regarding this study, which was supported by institutional funds.

[email protected]

COEUR D’ALENE, IDAHO – The impaired quality of life so common among children and teens with visible skin disorders is significantly improved through instruction in the use of cosmetic camouflage, according to data from a 6-month prospective study.

"We believe cosmetic camouflage may allow patients a protective window of time in order to adapt to or accept a new visible skin condition," Dr. Michele Ramien said at the annual meeting of the Society for Pediatric Dermatology.

"Visible skin conditions are a source of emotional and psychologic stress," she added. "Amongst children, differences are quickly identified and questioned by peers. The pediatric burn literature shows that visible scarring results in an array of negative responses: Stares, avoidance, teasing, bullying."

Dr. Ramien reported data from 38 patients aged 5-18 years with vascular or pigmentary disorders visible while wearing a T-shirt and pants. Two-thirds of the individuals were light skinned, and two-thirds of the skin disorders were facial. All but three of the patients were female. They were taught to use cosmetic camouflage by hospital-based cosmeticians, and they received a free 6-month supply of the products.

Mean scores on the Children's Dermatology Life Quality Index improved from 5.1 (out of a theoretically possible 30) at baseline to 2.1 at 6 months. The scores of children with pigmentary conditions improved from a mean of 6.2 to 3.2, while the scores of patients with vascular anomalies improved from 4.1 at baseline to 1.0 at 6 months.

The quality-of-life improvement was comparable in dark- and light-skinned patients, according to Dr. Ramien of the University of Montreal.

Patient surveys at 1 and 6 months showed cosmetic camouflage was well tolerated and used by the majority of patients. Indeed, all but one tried the prescribed regimen during the first month. The majority of subjects used cosmetic camouflage on a daily to once-weekly basis. At the 6-month mark, all but seven patients continued to use cosmetic camouflage.

Cosmetic camouflage entails the skillful application of specialized, commercially available products that are waterproof, are opaque, adhere to damaged skin, and will last for 8-16 hours. There is ample published evidence of the quality-of-life benefits of cosmetic camouflage in adults with disfiguring skin conditions, but little evidence of effectiveness in children until recently, Dr. Ramien observed.

"The proposed drawbacks of cosmetic camouflage that you may come across in the older literature – poor coverage of textural differences and shame related to concealing one’s true identity – those are not supported in the newer literature," she said.

Physicians without ready access to a hospital-based cosmetician have several other options.

"We realized that community dermatologists are really going to be the introduction point for the majority of pediatric patients with visible skin anomalies who might benefit from cosmetic camouflage," Dr. Ramien said. "Anyone who is interested in becoming further informed can contact representatives of the various companies that market the products, or networks of cosmeticians and aestheticians in your area who are interested in developing these services for your patients. Even the online websites of many of the cosmetic camouflage producers can be very useful in learning more about what’s available," she emphasized.

Dr. Ramien reported having no financial conflicts regarding this study, which was supported by institutional funds.

[email protected]

COEUR D’ALENE, IDAHO – The impaired quality of life so common among children and teens with visible skin disorders is significantly improved through instruction in the use of cosmetic camouflage, according to data from a 6-month prospective study.

"We believe cosmetic camouflage may allow patients a protective window of time in order to adapt to or accept a new visible skin condition," Dr. Michele Ramien said at the annual meeting of the Society for Pediatric Dermatology.

"Visible skin conditions are a source of emotional and psychologic stress," she added. "Amongst children, differences are quickly identified and questioned by peers. The pediatric burn literature shows that visible scarring results in an array of negative responses: Stares, avoidance, teasing, bullying."

Dr. Ramien reported data from 38 patients aged 5-18 years with vascular or pigmentary disorders visible while wearing a T-shirt and pants. Two-thirds of the individuals were light skinned, and two-thirds of the skin disorders were facial. All but three of the patients were female. They were taught to use cosmetic camouflage by hospital-based cosmeticians, and they received a free 6-month supply of the products.

Mean scores on the Children's Dermatology Life Quality Index improved from 5.1 (out of a theoretically possible 30) at baseline to 2.1 at 6 months. The scores of children with pigmentary conditions improved from a mean of 6.2 to 3.2, while the scores of patients with vascular anomalies improved from 4.1 at baseline to 1.0 at 6 months.

The quality-of-life improvement was comparable in dark- and light-skinned patients, according to Dr. Ramien of the University of Montreal.

Patient surveys at 1 and 6 months showed cosmetic camouflage was well tolerated and used by the majority of patients. Indeed, all but one tried the prescribed regimen during the first month. The majority of subjects used cosmetic camouflage on a daily to once-weekly basis. At the 6-month mark, all but seven patients continued to use cosmetic camouflage.

Cosmetic camouflage entails the skillful application of specialized, commercially available products that are waterproof, are opaque, adhere to damaged skin, and will last for 8-16 hours. There is ample published evidence of the quality-of-life benefits of cosmetic camouflage in adults with disfiguring skin conditions, but little evidence of effectiveness in children until recently, Dr. Ramien observed.

"The proposed drawbacks of cosmetic camouflage that you may come across in the older literature – poor coverage of textural differences and shame related to concealing one’s true identity – those are not supported in the newer literature," she said.

Physicians without ready access to a hospital-based cosmetician have several other options.

"We realized that community dermatologists are really going to be the introduction point for the majority of pediatric patients with visible skin anomalies who might benefit from cosmetic camouflage," Dr. Ramien said. "Anyone who is interested in becoming further informed can contact representatives of the various companies that market the products, or networks of cosmeticians and aestheticians in your area who are interested in developing these services for your patients. Even the online websites of many of the cosmetic camouflage producers can be very useful in learning more about what’s available," she emphasized.

Dr. Ramien reported having no financial conflicts regarding this study, which was supported by institutional funds.

[email protected]