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Colored Facial Cosmetics

Zoe Diana Draelos, MD

From the Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem; and Dermatology Consulting Services, High Point, North Carolina

Colored facial cosmetics are designed to add color, blend pigmentation defects, and meet the fashion needs of the individual. Products that fit into this category primarily include facial foundations, but also face powders and blushes. The formulation and use of colored facial cosmetics is an area of dermatology where medicine, science, art, and appearance all intermingle. This makes the study of colored cosmetics challenging and fascinating.

Colored cosmetics are of medical sigruficance for their ability to function as camouflaging aids, yet it also is important to recognize dermatoses that rarely may be related to their use.

The formulation and efficacy of colored facial cosmetics is grounded firmly in the science of cosmetic chemistry and skin physiology. Colored cosmetics are valued for their appearanceenhancing capability and the intangible aspects of well-being that their use imparts.

This article discusses the art and science of colored cosmetics to provide a fund of knowledge useful to the physician in tackling problems related to appearance and dermatologic disease.

FACIAL FOUNDATION

Facial foundations are pigmented products applied to the entire face and generally worn for 8 hours or longer before removal. This class of color cosmetics, more than any other, affects the integrity of the skin. Facial foundations can fulfill many functions, depending on their formulation.

This variety of functions accounts for the tremendous variety available for consumer purchase. Companies try to market facial foundations to meet every skin need, attempting to expand their current market share. A somewhat bewildering array of products results for the dermatologist to understand. Table 1 lists the functions of a facial foundation.

Facial foundations must be pigmented to match all skin colors. It is possible with 7 to 8 shades to match most white skin colors, but facial foundations for black skin must be formulated in at least 10 to 12 shades to cover the tremendous variation in skin pigmentation. Facial foundation is a relatively modern product, invented and patented by Max Factor in 1936 in the form of a cake makeup used primarily in the film industry. Popular demand for this cosmetic developed shortly thereafter as women found the excellent coverage, velvety look, and added facial color desirable. Since that time, the variety and popularity of facial foundations have expanded tremendously.

Formulation

Table 1
FUNCTIONS OF FACIAL FOUNDATION
Add facial color
Blend facial color
Camouflage pigmentation irregularities
Normalize facial skin
Provide sun protection
Act as a treatment product

There are four basic facial foundation formulations: oil-based, water-based, oil-free, and water-free or anhydrous forms.* Oilbased products are designed for dry skin, whereas water-based products can be adapted for all skin types. Oil-free formulations are used in oily skin foundations, whereas anhydrous forms are extremely long wearing and used for camouflage or theatrical purposes.

Oil-based foundations are water-in-oil emulsions containing pigments suspended in oil, such as mineral oil or lanolin alcohol. Vegetable oils (coconut, sesame, safflower) and synthetic esters (isopropyl myristate, octyl palmitate, isopropyl palmitate) also may be incorporated. The water evaporates from the foundation after application, leaving the pigment in oil on the face. This preparation creates a moist skin feeling, especially desirable in dry-complexioned patients. Oil-based foundations do not shift color as they mix with sebum because the color is fully developed in the oily phase of the formulation. These foundations are easy to apply because the pigment can be spread over the face for 5 minutes before setting.

Water-based facial foundations are oil-inwater emulsions containing a small amount of oil in which the pigment is emulsified with a relatively large quantity of water. The primary emulsifier is usually a soap, such as triethanolamine or a nonionic surfactant. The secondary emulsifier, present in smaller quantity, is usually glyceryl stearate or propylene glycol stearate. These popular foundations are appropriate for minimally dry to normal skin. Because the pigment is already developed in oil, this foundation type is not subject to color drift. The amount of time the product can be moved over the face, known in the industry as playtime, is shorter than with oilbased foundations. These products usually are packaged in a bottle.

Oil-free facial foundations contain no animal, vegetable, or mineral oils. They contain other oily substances, such as dimethicone or cyclomethicone. These foundations usually are designed for oily-complexioned individuals because they leave the skin with a dry feeling. Silicone is noncomedogenic, nonacnegenic, and hypoallergenic, accounting for the tremendous popularity of this type of facial foundation formulation. These products also are usually liquids packaged in a bottle. Oil-control facial foundations should not be confused with oil-free facial foundations. All facial foundations contain a blotter designed to absorb sebum. Oil-control facial foundations simply contain additional blotters, such as talc, kaolin, starch, or other polymers, designed to absorb sebum in higher concentration. Usually, they are based on dimethicone; however, mineral oil may be added to some formulations. Oil-control foundations are not necessarily oil-free.

Water-free, or anhydrous, foundations are waterproof. Vegetable oil, mineral oil, lanolin, alcohol, and synthetic esters form the oil phase, which may be mixed with waxes to form a cream. High concentrations of pigment can be incorporated into the formulation, yielding an opaque facial foundation.

The coloring agents are based on titanium dioxide with iron oxides, occasionally in combination with ultramarine blue. Titanium dioxide acts as a facial concealing or covering agent. These products can be dipped from a jar, squeezed from a tube, wiped from a compact, or stroked from a stick. These foundations are well suited for use with patients who require facial camouflaging.

Surface Characteristics

Facial foundations are manufactured in a variety of finishes: matte, semimatte, moist semimatte, and shiny. The finish is the surface characteristic of a cosmetic. Matte finish foundations yield a flat look with no shine and generally are oil-free. They are good for patients with oily skin who tend to develop facial shine with time. A semimatte finish has minimal shine and is generally an oil-free foundation or water-based foundation with minimal oil content. This finish performs well on slightly oily to normal skin.
A foundation with more shine is known as a moist semimatte foundation and generally is water-based with moderate oil content. This finish performs well on normal-to-dry skin. Shiny finishes are found in oil-based foundations and are appropriate only for persons with dry skin. The shinier foundations with increased oil content also have increased moisturizing ability but are poorly suited to persons with facial wrinkling and scarring.
The shinier surface characteristic tends to highlight any texture problem present on the skin surface. The matte finish facial foundations are recommended for camouflaging purposes.

Table 2
COVERING ABILITY OF FACE
POWDER INGREDIENTS*
Titanium dioxide
Kaolin
Magnesium carbonate
Magnesium stearate
Zinc stearate
Prepared chalk
Zinc oxide
Rice starch
Precipitated chalk
Talc
*Listed in order of increasing opacity.

Application

The foundation selected should match the natural skin color as closely as possible. This matching can be difficult because the nose and cheeks have redder tones than the forehead and chin. The foundation is matched to the skin along the jaw line because this is where the color must be carefully blended beneath the chin. Mismatched facial foundations generally leave a line at the jaw line. A foundation color should be selected in natural sunlight. The bright, artificial fluorescent lights used in most stores distort color perception, prompting selection of a facial foundation in a shade darker than desirable.

In general, facial foundation should be applied with the fingertips. A dab of foundation should be placed on the forehead, nose, cheeks, and chin and blended with a light circular motion until it is evenly spread over all the face, including the lips. A puff or sponge should be used, stroking in a downward direction, to remove any streaks and to flatten vellus facial hair. Special care should be taken to rub the foundation into the hairline, over the tragus, and beneath the chin. Foundation also should be blended around the eyes and may be applied to the entire upper eyelid, if desired. The foundation longer can be removed with light touch. If additional coverage is desired, a second layer of foundation can be applied.

Availability

Facial foundations can be purchased at mass merchandisers (discount stores, grocery stores, drugstores), department stores, boutiques, and spas. Less expensive, wide-appeal foundations are sold by mass merchandisers, whereas more expensive, upscale foundations are sold by department stores at the cosmetic counter. Expensive specialty facial foundations are sold by elite department stores, boutiques, and spas. Cosmetic manufacturers intentionally produce a wide variety of facial foundations marketed through various vendors to appeal to many different segments in the marketplace.

Facial foundations sold in mass merchandisers generally range in price from $3 to $10. They are sold as unboxed bottles or on cards affixed to a standup display. The consumer makes her selection without first testing the product or receiving assistance from an attendant. Selection must be based on the appearance of the product in the bottle and the color chip on the packaging.
Sometimes testers are available. Color selection usually is limited to 8 to 12 shades because the store provides the company with a fixed amount of space in which to display all the products they wish to offer for sale. This represents the self-service approach to cosmetic selection.

Other foundations are sold exclusively through cosmetic counters in department stores. Even within the department store market, there are products designed for lower price point department stores and higher price point department stores. Lower price point department stores market foundations that sell for $8 to $15 versus higher price point department store foundations that sell for $15 to $30. Department store products offer the benefit of assistance from someone who has been trained in the sale of the cosmetic line. The salesperson can assist in color selection and application techniques. Samples also are frequently available for the consumer to take home and test for allergenicity, color appropriateness, and esthetic characteristics. Cosmetics are kept behind a sales counter, requiring assistance for purchase. Most products sold at the cosmetic counter are not expiration dated or safety wrapped similar to those sold at mass merchandisers.

The most expensive facial foundations are sold through boutiques and spas. These products range from $25 to $60. Some of these exclusive products are manufactured by the same companies that produce foundations under a different label for sale in mass merchandisers. Generally, boutique lines have more attractive, elaborate packaging accompanied by a greater color selection and more expensive fragrances and specialty additives. These products rely heavily on the added services offered by the sales consultant to support the higher prices.

Another route for foundation purchase, which is becoming increasingly popular, is through direct sales in the form of household parties, individuals who sell cosmetics doorto- door, or offerings over the internet. These products vary greatly in price and quality. There are some well-established names in this market, such as Mary Kay, Avon, and Artistry by Amway, but tremendous growth has been seen in the private label manufacture of cosmetics offered through these routes. Direct sales of cosmetics in the dermatologistís office fit into this category.

Cost Considerations

Dermatologists frequently must address the issue of cost in relation to the value of a cosmetic product. It is true that part of the cost of a more expensive cosmetic goes into attractive packaging, a unique fragrance, and a prestige name or image. A wider range of colors is generally available with the more expensive product lines, however, and in some instances, the increased cost yields superior ingredients that perform better. This separation based on performance is now seeing erosion in the mass market as extraordinarily well-formulated products are entering a competitive marketplace. It is wise, in most cases, to recommend products to patients in the prestige and the mass market to allow the patient to select a facial foundation that fits her cost needs.

Sun Protection

An excellent method for achieving photoprotection is the use of facial foundation, which acts a physical sunscreen. The iron oxide pigment and agents that provide coverage (titanium dioxide, zinc oxide, kaolin) are used in sunscreen formulations to block both UVA and UV-B radiation. A facial foundation without any added chemical sunscreen ingredients, such as cinnamates, aminobenzoic acid esters, and avobenzone, usually has a sun protection factor (SPF) of at least 4. Facial foundations that have greater coverage to camouflage underlying pigmentation defects usually have a SPF of at least 8. The inclusion of additional sunscreen agents can raise the SPF to 15. Facial foundation is an excellent, cosmetically elegant way to achieve facial photoprotection.

The photoprotection afforded by a facial foundation can be improved by applying a sunscreen-containing moisturizer or another sunscreen product beneath the pigmented layer. Because most people do not apply sun protection products in sufficient amount to achieve the labeled SPF, applying multiple product layers enhances photoprotection. The SPF of the individual products is not additive, however.

Treatment Facial Foundations

In addition to providing photoprotection, facial foundations are basically pigmented moisturizers that can deliver efficiently a variety of substances to the entire skin surface of the face. Salicylic acid is added easily to the traditional facial foundation formulations, discussed previously, to create an acne treatment product that provides comedolysis while covering acne blemishes. Vitamins, such as panthenol, niacinamide, and vitamin E, can be added to create a facial foundation that moisturizes the skin surface while enhancing barrier function, yet provides other cosmetic benefits. Because facial foundation remains in direct contact with the skin surface for an extended period of time, it affects the functioning of the skin to a greater degree than any other colored facial cosmetic.

Types of Facial Foundations

Facial foundations are available in a variety of forms: liquid, mousse, water-containing cream, souffle, anhydrous cream, stick, cake, and shake 10tion.~ Liquid formulations are most popular because they are the easiest to apply, provide sheer-to-moderate coverage, and create a natural appearance. As previously mentioned, they contain mainly water, oils, and titanium dioxide. If the liquid is aerosolized, a foam foundation known as a mousse is produced.

Cream foundations have the additional ingredient of wax, which makes a thicker, occlusive, more moisturizing formula. It is also possible to incorporate increased concentrations of iron oxide into a cream formula, creating a product with better coverage to camouflage underlying pigmentation defects. Most camouflage cosmetics are formulated as creams for this reason.

Several variations on the cream foundation are currently marketed. Whipping the cream produces a souffle foundation. Souffle foundations do not have the coverage of a cream foundation, but they are lighter weight and somewhat easier to apply. Souffl6 formulations are popular among foundations developed for women of color. Another variation is an anhydrous cream, containing no water, that provides more occlusion and superior, longer-lasting coverage. These products are used for theatrical purposes and for surgical camouflage. If the cream contains a large amount of wax, the foundation can be extruded into a rod and packaged in a roll-up tube. These are stick foundations. The product also can be poured into a tin, the most common packaging for theatrical foundations used by men and women.

Another type of facial foundation is known as a creamlpowder, consisting of talc, kaolin, precipitated chalk, zinc oxide, and titanium dioxide compressed into a cake that is applied to the skin with a dry sponge (powder) or moistened sponge (cream). Some newer facial foundations are strictly powders that are applied with a dry sponge to the face. Other formulations are creams that are wiped from a compact, without the addition of water. This foundation type is popular in Asia but also is found in the United States.

Shake lotions, representing some of the oldest facial foundation formulations, are pigmented talc suspended in water and solvents that evaporate, leaving a thin layer of powder on the face. These foundations are still used because their simple formulation and few ingredients make them ideal for patients with sensitive skin or numerous contact allergies.
This tremendous variety in facial foundation formulation means that there is a product available for the unique needs of each female consumer who wishes to add color, cover blemishes, or achieve adequate camouflaging.

Dermatologic Uses

The primary dermatologic use of facial foundation is to provide camouflage for underlying pigment and contour defects of the face. This is a broad topic, and a complete section has been devoted to camouflaging techniques later in this article.

FACIAL POWDERS

Many women apply a face powder after application of a facial foundation. Facial powders are a valuable cosmetic to provide coverage of complexion imperfections, oil control, a matte finish, and increased tactile smoothness to the skin. Originally, facial powder was applied over a moisturizer to function as a type of powdered foundation. Liquid foundations have largely replaced the powdered foundation, as discussed previously, but for patients who wish sheer coverage with excellent oil control, a powdered foundation performs excellently. An appropriate moisturizer for the patientís skin type is applied first and allowed to set or dry, followed by application of a full-coverage, translucent powder. This section reviews some of the finer points regarding facial powder formulation, application, related specialty products, and unique dermatologic uses.

Formulation

Full-coverage powders contain predominantly talc, known as hydrated magnesium silicate, and increased amounts of covering pigments. The covering pigments used in face powder are listed in order of increasing opaqueness in Table 2. It generally is accepted that the optimal opacity is achieved with a particle size of 0.25 p. Magnesium carbonate also can be used to improve oil blotting, to keep the powder fluffy, and to absorb any added perfume. Kaolin (hydrated aluminum silicate) also may function to absorb oil and perspiration. Full-coverage facial powders usually are packaged in a compact and applied to the face with a puff.

Transparent facial powders are more popular today to add coverage and to improve oil-blotting abilities of a previously applied liquid foundation. Transparent powders have the same formulation as full-coverage powders except that they contain less talc, titanium dioxide, or zinc oxide because coverage is not a priority. Transparent facial powders commonly have a light shine, produced by nacreous pigments, such as bismuth oxychloride, mica, titanium dioxide-coated mica, or crystalline calcium carbonate.

Facial powder usually uses iron oxides as the main pigment, but other inorganic pigments, such as ultramarines, chrome oxide, and chrome hydrate, also may be used. These powders are designed to augment the underlying skin and foundation tones; transparent powders can be used by patients who have difficulty finding an appropriately tinted facial foundation.

Application

Facial powders are removed from a compact with a puff or dusted loosely from a container with a brush. They impart a matte finish to the face. Patients who desire a shiny or moist semimatte facial appearance should avoid powder because it absorbs the oil in the foundation, destroying the dewy look. Patients with dry complexions also may wish to avoid facial powder because it can dry the skin further. The oil-absorbing abilities of facial powder are extremely valuable, however, in the patient with an oily complexion prone to develop a facial shine.

Related Specialty Products

A variety of specialty powders are designed for unique cosmetic needs. Body powder, for example, usually contains no pigment, but increased absorptive qualities to absorb perspiration in intertriginous areas. Decorative powders for the body, neck, and shoulders contain light reflective materials to add sparkle and shine for added cosmetic interest. There are also face powders that are intended to set waterproof camouflaging facial foundations, which are discussed in detail later.

Dermatologic Uses

Face powder is valuable to the dermatologist to enhance coverage of underlying pigmentation disorders and to absorb oil, especially in the sebum-rich T zone. Face powder can improve the sun-protective qualities of a sunscreen or facial foundation by providing additional physical sunscreening agents on the skin surface. One of the most important qualities of face powder is its ability to allow other facial products to remain in place. For example, one of the biggest reasons patients sunburn while wearing facial sunscreen is the failure of the sunscreen to remain in place on the face. Perspiration and sebum float the sunscreen away from its application site with time. Further movement occurs as the skin surface is wiped. Powder can increase the time the sunscreen remains in place by absorbing oil and sebum as well as physically preventing movement. Powder is valuable as a setting agent over any cosmetic or skin care product applied to the face.

FACIAL BLUSHES

Facial blushes, also known as rouges, are designed to enhance rosy cheek color. In many cases, rosy cheeks simply indicate vasomotor instability or fine telangiectatic mats from actinic damage; however, cheek color remains fashionable. Blushes are available in colors from red to pink to orange to brown, depending on the wishes of the consumer. Many different surface characteristics also are imparted to blushes, from a matte finish, to a frosted shine, to a metallic glow, depending on current fashion trends. Blush is an important cosmetic to add color to an aging face or to camouflage the unattractive facial redness that accompanies rosacea.

Formulation

Blush and rouge are synonyms for a cosmetic designed to add color to the cheeks, but to many consumers blush denotes a powdered product, whereas rouge denotes a cream product. Powdered blushes are more popular and are formulated identically to compact face powder except for the addition of more vivid pigments. Because color rather than coverage is desired, powdered blushes do not contain much zinc oxide. Cream rouges are formulated similar to anhydrous foundations, discussed previously, which contain light esters, waxes, mineral oil, titanium dioxide, and pigments. 6
Youthful patients may prefer the cream rouge because facial foundation and other colored cosmetics usually are not worn at a young age. The cream rouge gives the face natural color without the appearance of wearing makeup. Older patients, who wear facial foundation and powder, usually prefer a powder blush because the product is dusted easily over the cheeks, and blending is not necessary.

Application

Blush is applied to the upper part of the cheek to add color and to draw attention to high cheek bones, currently considered a sign of female facial beauty. For a natural appearance, cheek color should be applied beginning at a point directly beneath the pupil on the fleshy part of the cheek, sweeping upward beyond the lateral eye.
Proper blush placement is important because applying the color too low on the cheek can give a clownlike appearance. It is also important to apply less rather than more blush with a puffy brush to blend the vivid color into the surrounding skin.

Dermatologic Uses

There are several dermatologic uses for blush. First, powder blush can be used to absorb oil in patients in whom oil control is important. If the blush is used for this purpose, a small amount should be dusted over the upper cheeks and on the central forehead and chin. Second, blush can be used in elderly patients to add color to a sallow face. Third, blush can serve as a camouflaging cosmetic for patients with rosacea, in whom better blending of facial erythema can create an improved appearance.

FACIAL COSMETICS FOR CAMOUFLAGING

Special facial color cosmetics are available for individuals with acquired or congenital contour and color defects of the face. These cosmetics are known as camouflage cosmetics because they attempt to recreate a more attractive appearance. They do not duplicate the appearance of a freshly washed, unadorned face, however. It is obvious to all that the individual is wearing a cosmetic. Camouflage cosmetics are designed to minimize facial defects, while accentuating attractive features of the face.

Camouflaging cosmetics are used by paramedical camouflage artists, estheticians, dermatologists, plastic surgeons, and cosmetic consultants5. Teir successful use requires a well-formulated, quality product applied with the skill of a stage-makeup technician and the artistic abilities of a painter.' This section discusses the types of facial defects suitable for camouflaging, the variety of camouflage cosmetics manufactured, the various formulations of camouflaging cosmetics, and the theory behind their artistic application.

Facial Defects

Key to understanding the use of camouflage cosmetics is a basic discussion of the types of facial defects that can occur. There are defects of contour, pigmentation, or a combination of both.3

Contour Defects

Defects of contour are defined as areas where the damaged or scarred skin is higher (hypertrophic) or lower (atrophic) than the surrounding normal tissue. The scar tissue also may possess a different texture than the surrounding skin. For example, follicular ostia may be lacking and give the skin a smooth, shiny appearance. In hairy areas, such as the male cheeks, the absence of the normal beard stubble creates an abnormal contour.

Table 3
Facial Color Disease Process Foundation Color
Red Psoriasis, lupus, rosacea Green undercover foundation
Yellow Solar elastosis, chemotherapy, dialysis Purple undercover foundation
Brown hyperpigmentation Chloasma, lentignes, nevi White undercover foundation
Hypopigmentation and depigmentation Postinflammatory, congenital, vitiligo Brown undercover foundation
Pigmentation Defects

Pigmentation defects are abnormalities solely in the color of the skin with no texture abnormalities. Table 3 lists examples of pigmentation defects frequently encountered by dermatologists. Pigmentation abnormalities arise from tumors of the skin, systemic disease, or extrinsic effects, such as sun exposure.

Contour Abnormality Camouflaging

The correction of abnormal facial surface contours is based on the principle that dark colors make protuberances appear to recede, whereas light colors make surface depressions appear more shallow. Creating an evenappearing surface on a scarred face is achieved through artistic shading. Powdered blush-type products are suited best for this purpose. Areas of the face that need to be lightened should be brushed with a light pink or peach pearled blush or buffer. Areas of the face that need to be darkened should be brushed with a deep plum or bronze matte finish blush or highlighter.

These same principles can be used to optimize the shape of the face, the size of the forehead and chin, or the contour of the nose, based on established concepts of the perfect facial proportions. The perfect facial shape is oval and symmetric about the midline. An oval face is 1.5 times as long as it is wide and should taper gradually from its widest dimension at the forehead to its smallest dimension at the chin. The face should be divided into equal thirds from superior to inferior: forehead to the glabella, glabella to the subnasale, and subnasale to the base of the chin. The face should divide equally into fifths from ear to ear, with each fifth being the width of one eye.

A round face can be camouflaged to appear to more oval by shading the lateral margins with a darker-colored blush to deemphasize the increased width. An oblong face is shaded with a darkly colored blush along the forehead and chin to deemphasize the increased length. A square face is darkened bilaterally at the jaws.

This same shading technique can be used to correct a poorly formed forehead and chin. Low-set foreheads should have a light blush applied beneath the hairline, whereas high foreheads should have a dark blush applied at this location. A receding chin should have a light blush applied at the tip and sides. A double chin should be shaded with a dark blush under the entire jawbone.

The artistic application of facial cosmetics is no substitute for a perfect face, and in some cases patients should be advised to conside; surgical revision. Facial cosmetics also can be used to camouflage color abnormalities.

Color Abnormality Camouflaging

Pigmentation defects can be camouflaged by applying an opaque cosmetic that allows none of the abnormal underlying skin tones to be appreciated or by applying foundations of complementary colors. For example, red pigmentation defects can be camouflaged by applying a green foundation, which is the complementary color to red. The blending of the red skin with the green foundation yields a brown tone, which can be covered readily by a more conventional facial foundation. Yellow skin tones can be blended with a complementary colored purple foundation to also yield brown tones. Skin areas that are lighter or darker than desired can be camouflaged by applying facial foundations with the appropriate amount of brown pigment to hide the defect. Table 3 summarizes these colorblending techniques.

Product Selection

Many companies in the United States and Europe manufacture cosmetics specifically designed for camouflaging purposes. The appendix at the end of this article lists some of the more popular products presently available. Some products are available only from the manufacturer; however, Dermablend and Lydia OíLeary Covermark are available in chain department stores. A good camouflage artist generally purchases a color palette from at least two different companies to provide the necessary mixture of cosmetic shades for matching a given patientís skin tone.

Application Technique for Camouflaging Facial Foundations

The most popular camouflage facial foundations are the creamy products, discussed previously under general facial foundations, which are scooped from a jar or tin with a spatula and applied to the hand for warming. These products are the easiest to use because they exhibit a long playtime, good blending characteristics, minimal application skill, excellent coverage, and adequate wearability for most individuals.

Initially a makeup base must be selected that is closest to the patientís natural skin color. Blending usually is necessary, but no more than three colors should be combined because this produces muddy final color quality. If the patient has an underlying pigmentation problem, this counts as one color.

Once the closest foundation color has been selected, it may necessary to blend in yellow, if the individual has a sallow complexion, or reds, if the patient has a ruddy complexion. All facial tones should be represented in the final foundation blend if a good color match is to be obtained. Blending is accomplished by applying a small amount of the makeup to the back of the hand. The hand provide a good surface for blending that can be held up to the face easily to evaluate the color match and warms the product, which allows easier mixing and application.

The final foundation color mix is then dabbed, not rubbed, over the scarred area, then applied from the central face outward into the hairline for approximately Ď/4 inch and blended over the ears and beneath the chin. It is necessary to feather the cosmetic where application ends to achieve a more natural appearance. The importance of dabbing cannot be overemphasized because scars do not contain appendageal structures, such as follicular ostia, that are necessary for good makeup as it is applied. The cosmetic should be pressed into the skin and allowed to dry 5 minutes.

After this brief drying period, the cosmetic must be set with an unpigmented, finely ground, talc-based face powder to prevent smudging, improve wearability, provide waterproof characteristics, and impart a matte finish. Camouflaging makeups are designed to be worn with this powder and do not function properly without it. The powder should be pressed, not dusted, on top of the foundation.

Shading and highlighting, previously discussed, are employed to minimize the scar contour abnormalities. The camouflage foundation may accentuate the surface irregularities of the scar and normal skin structures, such as pores and wrinkles. Depressed scars usually appear darker than the surrounding skin, even though the same color foundation has been applied, because of presence of shadows. A lighter powdered rouge is applied over the scar. If the scar is elevated, a darker powdered rouge is applied. Other colored facial cosmetics (e.g., eye shadow, eyeliner, mascara) usually are necessary to give an attractive final appearance. In general, removal of camouflaging cosmetics requires more than soap-and-water washing because of the waterproof nature of the product. Most companies provide an oily cleanser for cosmetic removal, then recommend soap and water cleansing of the skin. The cosmetic should be worn only when needed and removed thoroughly at bedtime.

SUMMARY

Colored cosmetics are an important part of the dermatologic armamentarium. They can camouflage contour and pigment abnormalities, provide moisturization, enhance oil control, add sun protection, deliver barrier-enhancing agents, increase acne treatment, and create a sense of personal well-being. Familiarity with these products allows the dermatologist to provide better patient care.

References

  1. Buchman H Stage Makeup, ed 6. New York, Watson-
  2. Draelos ZK: Cosmetics in Dermatology. Edinburgh,
  3. Draelos ZK: Cosmetic camouflaging techniques. Cutis
  4. Fiedler JG: Foundation makeup. In Balsam MS, Sagarin E (eds): Cosmetics, Science and Technology, ed 2. New York, Wiley-Interscience, 1972, pp 317-334
  5. Rayner V Clinical Cosmetology: A Medical Approach to Esthetics Procedures. Albany, NY, Milady Publishing, 1993, pp 116122
  6. Schlossman ML, Feldman AJ: Fluid foundation and blush make-up. In deNavarre MG (ed): The Chemistry and Manufacture of Cosmetics. Wheaton, IL, Allured Publishing, 1988, pp 748-751