• Properly identify the Baumann Skin Type using a validated questionnaire.
To determine a patient’s true skin type, a scientifically validated questionnaire is used to assess skin oiliness, dryness, sensitivity, uneven skin tone, and risk factors for wrinkles. When these parameters are combined, there are 16 possible Baumann Skin Types, which yield an accurate history of the patient’s skin characteristics.
• Choose products for each skin type.
There are many factors to consider in choosing what brands and SKUs (stock keeping units, in industry parlance, but particular products for our purposes) to use for each skin type. I use a brand-agnostic approach to choose the best technologies from various brands from around the world. I believe that brands often have a core competency, such as sunscreen technology, but that not all of the products in a particular line are superior. I select the best products (SKUs) from each brand, and combine and test them on various skin types to see which products and what combinations of products work best.
The following are the factors that I take into account when choosing SKUs for each Baumann Skin Type:
A. Importance of the ingredient recipe
Although the product label lists ingredients, it does not list the formulation’s recipe, which is proprietary and often patented. The "recipe" includes the order that ingredients are added in the process, the pH, the amount of each ingredient, the temperature at which the ingredient is added, and many other important factors that determine the final chemistry. Ingredients like vitamin C, green tea, and argan oil are expensive when formulated properly. Many copycat brands, such as the Walgreens and CVS knockoffs, use the same ingredients. However, they cannot use the patented recipe, and therefore their end product is different.
B. Manufacturing and packaging process
How a product is made and packaged is crucial. For example, retinol breaks down when exposed to light and air. I once visited a manufacturing plant that was stirring its "antiaging" retinol preparation in open vats. The retinol was losing its activity, which is why the product was "less irritating." The process of packaging the completed product is also important. In some cases the product is formulated in one place and shipped to another location for final packaging – and several ingredients can lose their potency during transit. Finally, the container that the product is packaged in is important. Air and light can get into tubes, affecting the efficacy of a product.
C. Ingredient interactions
The order of application and the combination of ingredients affect stability, efficacy, safety, and the chemical structure. Master formulators understand that every ingredient in the formulation matters, and there is really no such thing as an inactive ingredient. Ingredients can affect penetration and render other ingredients more or less effective depending on the order in which the ingredients are used on the skin. For example, olive oil actually increases penetration of other ingredients because it has a high content of oleic acid, while safflower oil can decrease penetration by strengthening the skin barrier.
• Design the regimen and order of application of products.
Once you have determined your patient’s skin type and matched the proper products to their skin type, you must tell them exactly how to apply them. The order in which products are applied makes a difference. Consider ingredient interactions, ingredient penetration times, and cross-reactions, plus skin type factors such as the condition of the skin barrier, sebum production, thickness of the stratum corneum, sun exposure, and bathing habits. I recommend providing a printed regimen with step-by-step instructions for morning and night.
• Educate patients.
Take the time to educate your patients on their skin issues. If you explain why you chose each product and why the particular ingredients are important, they are more likely to be compliant and get better results (and return to you for product recommendations and repurchases). Because we do not have the time to sit and explain all of these issues to each patient, we use educational newsletters that we send to patients based on their Baumann Skin Type. This helps keep them engaged and educates them about new technologies and products that are appropriate for their skin type.
• Encourage compliance.
Schedule a follow-up visit after 1 month to check on their progress and ensure compliance, and emphasize the importance of this visit. If you prescribed a retinoid, patients may experience irritation and stop using it. If you have an imaging system, baseline and follow-up photos help illustrate patients’ progress and keep them vigilant. Four weeks is a good time frame because patients tend to lose interest at that point.