FAC Facial Aesthetics Skin Evaluation & Treatment Techniques 3 — Questions and Answers
Question 1: Which skin characteristic is the primary risk factor for post-inflammatory hyperpigmentation (PIH) following aesthetic procedures?
- High Fitzpatrick skin type (IV–VI) (Correct answer)
- Presence of rosacea
- Low TEWL baseline
- Thin stratum corneum
Correct answer: High Fitzpatrick skin type (IV–VI)
Darker skin phototypes (Fitzpatrick IV–VI) have more reactive melanocytes and are significantly more prone to PIH after inflammation or procedural trauma.
Question 2: The Rubin classification of facial aging is specifically based on which criteria?
- Volume deflation and fat compartment loss
- Histologic epidermal thickness
- Depth of photoaging changes in skin layers (Correct answer)
- Number of dynamic versus static rhytids
Correct answer: Depth of photoaging changes in skin layers
Rubin's classification categorizes photoaging by histologic depth — epidermal changes (Level 1), dermal collagen damage (Level 2), and subcutaneous involvement (Level 3).
Question 3: When evaluating a patient for microneedling, which skin condition is an absolute contraindication?
- Mild facial acne scarring
- Active acne vulgaris with open lesions (Correct answer)
- Enlarged pores with oily skin
- Superficial fine lines
Correct answer: Active acne vulgaris with open lesions
Active acne with open or inflamed lesions is an absolute contraindication to microneedling due to risk of bacterial spread and worsening infection.
Question 4: Hyaluronic acid fillers exert their volumizing effect primarily through which mechanism?
- Stimulating neocollagenesis in the deep dermis
- Binding water molecules and expanding in tissue (Correct answer)
- Replacing lost subcutaneous fat directly
- Cross-linking existing elastin fibers
Correct answer: Binding water molecules and expanding in tissue
Hyaluronic acid is hygroscopic and can bind up to 1,000 times its weight in water, providing immediate volumization by hydrating and expanding within the tissue.
Question 5: A patient presents with solar lentigines and mild superficial rhytids. Which treatment approach addresses both concerns simultaneously?
- Hydroquinone monotherapy
- Intense pulsed light (IPL) therapy (Correct answer)
- Dermal filler injection
- Botulinum toxin type A
Correct answer: Intense pulsed light (IPL) therapy
IPL targets both melanin (reducing lentigines) and stimulates dermal collagen remodeling, making it effective for addressing pigmentation and mild textural changes together.
Question 6: In the context of skin evaluation, the term 'rhytid' specifically refers to:
- A pigmented macule caused by UV exposure
- A wrinkle or crease in the skin (Correct answer)
- Dilated cutaneous blood vessels
- Thickened, leathery skin texture
Correct answer: A wrinkle or crease in the skin
A rhytid is the medical term for a wrinkle or skin crease resulting from repeated muscle movement, volume loss, or photoaging.
Question 7: Which complication is specifically associated with superficial placement of hyaluronic acid filler in the periorbital region?
- Granuloma formation
- Tyndall effect causing bluish discoloration (Correct answer)
- Immediate necrosis
- Nerve compression neuropathy
Correct answer: Tyndall effect causing bluish discoloration
The Tyndall effect occurs when HA filler is placed too superficially in thin periorbital skin, causing light scattering that produces a bluish-gray discoloration.
FAC Facial Aesthetics Skin Evaluation & Treatment Techniques 3
Which skin characteristic is the primary risk factor for post-inflammatory hyperpigmentation (PIH) following aesthetic procedures?