NIC Esthetician Written ExamTreatment ProceduresHard

A client with Fitzpatrick skin type IV is undergoing a series of chemical peels to address hyperpigmentation. Which of the following ingredients should the esthetician be MOST cautious about using in high concentrations due to the increased risk of Post-Inflammatory Hyperpigmentation (PIH) in darker skin types?

  1. ASalicylic acid
  2. BMandelic acid
  3. CLactic acid
  4. DGlycolic acid
Show answer & explanation

Correct answer: D. Glycolic acid

Glycolic acid, with its small molecular size, penetrates deeply and rapidly, increasing the risk of inflammation and subsequent PIH in darker skin types (Fitzpatrick IV-VI) if used in high concentrations or aggressively. Lactic and Mandelic acids are generally safer due to larger molecular size and slower penetration.

Why the other options are wrong

  • A. Salicylic acid is a BHA, effective for acne, but its PIH risk is generally lower than high-concentration glycolic acid for its anti-inflammatory properties.
  • B. Mandelic acid has the largest molecular size among AHAs, making it very gentle and suitable for darker skin types with less PIH risk.
  • C. Lactic acid has a larger molecular size and is generally gentler, posing less risk of PIH.

Post-Inflammatory Hyperpigmentation (PIH)

Darkening of the skin that occurs after an inflammatory injury or trauma to the skin, common in darker skin types.

  • More prevalent in Fitzpatrick skin types III-VI
  • Can be triggered by aggressive treatments or sun exposure
  • Important consideration when selecting chemical peel types

Memory trick: Glycolic's Grip Gets Deep, PIH can Leap.

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