Unique Needs African American hair, skin require special treatment Aug 1, 2002 By: Coriene E. Hannapel

New York - Dermatologists should be aware of cosmetics and cosmetic products for people of color, if only because their patients are quite aware of them, Victoria L. Holloway, M.D., said at the Skin of Color Center's second annual meeting here at St. Luke's-Roosevelt Hospital Center.

Two products developed for treating facial hyperpigmentation in women with skin of color were compared head-to-head in a 12-week, randomized, double-blind clinical trial. Similar improvements were achieved at all follow-ups in multiple assessments among women using a hydroquinone-based product and those randomized to apply a cream containing vitamins A, C and E.

When treating patients of color, dermatologists need to be aware of unique concerns and make an earlier diagnosis of serious problems, such as cancer, an expert says.

Although Asians are the fastest-growing population group in the United States, most dermatologists are not familiar with differences in the skin of Asians as compared to Caucasian patients. Signs of aging are different, and more delicate treatment is needed for sensitive Asian skin.

Hispanics are more prone to hyperpigmentation than their Caucasian counterparts. Another condition that is more common in Hispanics is melasma, which occurs with significant frequency in pregnant women.

Unique clinical presentations in skin cancers among ethnic people can confuse physicians and perpetuate the problem of later diagnoses and higher mortality rates in darker-skinned individuals. Physicians should be particularly careful in checking feet and hands for possible signs of skin cancer, and use care not to confuse signs with those of other conditions.

Acne, eczema, psoriasis, are all skin conditions that can cause discomfort and embarrassment. But for many patients, the worst part of these and a number of other skin ailments may be the residual pigmentation left behind even when the conditions are successfully treated.

A prospective, open-label Phase 4 study evaluated three low concentration hyaluronic acid fillers for correction of nasolabial folds in 119 persons with skin of color. The results showed clinically significant improvement was achieved and maintained in most patients during follow-up of 24 weeks. No patients experienced permanent pigmentary changes, keloids, hypertrophic scarring, or other significant adverse events.

Light and dark skin types age differently, and so the aging concerns of each skin type are very different and require different treatment approaches. Special concern must be given to darker skin due to the significantly increased risk of side effects following cosmetic procedures, including post-inflammatory hyper- and hypopigmentation, as well as keloid and hypertrophic scar formation.