The top five cosmeceuticals for ethnic skin are vitamin C, hydroquinone, tretinoin, sunblock and salicylic acid, an expert says. In recommending cosmeceutical ingredients for patients, she says dermatologists must consider differences in aging and skin responses between ethnic and lighter skin types.
By 2050, half of all Americans will have some ethnic skin component, says Wendy E. Roberts, M.D., a Rancho Mirage, Calif., dermatologist in private practice at Desert Dermatology.
Thirty years ago, Dr. Roberts says, "We thought all creams had the same impact regardless of skin type."
Now, researchers have come to appreciate that certain cosmeceuticals possess measurable activity that can vary between skin types.
This knowledge assumes increasing importance as dermatologists expand their use of cosmeceuticals in treating medical conditions such as acne, postinflammatory hyperpigmentation (PIH), eczema and xerosis, Dr. Roberts tells Dermatology Times.
Dermatologists also must appreciate that, in some ways, ethnic skin ages differently than lighter skin.
Solar lentigines and dysplastic nevi also impact ethnic skin, she says. Therefore, "Photoprotection is critical in all skin types, including ethnic skin."
In treating ethnic skin, dermatologists' chief concerns include gauging the efficacy of cosmeceuticals in these skin types, Dr. Roberts says.
In analyzing study design, she says, one must consider variables including population size and diversity of skin types, as well as whether research reveals statistically significant differences in a product's activity in one skin type versus another.
"Look at claims such as increased elasticity," Dr. Roberts says. "Does that mean researchers are looking histologically at tissue and seeing an increase in elastin fibers? Or is this just a measurement from feeling a person's skin?"
Other concerns include product vehicles, which Dr. Roberts says are important because ethnic skin possesses a bit of hypersensitivity when it comes to products that can dry or irritate the skin.
Moreover, she says, patients who look Caucasian may have darker-skinned ancestry, which could cause their skin to react unfavorably to strong acids or harsh vehicles.
Accordingly, Dr. Roberts says, "I like to have a cosmeceutical in every vehicle." Examples include vitamin C and hydroquinone.
"Retinoids provide the foundation for youthful skin. They're important in jump-starting the skin toward repair, and they work very well with other cosmeceuticals," Dr. Roberts says.
Retinoids also inhibit tyrosinase, thereby contributing to a decrease in pigmentation, she says.
"Retinoids also accomplish lightening through desquamation," she adds.
Prescription products that contain retinoids include Retin-A Micro (tretinoin, OrthoNeutrogena), Tazorac (tazarotene, Allergan) and Renova (tretinoin, OrthoNeutrogena).