Do you know your skin type? With our melting pot society, it is becoming more difficult to know which product is right for your skin type or which cosmetic procedure (invasive or non-invasive) is going to give you the best results. Certain chemical peels are not good for certain skin types. Certain lasers are not right to use on certain skin types. So, how do you know?
According to a recent article in Skin Inc magazine, “Much of the world’s population is considered Fitzpatrick type IV–VI. (See Fitzpatrick Scale.) By 2050, according to the U.S. Census Bureau in 2000, 50% of Americans will be of darker-skinned racial backgrounds. One of the most common skin conditions in higher Fitzpatrick clients is hyperpigmentation. Although many of the popular treatments performed on a regular basis on Caucasians may be well-tolerated by clients with darker skin, special considerations need to be taken to ensure positive treatment outcomes for such clients. A deeper understanding of the causes of hyperpigmentation, and of the myriad of ingredients available for its treatment, will help spa professionals develop highly effective therapies for all of their clients, regardless of ethnicity.”
Within any ethnic background, a variety of Fitzpatrick skin types can be identified. Darker skin can commonly be seen in Hispanics, Latinos, Africans, African-Americans, Caribbeans, Native Americans, Pacific Islanders, East Indians, Pakistanis, Eskimos, Koreans, Chinese, Vietnamese, Filipinos, Japanese, Thai, Cambodians, Malaysians, Indonesians and Aleuts.
The most apparent difference in the skin of those from different ethnicities is, of course, the color, although there are also differences in skin thickness, vascularity, and predispositions to certain skin conditions and diseases. Hyperpigmentation can occur due to UV exposure, cutaneous trauma or hormonal fluctuations.
Melanin is the complex molecule that is responsible for the pigment in the body; specifically eyes, hair and skin. Melanin works to protect by reducing the penetration of UV rays into the skin and, even more importantly, into the nuclei of cells where DNA resides. Those with both dark and light skin have the same number of melanocytes—the cells responsible for melanogenesis or melanin production—although their level of responsiveness differs. Clients whose genetic heredity is that of global regions with extreme UV exposure have melanocytes that will, out of protective necessity, instigate the process of melanin deposition much more quickly than someone with lighter skin. Some clients with mixed genetic heritage may have lighter skin, but still have a greater predisposition for hyperpigmentation than a typical Fitzpatrick skin type I or II.
Dark skin tends to have more eumelanin. This more vigorous type of melanin contributes to the increased occurrence of hyperpigmentation in darker skin.Those with fairer skin, and especially red hair, will predominantly have pheomelanin. The final color of a person’s skin will be slightly different based on the ratio of eumelanin to pheomelanin, as well as the quantity of sustained UV exposure to which their skin is subjected.
Gentle treatment options
Many of the ingredients that are used to treat hyperpigmentation can be topically irritating. Therapeutic ingredients must be selected with care when treating clients with darker skin to avoid causing undue irritation that will worsen the condition rather than improve it.
To avoid stimulating pigment deposition, it is wise to use lower percentages of ingredients in blends to prevent melanogenesis, rather than one ingredient at a high percentage that could potentially be surface-stimulating. Hydroquinone is very effective at the low over-the-counter (OTC) percentage of 2%, especially when used in concert with other effective ingredients, such as lactic, kojic, ascorbic and azelaic acids, just to name a few. Care must be taken when using hydroquinone at 4% or higher on darker skin, as these are more irritating and can trigger post-inflammatory hyperpigmentation.
One of the most important steps in any daily care regimen or professional treatment is that of sun protection. A broad-spectrum moisturizer with an SPF of 30 or greater should be applied to all exposed areas every day and after any professional treatment. Although darker skin has more natural protection against UV exposure, this critical step cannot be omitted.
Another issue to consider is keloids. Darker skinned people may have this issue with keloid scarring. If you or a family member has had an incident of Keloiding, be sure to tell your esthetician or doctor. There is also the issue of hypopigmentation where the skin gets lighter in areas. View photos on the slideshow of each: hyperpigmentation, hypopigmentation and keloids.
Plastic Surgeons with medical estheticians on site are listed below. Consult with a medical esthetician or plastic surgeon for any procedure you are considering. You will be able to obtain medical grade skin care products from their offices.
Dr. Seth Yellin, Emory Facial Center, 5730 Glenridge Drive, Suite 230, Atlanta, GA 30328 404-303-0101
Premier Image Cosmetic Surgery, 4553 N. Shallowford Rd., Atlanta, GA 30338 770-457-6303 or 10779 Alpharetta Highway, Suite 140, Roswell, GA 30076 770-645-4310
Dr. Marisa Lawrence, 960 Johnson Ferry Road, Suite 120, Atlanta, GA 30342 404-303-7004
Dr. Brian Howard, North Fulton Plastic Surgery, 1357 Hembree Road, Suite 200, Roswell, GA 30076 770-619-9566
Dr. Carmen Kavali, 5505 Peachtree Dunwoody Road, Suite 410, Atlanta, GA 30342 404-250-3333
Seraphim Skin Care, 454 E. Paces Ferry Rd., Atlanta, GA 30305 404.266.0531
Visit each website to learn more about products, services and procedures offered at each facility. Call to make an appointment to consult with an experienced medical esthetician or with the plastic surgeon.