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.

Topical retinoid treatment is the mainstay of acne management in ethnic skin, as it is in fairer individuals. However, additional considerations are needed to address the unique postinflammatory sequelæ in dark skin and precipitating factors for acne eruptions.

Vitiligo in patients with skin of color can have devastating psychosocial consequences. A variety of newer therapeutic options are improving management for patients with disease manifestation ranging across the spectrum, from localized to general.

Although there is a lot of ongoing research into rosacea and a number of FDA-approved medications, very little of either have to do with skin of color. Research protocols have not included ethnic skin, and medications were approved before the FDA required the inclusion of ethnic subjects.

A multicenter study enrolling 100 patients investigated the safety of calcium hydroxylapatite microspheres (Radiesse, BioForm) injection for treatment of nasolabial folds. After follow-up to six months, there were no clinically significant adverse reactions, including no cases of keloids, hypertrophic scarring or hypo- or hyperpigmentation.

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.

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.

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.