Susan C Taylor, MD: Advances in Skin Care for Skin of Color

Susan C Taylor, MD

Credit: Penn Medicine

At the 2023 Fall Clinical Dermatology Conference, elected American Academy of Dermatology president, Susan C Taylor, MD, examined the advances in skin care for skin of color, with a particular focus on ingredients.¹ She discussed moisturization, exfoliation, hyperpigmentation, and photoprotection.

“My talk today centered around some of the differences between skin of color and White skin,” Taylor said in a statement to HCPLive. “For example, there are differences in the stratum corneum, differences with vitamin D, and differences with the melanosomes, which lead to pigmentary disorders and dry skin, for example, and that then leads us to suggested ingredients to remedy those problems.”

Skin of color is a term used to describe individuals with darker skin types, particularly those with Fitzpatrick skin types 4, 5, and 6. This category encompasses a diverse group of people, including Latinx or Hispanic individuals, as well as those of African, Asian, Indigenous, Native Hawaiian, and Pacific Islander descent.

There are common variations in skin color, such as darkened elbows and knees. This hyperpigmentation is considered a variant of normal and may result from factors like leaning on these areas. Another normal variation includes pigmentary demarcation lines (Type A and Type B) that affect the thighs, legs, and arms. These differences in pigmentation within the same person are part of the skin's normal characteristics.

Skin of color exhibits unique biological differences compared to lighter skin. These differences include variations in stratum corneum thickness, corneocyte size, lipid content, and melanosome distribution. Skin of color may have thicker stratum corneum and larger melanosomes with melanin distributed throughout all layers of the epidermis. These differences can impact skin conditions and treatments.

These differences can have several implications. Although patients with skin of color may have lower rates of skin cancer and less pronounced photodamage, they are more prone to pigmentation disorders, which can lead to the use of bleaching or lightening products. The differences in the dermis can lead to keloidal scarring, which is more prevalent in certain populations. Hair and hair follicle differences can result in pseudofolliculitis barbae and scalp issues.

Atopic dermatitis is more prevalent among Black children and Asian adults. Black children have a higher risk of severe atopic dermatitis compared with White children, which impacts their quality of life. Some of these differences can be attributed to variations in transepidermal water loss.

Taylor emphasized the importance of moisturizing for patients with skin of color. Moisturizers can be occlusive (reduce water evaporation), humectants (draw in moisture), and emollients (lubricate and fill crevices). Skin biology differences are considered when selecting moisturizers. Additionally, ceramides are crucial for patients with lower ceramide levels, which is common in Black individuals.

Exfoliation is vital to address some skin conditions in people of color. Some inflammatory disorders lead to hyperpigmentation, which is a common concern. Treatment for pigmentation disorders aims to reduce inflammation, inhibit melanosome transfer, exfoliate, and provide photoprotection.

Photoprotection is another crucial aspect, focused on protecting against UVA and visible light. This can be achieved with iron oxide in sunscreens and antioxidants. Photodamage manifestations can differ between lighter and darker skin tones.

There are fundamental differences in skin biology for individuals with skin of color. These differences affect the conditions they experience and the treatments they require. Luckily, innovation in skincare considers these unique factors. The introduction of proprietary ingredients with a distinct mode of action addresses the specific needs of skin of color.

References

1. ^{Taylor, S. Advances in Skin Care for Skin of Color – A Focus on Ingredients. Presented at: Fall Clinical Dermatology 2023 Conference. Las Vegas, NV. October 19 – 22, 2023.}