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| Saving Face: Sensible Skin Care |
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If you think you don't have to worry about protecting yourself from the sun because you've got a little bit of melanin in your skin think again. In fact, not only do you need to start wearing sunscreen, you may need to change your skin care routine all together. Black men often have to deal with razor bumps and other inflammatory skin conditions that are brought on by same melanin that serves as a UV protectant from the sun.
Dr. Andrew Alexis, MD, MPH, FAAD, assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons and staff member at St. Luke's-Roosevelt Hospital Center, both in New York, says. "Although people of color have more natural protection from ultraviolet (UV) radiation due to the increased amount of melanin in their skin, the cells that make melanin pigment tend to be more reactive to inflammation and injury, and therefore pigmentation problems are more common in skin of color," said Dr. Alexis. "These natural genetic factors, coupled with cultural differences in their skin and hair care practices, can result in differences in the appearance of common dermatologic conditions and the frequency in which they can occur."
Treating Pigmentation Disorders Takes Patience
The most common pigmentation problem (dyschromia) of the skin that can occur in people of color is post-inflammatory hyperpigmentation (PIH), which refers to increased pigmentation or dark spots at the sites of inflammation. Acne is one trigger for PIH, and the resulting dark spots often can be of equal or greater concern than the original pimples.
Dr. Alexis explained that although there are several effective treatments that can be used for PIH, none of these treatments are quick fixes and each requires time to take effect - from several weeks to several months in most cases. Common treatments include retinoid creams (vitamin A derivatives), bleaching creams (containing hydroquinone) and chemical peels. "While in-office procedures, such as chemical peels or any skin resurfacing cosmetic treatment, can help correct pigmentation problems, they have to be administered with caution due to the higher risk of inducing other pigmentary abnormalities," stated Dr. Alexis. "That's why it is important to consult a dermatologist with an expertise not only in using these procedures, but in treating darker skin tones as well."
A High Tech Treatment for Razor Bumps
It is well know that razor bumps, AKA pseudofolliculitis barbae, affect a disporportanate number of black men. In fact Dr. Alexis noted that several studies have reported that pseudofolliculitis barbae affects an estimated 45 to 83 percent of African-American men. The cause of this condition stems from the structure of the hair follicle, which is curved in people with skin of color. Pseudofolliculitis barbae is aggravated by shaving, as it can cause the sharp tip of shaved hair to grow back into the skin and results in a bump.
Dr. Alexis advises patients affected by pseudofolliculitis barbae to discuss ways to modify their shaving habits with their dermatologist. He also noted that there are several effective treatment options available. For example, lasers have evolved over the years and can now be safely used to reduce and remove hair in skin of color patients.
Two lasers Dr. Alexis recommends for use with darker skin are the 810 nanometer (nm) diode laser and the 1064nm Nd:YAG laser. Topical creams and gels also are effective in treating pseudofolliculitis barbae, including topical retinoids, topical antibiotics, topical steroids and the topical prescription medication eflornithine.
Dr. Alexis noted, "while people of color are prone to many unique medical and cosmetic skin conditions, dermatologists are well equipped to treat them using a variety of safe and effective treatment options, the key is to seek treatment early.
-LM
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