Dr. Dina Strachan Discusses Ethnic Skin Care

There's more to skin care than meets the eye, as anyone who's dealt with a frustrating blemish or more serious concern can attest. Individuals face unique challenges when it comes to dealing with their skin type. We spoke with Dr. Dina Strachan, a board-certified dermatologist in New York City, to get the full scoop on ethnic skin care concerns and heed some advice that everyone can benefit from.

Dr. Dina Strachan

LTK:Thanks for taking the time to chat with us, Dr. Strachan! What are some of the challenges that ethnic skin types face?

Dr. Strachan: People with darker skin are more prone to pigmentary disorders (skin discoloration). In some cases, they may happen more frequently (such as post-inflammatory hyperpigmentation after acne or eczema) or they may happen at the same frequency but may be more noticeable (such as vitiligo).

African-Americans have particular issues around hair. As their hair tends to be more tightly curled, it may get trapped under the skin, causing hair bumps and scarring on the face and scalp. Kinky hair is more fragile, and African-Americans can have some specific grooming practices that lead to certain types of hair loss. Tinea capitis, a fungal infection of the scalp, is more common in African-American children. African-Americans are more prone to a scarring disorder resulting in keloids.

People with light brown skin, such as many Hispanic and Asian people, are more prone to developing a condition called melasma, which results in brown patches on the face. And there are other conditions that are not just dermatologic, but that can involve the skin, which are more common in people of color, such as lupus and sarcoidosis.

LTK: There are several notions associated with ethnic skin, including a suggestion that dark-skinned individuals are less susceptible to skin cancer. What are the essential steps ethnic skin types should follow when it comes to proper sun care?

Dr. Strachan: People with dark skin are, indeed, less susceptible to skin cancer than whites. They do, however, get skin cancer. Skin cancer in people with dark skin, particularly melanoma – the life-threatening kind – may present differently. Melanoma in people with dark skin occurs more commonly on the feet, hands, nails, lips and genitals. Their rates are the same as in whites. The prognosis in people with dark skin, however, is worse. This may be because they don’t think they are at risk, so they don’t check or take action fast enough.

LTK: Hyperpigmentation is another major concern. Is there anything that can be done to prevent it completely? What treatments do you recommend for individuals who are already suffering from it, not just on the face but on the body, too?

Dr. Strachan: Assuming that you mean post-inflammatory hyperpigmentation, the best treatment is to control the underlying condition such as acne or eczema. Depending on the cause, prescription strength hydroquinone (a bleaching agent), retinoids, glycolic acid, salicylic acid and chemical peels can also help. Using sunscreen is also important.

LTK: With winter on the horizon, many will soon face the dreaded dry skin that comes with brutal winds and dropping temperatures. Sometimes it seems impossible to alleviate itchy, flaky skin! What can be done?

Dr. Strachan: Dry winter skin occurs for a number of reasons. The cold air outside is dry. The heated air inside is dry. For relief from the cold, people like to take long, hot showers or baths. My tips for preventing “winter itch” are as follows:

• Limit baths or showers to one a day for 10 minutes (just rinse if one wants a second shower after the gym, for example).
• Use a gentle cleanser.
• Unless you have a “dirty job,” there is no reason to lather one’s entire body daily. Use soap on the armpits, groin and buttocks only.
• Moisturize after bathing.
• Get a humidifier or put a pan of water on the radiator.

LTK: In terms of basic daily care, what are your regimen recommendations for oily, dry, sensitive and combination skin types?

Dr. Strachan: I recommend a very basic skin care regime for everyone. Wash one’s face twice a day with a gentle cleanser and follow with a moisturizer (with sunscreen during the day). Even among the “gentle cleansers,” some are more stripping than others. People with oily skin may want a cleanser that strips a bit more (such as Purpose), and those with dry skin may want one that strips a bit less (such as Cetaphil).

LTK: It's often said that diet and stress management are also related to the condition of the skin. To what extent do you think this is true – and does it have a greater bearing on the skin than a proper regimen involving treatments and using the right products?

Dr. Strachan: Stress has been shown to impact conditions such as acne, atopic dermatitis (eczema), seborrheic dermatitis and hives. The effect of diet in many cases is unclear. Food allergies can play a role in eczema (especially in children). Nutritional deficiencies can cause a variety of problems, such as scurvy, that involve the skin, hair and nails.

In the U.S., we probably see mostly hair loss from protein and iron deficiency. Dairy gets a bad rap but it is mostly without evidence. One study suggested that women who drank specifically skim milk were more acne prone. Some argue that there may be some other qualities of women who drink skim milk that explain why they get acne. Chocolate itself has not been shown to cause acne. It’s probably the fact that women crave chocolate before their periods; the hormonal changes cause the acne.

Although drinking adequate amounts of water is a good thing for one’s overall health, to prevent dry skin, it is likely more important to avoid hot water, use gentle cleansers and to use a moisturizer.

LTK: What is the single most important thing a person can do for his or her skin?

Dr. Strachan: Wear sunscreen every day.

For more information about Dr. Strachan and her services, visit her Web site and customized medical library to learn more about specific skin conditions.

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