There's more to skin care than meets the eye, as anyone who has dealt with a frustrating blemish or more serious concern can attest. Individuals with darker skin 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 provide some advice that everyone can benefit from.
Challenges With Darker Skin
LTK: What are some of the challenges for people with ethnic skin types?
Dr. Strachan: People with darker skin are more prone to pigment disorders (skin discoloration). In some cases, they may happen more frequently, such as post-inflammatory hyper pigmentation after acne or eczema. In other cases, 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 and cause hair bumps and scars 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 strictly dermatological, but can involve the skin, which are more common in people of color, such as lupus and sarcoidosis.
LTK: Hyperpigmentation is another major concern. Is there anything that can be done to prevent it completely? Which treatments do you recommend for individuals who already suffer 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 help. Using sunscreen is also important.
Risk of Skin Cancer in Dark Skin
LTK: Many people think that dark-skinned individuals are less susceptible to skin cancer. What are the essential steps people with 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 people with white skin. They do, however, get skin cancer. Skin cancer in people with dark skin, particularly life-threatening melanoma, 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 people with white skin. 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.
Preventing Dry Skin
LTK: In the winter months, many people experience dry skin. What can be done to prevent and treat itchy, flaky skin?
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 you want a second shower after the gym, for example).
- Use a gentle cleanser.
- Unless you have a "dirty job," there is no reason to lather your entire body daily. Use soap on the armpits, groin and buttocks only.
- Moisturize after bathing.
- Run a humidifier or put a pan of water on the radiator.
How Diet And Stress Affect Skin
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 hair loss mostly from protein and iron deficiency. Dairy gets a bad rap, but it is mostly without evidence. One study suggested that women who drank skim milk specifically were more acne prone. Some argue that there may be some other qualities in 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; and the hormonal changes cause the acne.
Although drinking adequate amounts of water is a good thing for your overall health, it is likely more important to avoid hot water, use gentle cleansers, and use a moisturizer to prevent dry skin.
Daily Skin Care
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 regimen for everyone. Wash your 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 people with dry skin may want a cleanser that strips a bit less (such as Cetaphil).
LTK: What is the single most important thing a person can do for his or her skin?
Dr. Strachan: Wear sunscreen every day.
People with dark skin do face some definite challenges in caring for their skin, but it's not an impossible task. Following Dr. Strachan's recommendations and seeing a dermatologist as needed can help everyone maintain clearer, healthier skin, regardless of their skin type. For more information about Dr. Strachan and her services, visit her website and customized medical library to learn more about specific skin conditions.