By 2050, more than 50 percent of the US population will have skin of color, and dermatologists like Seemal R. Desai, MD, a Clinical Assistant Professor of Dermatology at The University of Texas Southwestern Medical Center, and the Founder and Medical Director of Innovative Dermatology in Dallas, Texas, are on the front lines when it comes to addressing cosmetic and medical skin issues in these individuals. People with skin of color include African Americans, Asians, Hispanics or Latinos, Native Indians and Pacific Islanders primarily, as well as individuals from these groups who have intermarried. They can have different skin concerns and aesthetic goals and responses to common treatments when competed with their lighter-skinned counterparts.
Skin color is determined by a pigment called melanin which is made by melanocytes. The amount and type of melanin determines a person’s skin color.
Desai spoke with Beauty in the Bag about pigment disorders and how to treat some common concerns seen among people with skin of color.
Here’s what he had to say:
1.Is the skin bleaching agent hydroquinone (HQ) safe in ethnic or darker skin?
Yes, HQ is safe. Make sure to pair the HQ with a really good physical blocker sunscreen. I like physical sunscreens better than chemical sunscreens to avoid any potential allergy. The HQ should be used at night, and the sunscreen throughout the day. One tip: HQ can be irritating, even if it is just used on its own without a retinoid/retinol-based product. Therefore, you may want to start off applying the HQ every other night for two to three -weeks and then work up to nightly. Also, HQ is a bleaching agent so it will lighten your normal skin tone just like it will hopefully lighten the hyperpigmentation. Be careful where you apply it. For example, let’s say you have a patch of melasma (dark skin discoloration) on your cheek. I suggest using a Q-tip to “outline” the patch of darkness with the HQ topical to better visualize where to apply the medication allowing it be localized only to the patch of dark skin.
2. What natural products may help with melasma?
I like Arbutin, Zinc, Kojic Acid. I like Kojic Acid in 3% prescription-strength concentration. It is not that expensive, You can get lower strengths over the counter (OTC). My go-to OTC natural product for melasma and other pigmentary disorders now is actually a pill. I like Polypodium leucotomas (Heliocare). It is a dietary oral supplement. Think of it like a vitamin. It is a natural antioxidant that has many properties including UV protection. I am fan of it, and for all the natural-product lovers out there, it’s an extract of a fern!
3. Why are mandelic acid peels your new go-to in treating skin of color?
I love mandelic acid because of its molecular size. What that means is that it is a larger molecule, which allows it to penetrate the skin more evenly and thoroughly and thereby decreasing a chance of extensive damage and burn. This can be very helpful in skin of color. I sometimes also call it an “event peel” because it does not have lots of irritation and thereby often can be done a couple of days before a big event. Some nice studies done in Asia show us how mandelic acid works for melasma and post inflammatory hyperpigmentation