Photo Credit: med.nyu.edu
Treating skin of color is known to be challenging as it has different properties which can lead to unique skin conditions, but Nada Elbuluk, M.D, an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center in New York City, is more than up for the task. In fact, she welcomes it. Elbuluk specializes in the treatment of skin and color as well as pigmentary disorders including vitiligo and melasma.
She received her bachelor’s degree in psychology from Princeton University in New Jersey, where she also minored in Gender studies and African American studies. She earned her medical degree with a distinction in research at the University of Michigan in Ann Arbor. While there Elbuluk received a National Institutes of Health award that allowed her to also obtain a Master of Science in Clinical Research from the University of Michigan School of Public Health. She then completed her dermatology residency at Johns Hopkins Hospital in Baltimore. Elbuluk served as a clinical educator fellow and clinical instructor at The University of Pennsylvania in Philadelphia before joining New York University Langone Medical Center.
She talked to Beauty in the Bag about the challenges of treating skin of color, what she can offer her patients today as well as what she does every day to keep her skin looking so radiant.
Here’s what Elbuluk had to say:
What is different about skin of color?
Skin of color has more pigment also known as melanin. This increase in melanin can be a challenge in treating skin of color since any inflammation or trauma to the skin can lead to an decrease or increase in the amount of pigment, which is called hypo- or hyperpigmentation. When doing any procedure in skin color, we have to be mindful of this predisposition because the goal is to treat the condition without altering the individual’s baseline pigmentation.
How do you approach acne in skin of color?
I try to use a combination approach which often includes topical washes and creams as well as oral medications if needed. In some individuals, I also do chemical peels I like to choose treatments which I know can help with the acne and the dark spots which can be left behind from acne.
Tell us about melasma.
Also known as the mask of pregnancy, melasma is a pigmentary disorder. We know hormonal changes such as oral contraceptives, pregnancy, and hormone replacement therapy, as well as ultraviolet radiation from the sun play a role in triggering melasma. Although men can get it too, approximately 90% of people with melasma are women. It affects all races but is more common in skin of color. Melasma is a frustrating condition because it can frequently recur. A person can spend months clearing their melasma and then if they spend one day in the sun without sun protection, it can come back. Patients must be extremely diligent about sun protection year round to maintain the benefits of melasma treatment.
What’s new in melasma treatment today?
Topical retinoids, hydroquinone, and topical steroids, often used in combination are still the mainstays. Today, we also have many nonhydroquinone- based creams many of which come from natural sources, that are also being successfully used. Procedures such as chemical peels are also a mainstay in treatment and can be combined with creams.
Lasers are a mixed bag. Some people have used them successfully to treat melasma, but others say the rebound pigmentation is worse than the initial melasma. With more research, we will figure out the right devices and parameters that work best. Stay tuned.
What is the new thinking about vitiligo?
In vitiligo, people lose pigmentation. It occurs equally in all races and genders, but can be more obvious in the skin of color population. We know it is an autoimmmune disease that occurs when a person’s antibodies attack their own melanocytes (the cells that make pigment) thinking they are foreign. Treatment may include topical steroids, topical immunomodulators and/or light therapy. Local skin grafts harvested from unaffected parts of the skin can also be effective in combination with light therapy for localized patches of vitiligo. This disease has a huge effect on a person’s quality of life. Some people with vitiligo stop working or leaving their home and become depressed as a result of the disease. The psychological component of the disease is profound and treatment involves addressing this component as well.
By joining vitiligo support groups, patients can see that they are not alone. These groups provide a supportive and confidential environment in which people can share their stories and experiences with vitiligo. They can also learn more about the condition, treatment and cover-up options, as well as how to successfully live with such a visible condition.
How do you keep your complexion looking so fresh and clear?
It’s a pretty simple regimen. I wash my face twice a day in the morning and night with a gentle cleanser. I use a moisturizer with a sun protection factor of 30 every day and I use a retinol cream at night. This regimen helps protect against skin cancer and provides anti-aging benefits..