According to the Fitzpatrick Scale. African & Asian skin. african & asian skin 25 Colour spectrum

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1 25 Colour spectrum African & Asian skin All human skin has the same basic anatomical structure epidermis, dermis and subcutaneous layer but each racial skin type displays its own particular characteristics. Joanna Sterkowicz investigates Asian and African skin, their dermatological concerns and suitable treatments. According to the Fitzpatrick Scale numerical classification for skin colour, Asian skin ranges from III to V, with African skin falling into either V or VI. Commenting on the key features of Asian skin, Dr Marianne Duvenage, a dermatologist at Novi Skin Clinic in Pretoria, notes that it has more melanin (pigment granules) than Caucasian skin, but not more melanocytes (cells that make melanin). Wrinkling is not a feature of aging in Asian skin due to the sun-protective effects of melanin. However, the lighter-complexioned individuals do show evidence of sun damage. Asian skin is more prone to hyperpigmentation, which is the darkening of an area of skin due to the increased melanin content. It is also very prone to keloid scarring after surgery of the skin, explains Duvenage. Jacqui Faucitt, CEO of RégimA Skin Treatments, maintains that Asian skin generally has larger pores than Caucasian skin and is more prone to irritation, particularly from high fragrances and alcohol in cosmetics. Asian skin has a greater need for daily exfoliation to minimise the appearance of pores and even out skin tone and texture, she continues. Because of R online at Professional Beauty January/February 2014

2 26 the propensity for pigmentation, exfoliation must be very gentle, preferably with nightly alpha hydroxy acids and gentle natural peels. Asian skin is more prone to acne, which is usually accompanied by post-inflammatory hyperpigmentation. Other pigmentation problems include dark, patchy discoloration, sun spots or liver spots (solar lentigines), and brown wartygrowths (seborrheic keratoses), any of which may appear on the face or body. Keratosis pilaris (ingrown hairs) tend to be a problem on the upper arms and thighs and can also lead to pigmentation. She adds that generally hyperpigmentation has an earlier onset than wrinkles and laxity on Asian skin. Asians are therefore more concerned about skin lightening than they are about anti-ageing. More women consider their skin acne-prone and sensitive in the summer, particularly in humid climates, comments Faucitt. She adds that a daytime moisturiser for Asian skin is usually made with a combination skin type in mind, something that may minimise the pores, or at least not block them. The day moisturiser must contain UVA & UVB sun protection of between SPF 15 and 30, as higher factor sunscreens may cause blocking or darkening of the skin. African skin Due to the sun-protective effect of melanin, African skin is far less susceptible to sun damage than Caucasian skin, says Duvenage. She continues: Melanin is the pigment molecule that imparts the dark colour to African skin. The amount of Methodology According to Dr Robert Gobac of Dr Gobac Cosmeceuticals, racial differences in skin have been minimally investigated by objective methods and the data is often contradictory. Methods used included trans-epidermal water loss, water content, corneocyte variability, blood vessel reactivity, elastic recovery, ph gradient, lipid content, surface microflora, and microscopic evaluation of mast cell granules. Some of the most prominent differences found were that Asian and African skin has greater trans-epidermal water loss than Caucasian skin. Inflammatory acne is more common in black and Asian skin, and, therefore, will have severe repercussions on the formation of the hyperpigmentation marks that are left after acne healing. Those marks will remain for long periods of time and will often be of greater concern to the affected person than acne itself. Priori CoffeeBerry Perfecting Minerals provide protection against harmful UVA/UVB rays and are ideal for hyperpigmentation. pigment cells (melanocytes) is the same in African skin as in Caucasian skin. However, three to four times less UVA reaches the dermis in African skin than in Caucasian skin. For this reason, elastosis is very rarely seen in black skin, even in sun-exposed skin. The elastic fibres in African skin look the same as those found in sun-protected skin. Although the fat content in African skin is higher than in Caucasian skin, the former is more prone to dryness. The outer horny layer of the skin in African individuals is more compact. This protects the skin and makes it less susceptible to irritants. Dyspigmentation (pigment disorder) and lichenification (a thickening of the dermis) is more common in black skin. African skin displays far less fine lines, deep lines, laxity and overall sun damage than Caucasian skin. Duvenage concludes by pointing out that aging in African skin presents more as seborrheic keratoses (old age warts), sun freckles, mottled hyperpigmentation, and melasma/chloasma on the face, a general increase in darkness of the skin of the face and uneven skin tone. Faucitt adds that African skin is thicker than Caucasian skin due to the stratum corneum having more layers, and a more compact dermis with larger, more numerous, fibroblasts. This increased cohesiveness helps to minimise facial wrinkles and reduces potential for irritation. African skin has a greater pore size with increased sebum secretion, although lower ceramides than Caucasian skins. The increased lipids ensure high moisture levels, however they can result in an oily problematic skin, due to higher natural microbial skin flora being present. Glutathione is a natural antioxidant, which is also known to inhibit epidermal melanogenesis. African skins contain less glutathione than Caucasian skins, leading to darker skin. Post-inflammatory hyperpigmentation occurs when the skin reacts to an injury (which may include skin trauma such as: laser, deep peels, dermabrasion, over- Professional Beauty January/February 2014 online at

3 27 Expert views Jacqui Faucitt, CEO of RégimA Skin Treatments Asian skin has a greater need for daily exfoliation to minimise the appearance of pores and even out skin tone and texture. Because of the propensity for pigmentation, exfoliation must be very gentle, preferably with nightly alpha hydroxy acids and gentle natural peels. Asian skin is more prone to acne, which is usually accompanied by post-inflammatory hyperpigmentation. Dr Marianne Duvenage, dermatologist at Novi Skin Clinic Aging in African skin presents more as seborrheic keratoses (old age warts), sun freckles, mottled hyperpigmentation, and melasma/chloasma on the face, a general increase in darkness of the skin of the face and uneven skin tone. Dr Robert Gobac of Dr Gobac Cosmeceuticals Inflammatory acne is more common in African and Asian skin, and, therefore, will have severe repercussions on the formation of the hyperpigmentation marks that are left after acne healing. Increased granules in mast cells (cells in skin that act as inflammation regulators for defence purposes) in African skins will make them more reactive to inflammation. exposure to sunlight, etc) by becoming inflamed. This triggers the production of more melanin in the skin, although it is produced unevenly in spots or patches. If over-production of melanin occurs in the upper layers of skin, the spots are a darker shade of brown, if in the lower layers of skin, an ashy discoloration appears. Hyperpigmentation or post-inflammatory hyperpigmentation is more obvious in darker skins, so even a few pimples can leave residual black marks, she says. Spontaneous desquamation Gobac adds that African skin has a lower ph balance than white skin, which, in turn, should have a better defence mechanism against opportunistic infections from the skin surface. Unfortunately, the rate of spontaneous desquamation (ie. the natural process in which skin cells are sloughed away and replaced) is higher in R Professional Beauty January/February 2014

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6 30 African skin than white or Asian skin, and this will cause easier blockage of sebaceous gland ducts and the formation of acne. Inflammatory acne is more common in African and Asian skin, and, therefore, will have severe repercussions on the formation of the hyperpigmentation marks that are left after acne healing. Increased granules in mast cells (cells in skin that act as inflammation regulators for defence purposes) in African skins will make them more reactive to inflammation, explains Gobac. Faucitt maintains that whether there is a major or minor skin trauma, reducing inflammation as quickly as possible can minimise or eliminate potential scarring. Treatments Duvenage advocates the following treatments for both African and Asian skin: topical retinoic acid creams and topical and oral anti-oxidants. Laser treatments that can be done, but only with great care, include the Fraxel laser, the Pulsed Dye laser, QS Alexandritt and the QS Nd:Yag. Ablative lasers such as CO 2 and Erbium lasers are not recommended as they can easily induce postinflammatory hyperpigmentation. Microdermabrasion and superficial chemical peels are safe, while medium and deep peels require Type I (scores 0 6) Pale white; blond or red hair; blue eyes; freckles R Always burns, never tans Type II (scores 7 13) White; fair; blond or red hair; blue, green or hazel eyes R Usually burns, tans minimally Type III (scores 14 20) Cream white; fair with any hair or eye colour; quite common R Sometimes mild burn, tans uniformly Pre-procedure great care in application. Botox, hyaluronic acid fillers and body contouring treatments such as Zeltiq Coolsculpting are suitable. DermaFix treatments may safely be conducted on African and Asian skin types provided that the correct preparation protocols are adhered to. The DermaFix MelanoDerm treatment should be introduced to the client one month prior to any advanced skin resurfacing or microneedling procedure being performed. MelanoDerm works to suppress the over-stimulation of the melanocyte, thereby lowering the risk of pigmentation arising as a result of stimulation. Furthermore, the correct home care protocols should be adhered to post-treatment. These may include DermaFix DermaBright as a controllable form of AHA exfoliation to work on the texture and tone of skin, and DermaFix Vitamin Fitzpatrick scale From Wikipedia, the free encyclopedia The Fitzpatrick Scale is a numerical classification schema for the colour of skin. It was developed in 1975 by Thomas B. Fitzpatrick, a Harvard dermatologist, as a way to classify the response of different types of skin to UV light. Type IV (scores 21 27) Moderate brown; typical Mediterranean skin tone R Rarely burns, always tans well Type V (scores 28 34) Dark brown; Middle Eastern skin types R Very rarely burns, tans very easily Type VI (scores 35+) Deeply pigmented dark brown to black R Never burns, tans very easily One month post-procedure Patient treated with Scinderm s Melano MiniPeel C Serum to reduce inflammation to lower the risk of post-inflammatory hyperpigmentation flare ups. DermaFix DermaShield SPF 45 High Protection Zinc Oxide is a must in all skin-care regimes to protect against further UV stimulation and environmental assault. Another growing concern amongst this skin type group is bodybrightening and lightening. DermaFix BodyBright provides fast-acting skin brighteners to combat uneven skin tone on all areas of the body. The use of DermaFix DermaShield SPF 45 High Protection Zinc Oxide is recommended on all areas exposed to sunlight and UV radiation. Peel & Heal According to Faucitt, salon therapists should always treat African and Asian skin conditions conservatively to achieve a safe, perfect, lasting result. Experience has shown that postinflammatory hyperpigmentation can be treated extremely successfully with a series of peel & heal treatments and home care with active Vitamin C and natural AHAs nightly and daily sun protection. She notes that RégimA Peel & Heal Treatments in-salon peels of 20% and 40% have proven to be very successful and a safe alternative. The therapist must ensure that the client only uses RégimA home care if undergoing these peels, as ingredients in other products may be contra-indicated. R Professional Beauty January/February 2014 online at