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At the American Academy of Dermatology's Summer Academy Meeting 2008 inChicago, dermatologist Valerie D. Callender, MD, FAAD, clinical assistantprofessor of dermatology at Howard University College of Medicine inWashington, D.C., discussed the importance of early intervention in treatingacne and rosacea in patients with skin of color.
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"As we become a more diverse population with lots of different skin typesand tones, we also are seeing an increase in skin concerns that, while notnew, are affecting more and more people with darker skin," said Dr. Callender."Even skin conditions like acne and rosacea can create pigmentation problemsin these patients, which can be very hard to treat. However, these problemscan be improved by seeing a dermatologist who is trained to properly diagnosethese conditions and to carefully consider a patient's potential risk of skinirritation."
Dr. Callender explained that people with skin of color have diverse ethnicbackgrounds, which is why there is such a wide range of skin types. Thosewith pigmented skin include African-Americans, Asians, Hispanics/Latinos,Middle Easterners, and Native Indians.
Acne: Early and Aggressive Management is Key
While acne is considered the most common skin condition in the UnitedStates, there is no cure for this bothersome condition and problems can remainlong after the pimples and pustules have cleared -- particularly indarker-skinned patients. Post-inflammatory hyperpigmentation (commonlyreferred to as dark spots or blemishes) is a concern for these acne patients,as the irritation the skin experiences from acne lesions can leave their markin the form of long-lasting skin discoloration.
Topical retinoids, which Dr. Callender considers the mainstay of treatmentin acne patients of color, have been shown effective in clearing acne lesionswhile also reducing the occurrence of post-inflammatory hyperpigmentation.Tretinoin, tazarotene and adapalene are three commonly prescribed topicalretinoids that Dr. Callender recommends for her patients. She explained thatcombining one of these topical retinoids with other effective acne medications-- such as a benzoyl peroxide and oral antibiotic combinations -- can enhanceresults.
"One combination topical retinoid containing tretinoin and clindamycinworks great for darker-skinned acne patients because clindamycin reduces theinflammation of acne lesions," said Dr. Callender. "Your dermatologist candetermine the best treatment regimen based on your skin type and severity ofacne."
In addition, chemical peels and microdermabrasion can be used for acne andresulting pigmentation problems. For example, Dr. Callender noted thatchemical peels containing salicylic acid penetrate into the follicle whereacne starts and unclogs the follicle -- leading to an improvement in acne.Dr. Callender cautioned that these procedures should only be performed by adermatologist or another qualified physician since these procedures couldactually harm the skin if performed improperly.
Fractional laser resurfacing also has been found to be safe for treatingacne scars in patients of color. However, Dr. Callender recommended thatmicrodermabrasion and chemical peels should be tried before fractional laserresurfacing for treating superficial acne scars.
Rosacea: Proper Diagnosis is Important First Step
Rosacea, the chronic skin disease characterized by redness, flushing andprominent blood vessels of the face, is thou
