Patients with skin of color also have unique medical issues, which must be known and treated specifically to assure health AND beauty! Knowledge is key! Understanding your skin and body and its natural and genetic characteristics are the first steps to achieving beautiful skin and health - AND with longevity.Many of us have skin of color-increased amount and ability to manufacture pigment as a result of our genetics, in response to inflammation caused by sun, acne, injury, infection, medications, many lasers, skin products and peels, stress, hypothyroidism and hormone imbalances. Your skin may appear quite light, however skin of color includes Italian, Spanish and Hispanic, Asian, French, African, Indian and American Indian, Arab and Phillipino (THE most pigmented) heritages. Due to the movement of people over the centuries, genes have mixed and you may not realize you have pigmented skin. Examples are Russians who have Mongolian genes, Germans who have Italian genes, Irish who have American Indian genes, Northern Europeans with Spanish genes. Though you may appear to have light skin, it can still be affected when certain sources of lasers or types of procedures including threading, electrolysis and waxing or inflammatory skin products and peels are used - or your skin is harmed by a significant sunburn or internal inflammation or hormone imbalance. Skin that genetically has the heightened ability to produce pigment when melanocytes react to the inflammation by aggressively manufacturing pigment- dark spots or patches called hyperpigmentation or melasma. Pigmented heritages can also be at risk for developing vitiligo due to internal and external inflammation.

The following important information is essential for you to know in protecting and correctly treating and keeping your skin healthy and beautiful.

ABOUT MELANIN
Melanin in pigmented skin provides greater protection from the ravages of aging due to ultraviolet light (UVL). The melanin in brown skin provides a natural sun protection factor (SPF) of about 13.4 as compared to 3.4 for white skin. This natural protection from the sun means lesser or delayed damage to the skin and fewer signs of aging to a degree but does not prevent damage nor cancers. The changes that occur, as pigmented skin ages are often delayed in comparison to non-pigmented skin. This is also true because pigmented skin is generally thicker because it makes skin faster and has more collagen and oil, which decreases fine line production with age but predisposes to acne earlier in life. When aging symptoms occur, most prominent are changes in the texture of the skin (roughness), the appearance of benign growths (dermatosis papulosa nigra), pigmentation changes (dark marks or discolorations) and a loss of the volume of the skin (sagging). Pigmented skin is more sensitive and reactive to inflammation and this, combined with greater oil production makes enlarged pores more prevalent as well.

PROTECTION
Ensuring healthy skin and slowing down the ticking of the clock means protection from the sun for ALL skin types. Though the average person with darker pigmented skin has a natural SPF of 13 (which means you can theoretically stay in the sun without burning 13 times longer than a person with light skin however with the loss of ozone this is less true), we still need to include sunBLOCK in our daily skin care routine. This needs to be a habit as does layering sunBLOCK protection and remembering that sun penetrates clothing. Using sunBLOCKs rather than sunSCREENs, create a protective barrier that reflects UV rays, causing them to bounce off the skin. SunSCREEN is composed of inflammatory chemicals and does NOT prevent the sun from hitting and penetrating the skin and setting up the inflammatory response caused by UV. For most pigmented skin, a sunBLOCK is adequate although we need protective clothing, hats, etc, but if you have certain medical conditions, such as lupus, or take certain medications, or have dark marks, melasma or skin discolorations, you need to avoid the sun as much as possible which means a hat, protective clothing and layering sunBLOCKs, for example applying daily sunBLOCK then repeating every 2 hours or using mineral makeup or powdered brush sunBLOCKs.

Skin Roughness
As skin matures and is chronically inflamed by what we eat, stress, UV, hypothyroid, skin and hair products, etc, its oil and hyaluronic acid and collagen production decreases and natural exfoliation slows tremendously. Skin that was once plump, hydrated, smooth and soft becomes rough, bumpy, wrinkled, spotted and lax- especially on sun-exposed areas. The roughness is due to the slow down in production of skin cells and components and cells and melanocytes that stick together and clump and do not slough as they youthfully would. Pigmented skin prevention, health and maintenance is based on the same principles as non-pigmented because the anatomy and physiology is the same AND different but the imperative foundation is knowing, doing and using nothing that is inflammatory. The good news is if you have abnormal pigment spots or areas, enlarged pores, acne, dryness, laxity and much more, it can be repaired over time.

Dermatosis Papulosa Nigra
Benign growths occur frequently in skin of color as it matures and reacts to internal and external inflammation and free radicals. Of the benign growths, seborrheic keratoses are the most common type that appears. Dermatosis papulosa nigra (DPN), a cluster of small seborrheic keratoses, are prominently located on faces of both men and women. They are small, brown or black bumps that are sometimes mistaken for moles. Since DPNs are overall non-cancerous, they do not have to be treated but in today’s world of an epidemic of melanoma and skin cancers, it is always best to watch for changes or growth in any moles and see a dermatologist to have this checked. An ounce of prevention is worth a world of cure. DPN’s do, however, increase in number and size as skin matures and it is for these reasons that many want them treated. Generally treatment requires laser removal procedures but GREAT care must be taken to only treat the DPN’s and NOT the surrounding pigmented skin.

Pigmentation changes
There are 4 commonly occurring types of darkening.

• Localized areas
• More generalized areas
• Dark under eye circles
• Uneven skin tone

All can be repaired over time and require non-inflammatory skin products that have therapeutic concentration of ingredients designed to normalize and stabilize melanocytes, decrease inflammation and exfoliate progressively the hyperpigmented spots, treatments and technology. THE MOST IMPORTANT treatment is internally, addressing diet, nutrition, stress, hormones and lifestyle, to minimize internal inflammation, which sensitizes and perpetuates abnormal pigment, growth, oil, aging, acne and enlarged pore production. To cure any external problem requires addressing the inside because the skin is a window to what is going on internally.

Skin Cancers
Pigmented skin is at lesser but also at risk for skin cancer and early detection is imperative for everyone. Examine your skin daily as you bathe, dry off or apply products - from head to toe, paying attention to everywhere including your feet soles, nailbeds, scalp, eyes and mouth (even have your hair dresser look for moles in your hair). Have someone or look in the mirror to examine your back and shoulders well. Look for chronically crusty or concave or red or dark brown or black spots in these areas no matter how small. Pay particular attention to new spots or spots that change. The change can be an increase in size, shape or color or a raised bump that develops within the spot. A bump on the foot or toe or that is sore or does not heal is another tip off for skin cancer. Be on the lookout for dark streaks or lines along one fingernail or toenail only. If you find anything unusual, any area that you think might have changed or any particularly dark or irregular spot, call our office immediately.

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