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Why It’s Important to Understand Diversity in Dermatology Care

Posted on: July 29th, 2020 by Kristen Chang

Just as no two people have the same thumbprint, no two people have the same skin. Everyone’s skin is different. This is why the board-certified dermatologists at California Skin Institute customize skin care for each individual patient.

While there are standard medical protocols we as physicians follow for the treatment of skin diseases, chronic skin conditions and skin aesthetics, we also rely on our extensive training and experience to customize care for each patient based on several factors.

The individual factors your California Skin Institute dermatologist may consider in developing a treatment plan for your skin are:

  • Age
  • Heredity
  • Hormonal influences
  • Environmental exposure
  • Allergies and other medical conditions
  • Prescription medications
  • Pigmentation levels

Melanin’s Role in Skin Care Needs

Skin color is determined by a biological pigment known as melanin, produced by specialized skin cells called melanocytes. The amount and type of melanin creates a person’s skin color. Darker skin tones contain more pigment which can be somewhat protective against the sun. However, it is a myth that people with darker skin do not need to wear sunscreen. Skin damage from ultraviolet radiation can affect anyone, regardless of skin tone, and can be lethal. Reggae legend, Bob Marley, died from skin cancer at age 36.

Whether from the sun’s rays or other causes, skin concerns can arise when inflammation causes melanocytes to malfunction.

Inflammation can cause these cells to become overactive, creating visible dark spots on the skin known as hyperpigmentation. Hyperpigmentation mostly results from external factors harming the skin’s surface. In addition to sun exposure, the use of overly harsh skin care products can cause hyperpigmentation in darker skin. For this reason, we usually recommend that people with skin of color avoid abrasive cleansers and exfoliators and instead opt for products with milder formulation.

A type of hyperpigmentation seen more commonly in skin of color is dermatosis papulosa nigra. In this condition, raised dark spots are found on the face and neck. It tends to be hereditary, increases with age and has been reported to affect 35% of African Americans. It also affects those of Asian descent. Treatment can include cryotherapy (freezing), cautery (burning the lesions off) or specialized lasers that will not scar or damage the skin.

At the other end of the spectrum in pigment disorders is depigmentation. One cause for depigmentation in the skin can be from an auto-immune disease called vitiligo. Vitiligo is characterized by a loss of melanocytes that causes white patches to appear on the skin. Vitiligo is reported to affect 2% of the population, regardless of race or ethnicity. However, in skin of color, the effects tend to be more noticeable. It can be treated topically with prescription corticosteroid creams and light treatment.

Melanin-rich skin that creates darker skin tones also helps to minimize signs of aging, such as wrinkles and sagging. Those with darker skin have a thicker and more compact dermis than those with lighter skin, with the thickness being proportional to the degree of pigmentation. The dermis is the layer of skin that contains collagen and elastin. When the dermis is thicker, cells are more densely packed and fine lines and wrinkles are less visible, resulting in a more youthful appearance.

Skin Care for People with Skin of Color

Serving California’s diverse population means treating many different types of skin conditions. Our board-certified dermatologists all have expertise in diagnosing and treating skin conditions more prevalent, or of concern to people with skin of color. We provide each of our patients with personalized care.

Here on our website, the articles we present on skin care and treatments are written to offer useful information to everyone, regardless of skin type or skin tone. On a per patient basis, California Skin Institute is dedicated to providing individualized care to all patients. This includes medical treatment and guidance on the effective use of skin and hair care products.

California Skin Institute offices remain open for all of your dermatology needs. Telehealth appointments are also available. Our highest priority is to continue providing excellent dermatology care in a safe environment for our patients and staff. Schedule your appointment today.


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