Pigmentation Disorders

A reader recently wrote to us with the following question:

A certain ad for a skin care line for darker tones claimed that black skin contains "more" collagen. I try to explain to my clients that skin is skin, with some containing a richer concentration of melanin than others, but this seems too simplistic. Am I wrong? How should I answer?

Answer:

You are right that the answers to these questions are difficult and not completely clear. Differences in melanin content and dispersion, accounting for the difference we see in skin color, are well known and easy to demonstrate.

Other differences among skin in different ethnic groups have been studied but are not as easy to explain. While the data is limited, there are more and more studies showing that some differences in skin architecture and physiology among ethnic groups do exist.

These early studies have suggested that the thickness of the skin is the same in light and dark skin, specifically in the epidermis. Darker skin types, however, may have more cornified cell layers and greater lipid content compared to white stratum corneum.

Another study showed statistically significant differences in ceramide and cholesterol ratios for different ethnicities, with Asians having the highest ratio, white skin intermediate, and black skin the lowest (Br. J. Dermatol. 2010;163:1169-73).

With regards to the dermis, darker skin has been found to have more and larger fibroblasts, smaller collagen fiber bundles, and more macrophages than white skin. This may have implications in the development of keloid formation that we sometimes see an increased incidence of in darker skin.

Other differences are summarized in the following tables:

Objective Differences in Skin Structure and Physiology Based on Race (Semin. Cut. Med. Surg. 2009;28:115-2)

^{* Skin elastic recovery/extensibility, skin microflora, and pore size were labeled as ‘insufficient evidence for’ racial differences rather than 'inconclusive' because only two studies or less examined these variables}

^{** Ethnic differences in the structural properties of facial skin. (J. Dermatol. Sci. 2009;53135-9)}

Therapeutic Implications of Key Biologic Differences Between Races

^{Ethnic Differences in Skin Properties. Textbook of Cosmetic Dermatology, 4th edition. 2010, p. 395-404}

The bottom line is that differences in ethnic groups do exist, and research is still being done to elucidate what these differences are.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

A reader recently wrote to us with the following question:

A certain ad for a skin care line for darker tones claimed that black skin contains "more" collagen. I try to explain to my clients that skin is skin, with some containing a richer concentration of melanin than others, but this seems too simplistic. Am I wrong? How should I answer?

Answer:

You are right that the answers to these questions are difficult and not completely clear. Differences in melanin content and dispersion, accounting for the difference we see in skin color, are well known and easy to demonstrate.

Other differences among skin in different ethnic groups have been studied but are not as easy to explain. While the data is limited, there are more and more studies showing that some differences in skin architecture and physiology among ethnic groups do exist.

These early studies have suggested that the thickness of the skin is the same in light and dark skin, specifically in the epidermis. Darker skin types, however, may have more cornified cell layers and greater lipid content compared to white stratum corneum.

Another study showed statistically significant differences in ceramide and cholesterol ratios for different ethnicities, with Asians having the highest ratio, white skin intermediate, and black skin the lowest (Br. J. Dermatol. 2010;163:1169-73).

With regards to the dermis, darker skin has been found to have more and larger fibroblasts, smaller collagen fiber bundles, and more macrophages than white skin. This may have implications in the development of keloid formation that we sometimes see an increased incidence of in darker skin.

Other differences are summarized in the following tables:

Objective Differences in Skin Structure and Physiology Based on Race (Semin. Cut. Med. Surg. 2009;28:115-2)

^{* Skin elastic recovery/extensibility, skin microflora, and pore size were labeled as ‘insufficient evidence for’ racial differences rather than 'inconclusive' because only two studies or less examined these variables}

^{** Ethnic differences in the structural properties of facial skin. (J. Dermatol. Sci. 2009;53135-9)}

Therapeutic Implications of Key Biologic Differences Between Races

^{Ethnic Differences in Skin Properties. Textbook of Cosmetic Dermatology, 4th edition. 2010, p. 395-404}

The bottom line is that differences in ethnic groups do exist, and research is still being done to elucidate what these differences are.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

A reader recently wrote to us with the following question:

A certain ad for a skin care line for darker tones claimed that black skin contains "more" collagen. I try to explain to my clients that skin is skin, with some containing a richer concentration of melanin than others, but this seems too simplistic. Am I wrong? How should I answer?

Answer:

You are right that the answers to these questions are difficult and not completely clear. Differences in melanin content and dispersion, accounting for the difference we see in skin color, are well known and easy to demonstrate.

Other differences among skin in different ethnic groups have been studied but are not as easy to explain. While the data is limited, there are more and more studies showing that some differences in skin architecture and physiology among ethnic groups do exist.

These early studies have suggested that the thickness of the skin is the same in light and dark skin, specifically in the epidermis. Darker skin types, however, may have more cornified cell layers and greater lipid content compared to white stratum corneum.

Another study showed statistically significant differences in ceramide and cholesterol ratios for different ethnicities, with Asians having the highest ratio, white skin intermediate, and black skin the lowest (Br. J. Dermatol. 2010;163:1169-73).

With regards to the dermis, darker skin has been found to have more and larger fibroblasts, smaller collagen fiber bundles, and more macrophages than white skin. This may have implications in the development of keloid formation that we sometimes see an increased incidence of in darker skin.

Other differences are summarized in the following tables:

Objective Differences in Skin Structure and Physiology Based on Race (Semin. Cut. Med. Surg. 2009;28:115-2)

^{* Skin elastic recovery/extensibility, skin microflora, and pore size were labeled as ‘insufficient evidence for’ racial differences rather than 'inconclusive' because only two studies or less examined these variables}

^{** Ethnic differences in the structural properties of facial skin. (J. Dermatol. Sci. 2009;53135-9)}

Therapeutic Implications of Key Biologic Differences Between Races

^{Ethnic Differences in Skin Properties. Textbook of Cosmetic Dermatology, 4th edition. 2010, p. 395-404}

The bottom line is that differences in ethnic groups do exist, and research is still being done to elucidate what these differences are.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Dyspigmentation from acne or inflammatory skin disease is a frustrating problem for both patients and dermatologists.

Postinflammatory hyperpigmentation can last up to 2 years without proper treatment. Dark skin individuals (skin types IV-VI) often have dyschromia, while lighter skin patients (skin types I-III) can have both dyschromia and erythema.

For dyschromia and erythema, cosmeceutical skin care preparations with green tea polyphenols, caffeine, niacinamide, grape seed extract, or coffeeberry may help reduce the inflammation associated with acne scars.

For darker skinned patients, hydroquinone is still the mainstay of therapy. Many dermatologists, given the risks, have shied away from hydroquinone 4% creams. Most of these risks, however, are associated with long-term use.

Short-term, higher dose treatment regimens are more efficacious, have less reported risks, encourage repeated use, and ensure greater compliance as patients see quick results.

Short bursts of compounded hydroquinone has excellent results in skin of color patients. In my practice, I use hydroquinone 8%-10% mixed with retinoic acid 0.025% cream and hydrocortisone 1% cream applied at bedtime for a maximum of 6-8 weeks on acne scars or melasma. This short pulse therapy provides immediate lightening of dark spots and minimizes the risks associated with long-term hydroquinone use.

Patients must be counseled about the risks of ochronosis: They cannot be pregnant, nursing or planning to become pregnant. The skin of some patients may become irritated; for these patients I switch to every-other-day dosing.

After 6-8 weeks of compounded hydroquinone treatment, a step-down treatment regimen – including glycolic acid peels or topical agents like broad spectrum sunscreens and preparations containing arbutin, niacinamide, soy, licorice root extract, or bearberry – provide excellent treatments for continued skin lightening.

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Dyspigmentation from acne or inflammatory skin disease is a frustrating problem for both patients and dermatologists.

Postinflammatory hyperpigmentation can last up to 2 years without proper treatment. Dark skin individuals (skin types IV-VI) often have dyschromia, while lighter skin patients (skin types I-III) can have both dyschromia and erythema.

For dyschromia and erythema, cosmeceutical skin care preparations with green tea polyphenols, caffeine, niacinamide, grape seed extract, or coffeeberry may help reduce the inflammation associated with acne scars.

For darker skinned patients, hydroquinone is still the mainstay of therapy. Many dermatologists, given the risks, have shied away from hydroquinone 4% creams. Most of these risks, however, are associated with long-term use.

Short-term, higher dose treatment regimens are more efficacious, have less reported risks, encourage repeated use, and ensure greater compliance as patients see quick results.

Short bursts of compounded hydroquinone has excellent results in skin of color patients. In my practice, I use hydroquinone 8%-10% mixed with retinoic acid 0.025% cream and hydrocortisone 1% cream applied at bedtime for a maximum of 6-8 weeks on acne scars or melasma. This short pulse therapy provides immediate lightening of dark spots and minimizes the risks associated with long-term hydroquinone use.

Patients must be counseled about the risks of ochronosis: They cannot be pregnant, nursing or planning to become pregnant. The skin of some patients may become irritated; for these patients I switch to every-other-day dosing.

After 6-8 weeks of compounded hydroquinone treatment, a step-down treatment regimen – including glycolic acid peels or topical agents like broad spectrum sunscreens and preparations containing arbutin, niacinamide, soy, licorice root extract, or bearberry – provide excellent treatments for continued skin lightening.

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Dyspigmentation from acne or inflammatory skin disease is a frustrating problem for both patients and dermatologists.

Postinflammatory hyperpigmentation can last up to 2 years without proper treatment. Dark skin individuals (skin types IV-VI) often have dyschromia, while lighter skin patients (skin types I-III) can have both dyschromia and erythema.

For dyschromia and erythema, cosmeceutical skin care preparations with green tea polyphenols, caffeine, niacinamide, grape seed extract, or coffeeberry may help reduce the inflammation associated with acne scars.

For darker skinned patients, hydroquinone is still the mainstay of therapy. Many dermatologists, given the risks, have shied away from hydroquinone 4% creams. Most of these risks, however, are associated with long-term use.

Short-term, higher dose treatment regimens are more efficacious, have less reported risks, encourage repeated use, and ensure greater compliance as patients see quick results.

Short bursts of compounded hydroquinone has excellent results in skin of color patients. In my practice, I use hydroquinone 8%-10% mixed with retinoic acid 0.025% cream and hydrocortisone 1% cream applied at bedtime for a maximum of 6-8 weeks on acne scars or melasma. This short pulse therapy provides immediate lightening of dark spots and minimizes the risks associated with long-term hydroquinone use.

Patients must be counseled about the risks of ochronosis: They cannot be pregnant, nursing or planning to become pregnant. The skin of some patients may become irritated; for these patients I switch to every-other-day dosing.

After 6-8 weeks of compounded hydroquinone treatment, a step-down treatment regimen – including glycolic acid peels or topical agents like broad spectrum sunscreens and preparations containing arbutin, niacinamide, soy, licorice root extract, or bearberry – provide excellent treatments for continued skin lightening.

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Why is it that office visits for pigmentary disorders, such as vitiligo and hypo- and hyperpigmentation, are often covered by many health insurance plans but a diagnosis code for melasma is not?

Additionally, why are the treatments for vitiligo – including prescriptions such as corticosteroids and phototherapy – covered but treatments for melasma – including topical hydroquinone, chemical peels, and lasers – are not?

I've searched for answers to the these questions, even discussing them with my billing office, but the only answer I've been able to get is that insurance companies consider melasma to be "cosmetic." Even though both conditions may alter a person's appearance and cause cosmetic concerns, vitiligo has been delineated a medical condition because of research demonstrating that the etiology of vitiligo is autoimmune.

While melasma, like photoaging, does harbor sun exposure as a significant factor in the etiology and severity of the condition, melasma is not always due to sun exposure alone.

It has been well-documented that there is often a genetic predisposition and hormonal contribution to melasma. In clinical practice, we often see patients with hormonal shifts, because of either pregnancy or hormonal contraceptives, that develop melasma despite vigorous photoprotection.

Maybe if, in the future, a specific inherited gene is identified that shows a predisposition to melasma in certain individuals, the coverage may change.

Last year, a study was published in the Journal of Investigative Dermatology that identified upregulation of expression of certain genes associated with tyrosinase and Wnt in skin affected by melasma, as well as a down regulation of lipid metabolism associated genes, when compared with non-lesional skin (J. Invest. Dermatol. 2011;131:1692-700).

This type of research is a step in the right direction in identifying the true etiology of melasma. Until we find an answer, does anyone have any other insight as to why insurance coverage is the way it is?

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Why is it that office visits for pigmentary disorders, such as vitiligo and hypo- and hyperpigmentation, are often covered by many health insurance plans but a diagnosis code for melasma is not?

Additionally, why are the treatments for vitiligo – including prescriptions such as corticosteroids and phototherapy – covered but treatments for melasma – including topical hydroquinone, chemical peels, and lasers – are not?

I've searched for answers to the these questions, even discussing them with my billing office, but the only answer I've been able to get is that insurance companies consider melasma to be "cosmetic." Even though both conditions may alter a person's appearance and cause cosmetic concerns, vitiligo has been delineated a medical condition because of research demonstrating that the etiology of vitiligo is autoimmune.

While melasma, like photoaging, does harbor sun exposure as a significant factor in the etiology and severity of the condition, melasma is not always due to sun exposure alone.

It has been well-documented that there is often a genetic predisposition and hormonal contribution to melasma. In clinical practice, we often see patients with hormonal shifts, because of either pregnancy or hormonal contraceptives, that develop melasma despite vigorous photoprotection.

Maybe if, in the future, a specific inherited gene is identified that shows a predisposition to melasma in certain individuals, the coverage may change.

Last year, a study was published in the Journal of Investigative Dermatology that identified upregulation of expression of certain genes associated with tyrosinase and Wnt in skin affected by melasma, as well as a down regulation of lipid metabolism associated genes, when compared with non-lesional skin (J. Invest. Dermatol. 2011;131:1692-700).

This type of research is a step in the right direction in identifying the true etiology of melasma. Until we find an answer, does anyone have any other insight as to why insurance coverage is the way it is?

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Why is it that office visits for pigmentary disorders, such as vitiligo and hypo- and hyperpigmentation, are often covered by many health insurance plans but a diagnosis code for melasma is not?

Additionally, why are the treatments for vitiligo – including prescriptions such as corticosteroids and phototherapy – covered but treatments for melasma – including topical hydroquinone, chemical peels, and lasers – are not?

I've searched for answers to the these questions, even discussing them with my billing office, but the only answer I've been able to get is that insurance companies consider melasma to be "cosmetic." Even though both conditions may alter a person's appearance and cause cosmetic concerns, vitiligo has been delineated a medical condition because of research demonstrating that the etiology of vitiligo is autoimmune.

While melasma, like photoaging, does harbor sun exposure as a significant factor in the etiology and severity of the condition, melasma is not always due to sun exposure alone.

It has been well-documented that there is often a genetic predisposition and hormonal contribution to melasma. In clinical practice, we often see patients with hormonal shifts, because of either pregnancy or hormonal contraceptives, that develop melasma despite vigorous photoprotection.

Maybe if, in the future, a specific inherited gene is identified that shows a predisposition to melasma in certain individuals, the coverage may change.

Last year, a study was published in the Journal of Investigative Dermatology that identified upregulation of expression of certain genes associated with tyrosinase and Wnt in skin affected by melasma, as well as a down regulation of lipid metabolism associated genes, when compared with non-lesional skin (J. Invest. Dermatol. 2011;131:1692-700).

This type of research is a step in the right direction in identifying the true etiology of melasma. Until we find an answer, does anyone have any other insight as to why insurance coverage is the way it is?

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Earlobe keloids are a common problem in skin of color patients that can be frustrating to both patients and physicians.

An article in the March issue of Dermatologic Surgery (2012;38:406-12) described a new morphologic classification for earlobe keloids and a surgical approach for their management.

Although surgical management is important for resistant, recurrent keloids, I often use a five-step nonsurgical regimen for treating earlobe keloids.

1. Set expectations and counsel the patient. Keloids can recur.

2. Avoid triggers. Make sure there is no underlying contact dermatitis from nickel or other metal alloys that can cause inflammation contributing to the scar tissue formation.

3. Intralesional steroids. Consider starting with Kenalog 20 mg/cc and increase by 10 mg/cc at each 4 week visit for optimal benefit. Often times, I use very gentle subscision in the tough scar tissue with a 26 gauge ½ inch needle to open up channels for the Kenalog to penetrate.

4. Compression therapy. Clip on compression earrings or a medical compression device called a Zimmer splint, which has two discs that clip on the ear placing pressure on both sides of the lobe.

5. Use silicone based gels and instruct patients to massage the area several times daily.

Keloids can be a frustrating and aesthetically unacceptable problem. Surgical methods are useful, including keloidectomy, core extirpation, or a combination.

However, in-office and home-based remedies both decrease recurrence rates and improve the size and thickness of keloids so that surgery can be reserved as an adjunct treatment by removing redundant skin rather than thick keloidal scar tissue.

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Earlobe keloids are a common problem in skin of color patients that can be frustrating to both patients and physicians.

An article in the March issue of Dermatologic Surgery (2012;38:406-12) described a new morphologic classification for earlobe keloids and a surgical approach for their management.

Although surgical management is important for resistant, recurrent keloids, I often use a five-step nonsurgical regimen for treating earlobe keloids.

1. Set expectations and counsel the patient. Keloids can recur.

2. Avoid triggers. Make sure there is no underlying contact dermatitis from nickel or other metal alloys that can cause inflammation contributing to the scar tissue formation.

3. Intralesional steroids. Consider starting with Kenalog 20 mg/cc and increase by 10 mg/cc at each 4 week visit for optimal benefit. Often times, I use very gentle subscision in the tough scar tissue with a 26 gauge ½ inch needle to open up channels for the Kenalog to penetrate.

4. Compression therapy. Clip on compression earrings or a medical compression device called a Zimmer splint, which has two discs that clip on the ear placing pressure on both sides of the lobe.

5. Use silicone based gels and instruct patients to massage the area several times daily.

Keloids can be a frustrating and aesthetically unacceptable problem. Surgical methods are useful, including keloidectomy, core extirpation, or a combination.

However, in-office and home-based remedies both decrease recurrence rates and improve the size and thickness of keloids so that surgery can be reserved as an adjunct treatment by removing redundant skin rather than thick keloidal scar tissue.

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

Earlobe keloids are a common problem in skin of color patients that can be frustrating to both patients and physicians.

An article in the March issue of Dermatologic Surgery (2012;38:406-12) described a new morphologic classification for earlobe keloids and a surgical approach for their management.

Although surgical management is important for resistant, recurrent keloids, I often use a five-step nonsurgical regimen for treating earlobe keloids.

1. Set expectations and counsel the patient. Keloids can recur.

2. Avoid triggers. Make sure there is no underlying contact dermatitis from nickel or other metal alloys that can cause inflammation contributing to the scar tissue formation.

3. Intralesional steroids. Consider starting with Kenalog 20 mg/cc and increase by 10 mg/cc at each 4 week visit for optimal benefit. Often times, I use very gentle subscision in the tough scar tissue with a 26 gauge ½ inch needle to open up channels for the Kenalog to penetrate.

4. Compression therapy. Clip on compression earrings or a medical compression device called a Zimmer splint, which has two discs that clip on the ear placing pressure on both sides of the lobe.

5. Use silicone based gels and instruct patients to massage the area several times daily.

Keloids can be a frustrating and aesthetically unacceptable problem. Surgical methods are useful, including keloidectomy, core extirpation, or a combination.

However, in-office and home-based remedies both decrease recurrence rates and improve the size and thickness of keloids so that surgery can be reserved as an adjunct treatment by removing redundant skin rather than thick keloidal scar tissue.

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

A presentation at the Triological Society's 2012 Combined Sections Meeting held in January highlighted that, when compared with white patients, black patients have a sevenfold increased risk for developing keloid scarring following surgery in the head and neck area.

Dr. Lamont Jones and colleagues at Henry Ford Hospital, Detroit, conducted a retrospective chart review of 6,692 patients who had head and neck procedures requiring incisions between 2005 and 2009. Twenty patients developed keloid scarring as a result of their surgery. Keloid rates according to ethnicity were 0.8% in black patients, 0.1% in white patients, and 0.2% in other ethnic groups.

They explain, however, that the keloid rate in black patients is actually significantly lower than previous estimates, which have been as high as 16%.

There were no differences in keloid formation according to gender. Patients who developed keloid scars tended to be younger in age, but the age difference was not statistically significant.

While the decreased rates of keloid formation compared to previous estimates can be reassuring for many black patients who fear surgery, the increased risk over other ethnic groups is still real and should be discussed in preoperative discussions.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

A presentation at the Triological Society's 2012 Combined Sections Meeting held in January highlighted that, when compared with white patients, black patients have a sevenfold increased risk for developing keloid scarring following surgery in the head and neck area.

Dr. Lamont Jones and colleagues at Henry Ford Hospital, Detroit, conducted a retrospective chart review of 6,692 patients who had head and neck procedures requiring incisions between 2005 and 2009. Twenty patients developed keloid scarring as a result of their surgery. Keloid rates according to ethnicity were 0.8% in black patients, 0.1% in white patients, and 0.2% in other ethnic groups.

They explain, however, that the keloid rate in black patients is actually significantly lower than previous estimates, which have been as high as 16%.

There were no differences in keloid formation according to gender. Patients who developed keloid scars tended to be younger in age, but the age difference was not statistically significant.

While the decreased rates of keloid formation compared to previous estimates can be reassuring for many black patients who fear surgery, the increased risk over other ethnic groups is still real and should be discussed in preoperative discussions.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

A presentation at the Triological Society's 2012 Combined Sections Meeting held in January highlighted that, when compared with white patients, black patients have a sevenfold increased risk for developing keloid scarring following surgery in the head and neck area.

Dr. Lamont Jones and colleagues at Henry Ford Hospital, Detroit, conducted a retrospective chart review of 6,692 patients who had head and neck procedures requiring incisions between 2005 and 2009. Twenty patients developed keloid scarring as a result of their surgery. Keloid rates according to ethnicity were 0.8% in black patients, 0.1% in white patients, and 0.2% in other ethnic groups.

They explain, however, that the keloid rate in black patients is actually significantly lower than previous estimates, which have been as high as 16%.

There were no differences in keloid formation according to gender. Patients who developed keloid scars tended to be younger in age, but the age difference was not statistically significant.

While the decreased rates of keloid formation compared to previous estimates can be reassuring for many black patients who fear surgery, the increased risk over other ethnic groups is still real and should be discussed in preoperative discussions.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

WASHINGTON – While the use of sun protection measures became more common between 2000 and 2010, there was not a corresponding decrease in sunburns, according to an analysis of national data.

Overall among women, staying in the shade, using sunscreen, and wearing clothing to the ankles increased significantly over time by 5%, 6%, and 5%, respectively, between 2000 and 2010. Similarly, among men, staying in the shade, sunscreen use, and wearing clothing to the ankles increased by 7%, 2%, and 5%, respectively. However, the overall prevalence of sunburn did not change significantly over those years. In 2010, 51% of women and 49% of men reported having at least one sunburn in the past year. The results come from a poster presented at the annual meeting of the American Society of Preventive Oncology.

Photo credit: © Spiritartist/iStockphoto

The rates of melanoma and nonmelanoma skin cancers have increased in recent years. Monitoring and reporting sun-protective behaviors and sunburns over time are important ways to measure the impact of skin cancer prevention activity and to track progress toward Healthy People 2020 objectives, noted lead author Dawn M. Holman and her coinvestigators at the Centers for Disease Control and Prevention.

To estimate how commonly people engage in these behaviors that protect against sun exposure, the researchers used data from the National Health Interview Survey – Cancer Control Supplement, for years 2000, 2003, 2005, 2008, and 2010. The survey assessed the following behaviors as related to sun protection and sunburn: use of sunscreen, staying in the shade, wearing a wide-brimmed hat, wearing a long-sleeved shirt, and wearing long clothing to the ankles. Respondents reported their use as being: always, most of the time, sometimes, rarely, or never for each item. Respondents were also asked about the number of sunburns they’ve had in the last year.

Data were weighted to produce nationally representative estimates. Analyses were limited to those aged 18-29 years – age-adjusted to the 2000 U.S. population. The researchers estimated the percentage who reported engaging in each behavior always or most of the time and the percentage reporting one or more sunburns in the past year overall, by gender and by race/ethnicity.

Among women, using sunscreen (37%) and staying in the shade (35%) were the most common reported protective behaviors in 2010. Wearing a long-sleeved shirt (5%) and wearing a wide-brimmed hat (4%) were the least common. Black women were significantly less likely to report sunscreen use than were other racial/ethnic groups.

Among men, wearing long clothing to the ankles (33%) and staying in the shade (26%) were the most commonly reported behaviors in 2010. Fewer men reported using sunscreen (16%), wearing a long-sleeved shirt (8%), and wearing a wide-brimmed hat (7%). Of note, sunburn was significantly more common among non-Hispanic whites, compared with other racial/ethnic groups.

The results point to the "need for continued public health efforts to facilitate sun protection by: creating environments that support protective behaviors and by changing social norms regarding tanning and tanned skin. Facilitating sun protection may prevent sunburns and future increases in the burden of skin cancer," the researchers wrote.

The authors did not report whether they had any relevant financial interests.

WASHINGTON – While the use of sun protection measures became more common between 2000 and 2010, there was not a corresponding decrease in sunburns, according to an analysis of national data.

Overall among women, staying in the shade, using sunscreen, and wearing clothing to the ankles increased significantly over time by 5%, 6%, and 5%, respectively, between 2000 and 2010. Similarly, among men, staying in the shade, sunscreen use, and wearing clothing to the ankles increased by 7%, 2%, and 5%, respectively. However, the overall prevalence of sunburn did not change significantly over those years. In 2010, 51% of women and 49% of men reported having at least one sunburn in the past year. The results come from a poster presented at the annual meeting of the American Society of Preventive Oncology.

Photo credit: © Spiritartist/iStockphoto

The rates of melanoma and nonmelanoma skin cancers have increased in recent years. Monitoring and reporting sun-protective behaviors and sunburns over time are important ways to measure the impact of skin cancer prevention activity and to track progress toward Healthy People 2020 objectives, noted lead author Dawn M. Holman and her coinvestigators at the Centers for Disease Control and Prevention.

To estimate how commonly people engage in these behaviors that protect against sun exposure, the researchers used data from the National Health Interview Survey – Cancer Control Supplement, for years 2000, 2003, 2005, 2008, and 2010. The survey assessed the following behaviors as related to sun protection and sunburn: use of sunscreen, staying in the shade, wearing a wide-brimmed hat, wearing a long-sleeved shirt, and wearing long clothing to the ankles. Respondents reported their use as being: always, most of the time, sometimes, rarely, or never for each item. Respondents were also asked about the number of sunburns they’ve had in the last year.

Data were weighted to produce nationally representative estimates. Analyses were limited to those aged 18-29 years – age-adjusted to the 2000 U.S. population. The researchers estimated the percentage who reported engaging in each behavior always or most of the time and the percentage reporting one or more sunburns in the past year overall, by gender and by race/ethnicity.

Among women, using sunscreen (37%) and staying in the shade (35%) were the most common reported protective behaviors in 2010. Wearing a long-sleeved shirt (5%) and wearing a wide-brimmed hat (4%) were the least common. Black women were significantly less likely to report sunscreen use than were other racial/ethnic groups.

Among men, wearing long clothing to the ankles (33%) and staying in the shade (26%) were the most commonly reported behaviors in 2010. Fewer men reported using sunscreen (16%), wearing a long-sleeved shirt (8%), and wearing a wide-brimmed hat (7%). Of note, sunburn was significantly more common among non-Hispanic whites, compared with other racial/ethnic groups.

The results point to the "need for continued public health efforts to facilitate sun protection by: creating environments that support protective behaviors and by changing social norms regarding tanning and tanned skin. Facilitating sun protection may prevent sunburns and future increases in the burden of skin cancer," the researchers wrote.

The authors did not report whether they had any relevant financial interests.

WASHINGTON – While the use of sun protection measures became more common between 2000 and 2010, there was not a corresponding decrease in sunburns, according to an analysis of national data.

Overall among women, staying in the shade, using sunscreen, and wearing clothing to the ankles increased significantly over time by 5%, 6%, and 5%, respectively, between 2000 and 2010. Similarly, among men, staying in the shade, sunscreen use, and wearing clothing to the ankles increased by 7%, 2%, and 5%, respectively. However, the overall prevalence of sunburn did not change significantly over those years. In 2010, 51% of women and 49% of men reported having at least one sunburn in the past year. The results come from a poster presented at the annual meeting of the American Society of Preventive Oncology.

Photo credit: © Spiritartist/iStockphoto

The rates of melanoma and nonmelanoma skin cancers have increased in recent years. Monitoring and reporting sun-protective behaviors and sunburns over time are important ways to measure the impact of skin cancer prevention activity and to track progress toward Healthy People 2020 objectives, noted lead author Dawn M. Holman and her coinvestigators at the Centers for Disease Control and Prevention.

To estimate how commonly people engage in these behaviors that protect against sun exposure, the researchers used data from the National Health Interview Survey – Cancer Control Supplement, for years 2000, 2003, 2005, 2008, and 2010. The survey assessed the following behaviors as related to sun protection and sunburn: use of sunscreen, staying in the shade, wearing a wide-brimmed hat, wearing a long-sleeved shirt, and wearing long clothing to the ankles. Respondents reported their use as being: always, most of the time, sometimes, rarely, or never for each item. Respondents were also asked about the number of sunburns they’ve had in the last year.

Data were weighted to produce nationally representative estimates. Analyses were limited to those aged 18-29 years – age-adjusted to the 2000 U.S. population. The researchers estimated the percentage who reported engaging in each behavior always or most of the time and the percentage reporting one or more sunburns in the past year overall, by gender and by race/ethnicity.

Among women, using sunscreen (37%) and staying in the shade (35%) were the most common reported protective behaviors in 2010. Wearing a long-sleeved shirt (5%) and wearing a wide-brimmed hat (4%) were the least common. Black women were significantly less likely to report sunscreen use than were other racial/ethnic groups.

Among men, wearing long clothing to the ankles (33%) and staying in the shade (26%) were the most commonly reported behaviors in 2010. Fewer men reported using sunscreen (16%), wearing a long-sleeved shirt (8%), and wearing a wide-brimmed hat (7%). Of note, sunburn was significantly more common among non-Hispanic whites, compared with other racial/ethnic groups.

The results point to the "need for continued public health efforts to facilitate sun protection by: creating environments that support protective behaviors and by changing social norms regarding tanning and tanned skin. Facilitating sun protection may prevent sunburns and future increases in the burden of skin cancer," the researchers wrote.

The authors did not report whether they had any relevant financial interests.

It's always a good idea to expand your knowledge and expertise in regards to patients with skin of color. Here is a synopsis of the skin of color-themed presentations taking place at the annual American Academy of Dermatology Meeting in San Diego from March 16-20.

On Saturday, March 17, there will be a focus session on Medical & Aesthetic Dermatology in Skin of Color (U041) starting from 7:15 a.m. to 8:45 a.m., followed by a focus session entitled Practical Approach to Medical and Cosmetic Dermatology in Skin of Color Patients (U051) from 12:15 p.m. to 1:45 p.m. There will be a symposium on Disorders of Pigmentation (S019) from 2:00 p.m. to 5 p.m.

On Sunday, March 18, a focus session from 7 a.m. to 8 a.m. will cover Building Beauty: Understanding Facial Proportions, Phi, and Use of Volumizing Soft Tissue Fillers (U073).

Finally, on Monday, March 19, an early focus session from 7:15 a.m. to 8:45 a.m. will cover Hair Disease & the African American Patient (U108), and a second focus session from 2:30 p.m. to 4 p.m. will cover Melasma: Pathogenesis and Treatment (U129). There will also be a forum starting at 12 p.m. to 2 p.m. on Vitiligo (F063).

The online version of the scientific program contains all the information you'll need in regards to the meeting. Hope to see you there!

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

It's always a good idea to expand your knowledge and expertise in regards to patients with skin of color. Here is a synopsis of the skin of color-themed presentations taking place at the annual American Academy of Dermatology Meeting in San Diego from March 16-20.

On Saturday, March 17, there will be a focus session on Medical & Aesthetic Dermatology in Skin of Color (U041) starting from 7:15 a.m. to 8:45 a.m., followed by a focus session entitled Practical Approach to Medical and Cosmetic Dermatology in Skin of Color Patients (U051) from 12:15 p.m. to 1:45 p.m. There will be a symposium on Disorders of Pigmentation (S019) from 2:00 p.m. to 5 p.m.

On Sunday, March 18, a focus session from 7 a.m. to 8 a.m. will cover Building Beauty: Understanding Facial Proportions, Phi, and Use of Volumizing Soft Tissue Fillers (U073).

Finally, on Monday, March 19, an early focus session from 7:15 a.m. to 8:45 a.m. will cover Hair Disease & the African American Patient (U108), and a second focus session from 2:30 p.m. to 4 p.m. will cover Melasma: Pathogenesis and Treatment (U129). There will also be a forum starting at 12 p.m. to 2 p.m. on Vitiligo (F063).

The online version of the scientific program contains all the information you'll need in regards to the meeting. Hope to see you there!

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

It's always a good idea to expand your knowledge and expertise in regards to patients with skin of color. Here is a synopsis of the skin of color-themed presentations taking place at the annual American Academy of Dermatology Meeting in San Diego from March 16-20.

On Saturday, March 17, there will be a focus session on Medical & Aesthetic Dermatology in Skin of Color (U041) starting from 7:15 a.m. to 8:45 a.m., followed by a focus session entitled Practical Approach to Medical and Cosmetic Dermatology in Skin of Color Patients (U051) from 12:15 p.m. to 1:45 p.m. There will be a symposium on Disorders of Pigmentation (S019) from 2:00 p.m. to 5 p.m.

On Sunday, March 18, a focus session from 7 a.m. to 8 a.m. will cover Building Beauty: Understanding Facial Proportions, Phi, and Use of Volumizing Soft Tissue Fillers (U073).

Finally, on Monday, March 19, an early focus session from 7:15 a.m. to 8:45 a.m. will cover Hair Disease & the African American Patient (U108), and a second focus session from 2:30 p.m. to 4 p.m. will cover Melasma: Pathogenesis and Treatment (U129). There will also be a forum starting at 12 p.m. to 2 p.m. on Vitiligo (F063).

The online version of the scientific program contains all the information you'll need in regards to the meeting. Hope to see you there!

- Lily Talakoub, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

MIAMI BEACH – Early and aggressive anti-inflammatory therapy – preferably combination – is the key to treating acne and postinflammatory hyperpigmentation in patients with skin of color.

Acne prevalence is about the same in black and white patients, said Dr. Valerie D. Callender. The same mechanisms cause acne and the same treatments, in general, are used regardless of skin type, she said. "What is important is ... there are sequelae of acne that make it a little different, and there are certain, special considerations we have to keep in mind when treating patients with darker skin types."

Prevention of keloids, hypertrophic scars, and postinflammatory hyperpigmentation are among the special considerations in this patient population, Dr. Callender said at the South Beach Symposium.

Keloids and hypertrophic scars usually result from inflammatory acne papules, nodules, and cysts, and can be challenging to treat. The keloids and scarring commonly arise along the jawline and on the chest, shoulder, and back. "It’s important to be very aggressive to resolve the inflammation, to treat them effectively. A lot of these patients do very well with isotretinoin and oral antibiotics," said Dr. Callender of the dermatology department at Howard University in Washington, D.C.

In patients with keloids, consider injection of 20 mg/cc intralesional triamcinolone every 4 weeks, sometimes every 2 weeks, to get these lesions to go down, she said. "Remember that is part of their acne regimen."

Postinflammatory hyperpigmentation (PIH) is a common presenting complaint among skin of color patients with acne or another inflammatory skin condition.

PIH is "psychologically devastating for these patients. We have to treat the PIH just as aggressively as we treat the acne," Dr. Callender said. In some cases, the disfigurement is severe and the hyperpigmented patches and macules can persist for months or even years.

In a study of 2,895 females aged 10-70, prevalence of PIH varied by ethnicity (J. Eur. Acad. Dermatol. Venereol. 2011;25:1054-60). The researchers at Massachusetts General Hospital in Boston found that PIH affected 65% of 384 black study patients and 48% of 258 Hispanic patients. "The other racial groups were less than 20% for PIH; this goes along with what we do in our practices," Dr. Callender said.

There are multiple options for prevention and treatment of PIH. Sunscreen, sun avoidance, and early diagnosis can prevent or minimize adverse effects. Hydroquinone, retinoids, azelaic acid, and/or kojic acid are recommended treatments.

"I love my hydroquinone, I use it a lot," Dr. Callender said. Hydroquinone lightens areas of hyperpigmentation through inhibition of tyrosine conversion to melanin, reduces the number of melanosomes, and inhibits DNA and RNA synthesis of melanocytes.

Topical retinoid agents are useful because they not only treat acne, but also address the hyperpigmentation, she said. Also, once the hyperpigmentation is under control, the topical retinoids help to exfoliate the skin and keep PIH from recurring. "We love to keep these patients on long-term topical retinoid therapy."

Tolerability is very important when prescribing topical retinoids and other agents. Carefully consider each patient’s potential risk for cutaneous irritation, including erythema, peeling, burning, and dryness. Be sure to inform nurses and office staff that when a patient calls about tolerability, "you have to inquire about any changes in pigmentation [as well], especially in skin of color patients," Dr. Callender said. Moisturizers, cleansers, and less irritating vehicles can improve tolerability.

"We also use adjunctive therapies and sunscreen protection [for PIH]. Remember combination therapy is the way to go," she said.

She and her associates conducted a meta-analysis looking at the tolerability of a fixed combination adapalene 0.1% and benzoyl peroxide 2.5% gel product (Epiduo) for acne in patients by Fitzpatrick skin type (J. Clin. Aesthet. Dermatol. 2010;3:15-9). They found erythema, scaling, and dryness scores higher for white patients in all three studies. Burning and stinging scores were not significantly different. "Tolerability is good for your skin of color patients. You don’t need to be overly concerned about a lot of irritation just because their skin is dark."

Chemical peels, lasers, and light-based therapies are additional treatment options for acne. Peels made with glycolic acid, salicylic acid, Jessner’s solution, or a combination is acceptable in skin of color patients. However, "be very, very careful with peels in skin of color patients. Make sure [to] use superficial peeling agents," Dr. Callender said.

More clinical studies of lasers and light-based therapies to treat acne are including the darker skin types, Dr. Callender said. Blue light, diode laser, intense pulse light, and photodynamic therapy are examples. "As we learn how to adjust the settings, they will be safer for skin of color patients," she said.

Dr. Callender disclosed that she is a consultant for Allergan and Galderma, which markets Epiduo; a researcher for Allergan, Galderma, and Intendis; and a member of the speakers’ bureau for Galderma.

MIAMI BEACH – Early and aggressive anti-inflammatory therapy – preferably combination – is the key to treating acne and postinflammatory hyperpigmentation in patients with skin of color.

Acne prevalence is about the same in black and white patients, said Dr. Valerie D. Callender. The same mechanisms cause acne and the same treatments, in general, are used regardless of skin type, she said. "What is important is ... there are sequelae of acne that make it a little different, and there are certain, special considerations we have to keep in mind when treating patients with darker skin types."

Prevention of keloids, hypertrophic scars, and postinflammatory hyperpigmentation are among the special considerations in this patient population, Dr. Callender said at the South Beach Symposium.

Keloids and hypertrophic scars usually result from inflammatory acne papules, nodules, and cysts, and can be challenging to treat. The keloids and scarring commonly arise along the jawline and on the chest, shoulder, and back. "It’s important to be very aggressive to resolve the inflammation, to treat them effectively. A lot of these patients do very well with isotretinoin and oral antibiotics," said Dr. Callender of the dermatology department at Howard University in Washington, D.C.

In patients with keloids, consider injection of 20 mg/cc intralesional triamcinolone every 4 weeks, sometimes every 2 weeks, to get these lesions to go down, she said. "Remember that is part of their acne regimen."

Postinflammatory hyperpigmentation (PIH) is a common presenting complaint among skin of color patients with acne or another inflammatory skin condition.

PIH is "psychologically devastating for these patients. We have to treat the PIH just as aggressively as we treat the acne," Dr. Callender said. In some cases, the disfigurement is severe and the hyperpigmented patches and macules can persist for months or even years.

In a study of 2,895 females aged 10-70, prevalence of PIH varied by ethnicity (J. Eur. Acad. Dermatol. Venereol. 2011;25:1054-60). The researchers at Massachusetts General Hospital in Boston found that PIH affected 65% of 384 black study patients and 48% of 258 Hispanic patients. "The other racial groups were less than 20% for PIH; this goes along with what we do in our practices," Dr. Callender said.

There are multiple options for prevention and treatment of PIH. Sunscreen, sun avoidance, and early diagnosis can prevent or minimize adverse effects. Hydroquinone, retinoids, azelaic acid, and/or kojic acid are recommended treatments.

"I love my hydroquinone, I use it a lot," Dr. Callender said. Hydroquinone lightens areas of hyperpigmentation through inhibition of tyrosine conversion to melanin, reduces the number of melanosomes, and inhibits DNA and RNA synthesis of melanocytes.

Topical retinoid agents are useful because they not only treat acne, but also address the hyperpigmentation, she said. Also, once the hyperpigmentation is under control, the topical retinoids help to exfoliate the skin and keep PIH from recurring. "We love to keep these patients on long-term topical retinoid therapy."

Tolerability is very important when prescribing topical retinoids and other agents. Carefully consider each patient’s potential risk for cutaneous irritation, including erythema, peeling, burning, and dryness. Be sure to inform nurses and office staff that when a patient calls about tolerability, "you have to inquire about any changes in pigmentation [as well], especially in skin of color patients," Dr. Callender said. Moisturizers, cleansers, and less irritating vehicles can improve tolerability.

"We also use adjunctive therapies and sunscreen protection [for PIH]. Remember combination therapy is the way to go," she said.

She and her associates conducted a meta-analysis looking at the tolerability of a fixed combination adapalene 0.1% and benzoyl peroxide 2.5% gel product (Epiduo) for acne in patients by Fitzpatrick skin type (J. Clin. Aesthet. Dermatol. 2010;3:15-9). They found erythema, scaling, and dryness scores higher for white patients in all three studies. Burning and stinging scores were not significantly different. "Tolerability is good for your skin of color patients. You don’t need to be overly concerned about a lot of irritation just because their skin is dark."

Chemical peels, lasers, and light-based therapies are additional treatment options for acne. Peels made with glycolic acid, salicylic acid, Jessner’s solution, or a combination is acceptable in skin of color patients. However, "be very, very careful with peels in skin of color patients. Make sure [to] use superficial peeling agents," Dr. Callender said.

More clinical studies of lasers and light-based therapies to treat acne are including the darker skin types, Dr. Callender said. Blue light, diode laser, intense pulse light, and photodynamic therapy are examples. "As we learn how to adjust the settings, they will be safer for skin of color patients," she said.

Dr. Callender disclosed that she is a consultant for Allergan and Galderma, which markets Epiduo; a researcher for Allergan, Galderma, and Intendis; and a member of the speakers’ bureau for Galderma.

MIAMI BEACH – Early and aggressive anti-inflammatory therapy – preferably combination – is the key to treating acne and postinflammatory hyperpigmentation in patients with skin of color.

Acne prevalence is about the same in black and white patients, said Dr. Valerie D. Callender. The same mechanisms cause acne and the same treatments, in general, are used regardless of skin type, she said. "What is important is ... there are sequelae of acne that make it a little different, and there are certain, special considerations we have to keep in mind when treating patients with darker skin types."

Prevention of keloids, hypertrophic scars, and postinflammatory hyperpigmentation are among the special considerations in this patient population, Dr. Callender said at the South Beach Symposium.

Keloids and hypertrophic scars usually result from inflammatory acne papules, nodules, and cysts, and can be challenging to treat. The keloids and scarring commonly arise along the jawline and on the chest, shoulder, and back. "It’s important to be very aggressive to resolve the inflammation, to treat them effectively. A lot of these patients do very well with isotretinoin and oral antibiotics," said Dr. Callender of the dermatology department at Howard University in Washington, D.C.

In patients with keloids, consider injection of 20 mg/cc intralesional triamcinolone every 4 weeks, sometimes every 2 weeks, to get these lesions to go down, she said. "Remember that is part of their acne regimen."

Postinflammatory hyperpigmentation (PIH) is a common presenting complaint among skin of color patients with acne or another inflammatory skin condition.

PIH is "psychologically devastating for these patients. We have to treat the PIH just as aggressively as we treat the acne," Dr. Callender said. In some cases, the disfigurement is severe and the hyperpigmented patches and macules can persist for months or even years.

In a study of 2,895 females aged 10-70, prevalence of PIH varied by ethnicity (J. Eur. Acad. Dermatol. Venereol. 2011;25:1054-60). The researchers at Massachusetts General Hospital in Boston found that PIH affected 65% of 384 black study patients and 48% of 258 Hispanic patients. "The other racial groups were less than 20% for PIH; this goes along with what we do in our practices," Dr. Callender said.

There are multiple options for prevention and treatment of PIH. Sunscreen, sun avoidance, and early diagnosis can prevent or minimize adverse effects. Hydroquinone, retinoids, azelaic acid, and/or kojic acid are recommended treatments.

"I love my hydroquinone, I use it a lot," Dr. Callender said. Hydroquinone lightens areas of hyperpigmentation through inhibition of tyrosine conversion to melanin, reduces the number of melanosomes, and inhibits DNA and RNA synthesis of melanocytes.

Topical retinoid agents are useful because they not only treat acne, but also address the hyperpigmentation, she said. Also, once the hyperpigmentation is under control, the topical retinoids help to exfoliate the skin and keep PIH from recurring. "We love to keep these patients on long-term topical retinoid therapy."

Tolerability is very important when prescribing topical retinoids and other agents. Carefully consider each patient’s potential risk for cutaneous irritation, including erythema, peeling, burning, and dryness. Be sure to inform nurses and office staff that when a patient calls about tolerability, "you have to inquire about any changes in pigmentation [as well], especially in skin of color patients," Dr. Callender said. Moisturizers, cleansers, and less irritating vehicles can improve tolerability.

"We also use adjunctive therapies and sunscreen protection [for PIH]. Remember combination therapy is the way to go," she said.

She and her associates conducted a meta-analysis looking at the tolerability of a fixed combination adapalene 0.1% and benzoyl peroxide 2.5% gel product (Epiduo) for acne in patients by Fitzpatrick skin type (J. Clin. Aesthet. Dermatol. 2010;3:15-9). They found erythema, scaling, and dryness scores higher for white patients in all three studies. Burning and stinging scores were not significantly different. "Tolerability is good for your skin of color patients. You don’t need to be overly concerned about a lot of irritation just because their skin is dark."

Chemical peels, lasers, and light-based therapies are additional treatment options for acne. Peels made with glycolic acid, salicylic acid, Jessner’s solution, or a combination is acceptable in skin of color patients. However, "be very, very careful with peels in skin of color patients. Make sure [to] use superficial peeling agents," Dr. Callender said.

More clinical studies of lasers and light-based therapies to treat acne are including the darker skin types, Dr. Callender said. Blue light, diode laser, intense pulse light, and photodynamic therapy are examples. "As we learn how to adjust the settings, they will be safer for skin of color patients," she said.

Dr. Callender disclosed that she is a consultant for Allergan and Galderma, which markets Epiduo; a researcher for Allergan, Galderma, and Intendis; and a member of the speakers’ bureau for Galderma.

As a follow-up to our recent blog on using skin camouflage to cover skin disorders, a technology called Microskin is also available to mask skin imperfections.

Microskin, also known as simulated second skin, is a topical skin camouflage that is individually tailored to match a person's skin color and cover conditions such as birthmarks, vitiligo, burns, scars, striae, pigmentary disorders, rosacea, and photodamage.

Unlike traditional make-up, Microskin is an alcohol-based liquid that won't wipe off on clothing. It is waterproof and adheres to the epidermis forming a simulated second skin over the affected area.

Courtesy of Microskin

One application typically lasts for 1-2 days on the face and several days longer on the body. Small areas are treated with a sponge, whereas larger areas may be airbrushed.

Microskin was developed in Australia, where it was studied at a pediatric burn center to assess the product's impact on burn patients. The U.S. headquarters are located in New York, but consultations are often set up at various cities around the country throughout the year.

Microskin is is not a treatment or medication for skin conditions, but it can be another acceptable option for helping patients achieve cosmetic improvement.

More information may be found at microskincenter.com.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

As a follow-up to our recent blog on using skin camouflage to cover skin disorders, a technology called Microskin is also available to mask skin imperfections.

Microskin, also known as simulated second skin, is a topical skin camouflage that is individually tailored to match a person's skin color and cover conditions such as birthmarks, vitiligo, burns, scars, striae, pigmentary disorders, rosacea, and photodamage.

Unlike traditional make-up, Microskin is an alcohol-based liquid that won't wipe off on clothing. It is waterproof and adheres to the epidermis forming a simulated second skin over the affected area.

Courtesy of Microskin

One application typically lasts for 1-2 days on the face and several days longer on the body. Small areas are treated with a sponge, whereas larger areas may be airbrushed.

Microskin was developed in Australia, where it was studied at a pediatric burn center to assess the product's impact on burn patients. The U.S. headquarters are located in New York, but consultations are often set up at various cities around the country throughout the year.

Microskin is is not a treatment or medication for skin conditions, but it can be another acceptable option for helping patients achieve cosmetic improvement.

More information may be found at microskincenter.com.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].

As a follow-up to our recent blog on using skin camouflage to cover skin disorders, a technology called Microskin is also available to mask skin imperfections.

Microskin, also known as simulated second skin, is a topical skin camouflage that is individually tailored to match a person's skin color and cover conditions such as birthmarks, vitiligo, burns, scars, striae, pigmentary disorders, rosacea, and photodamage.

Unlike traditional make-up, Microskin is an alcohol-based liquid that won't wipe off on clothing. It is waterproof and adheres to the epidermis forming a simulated second skin over the affected area.

Courtesy of Microskin

One application typically lasts for 1-2 days on the face and several days longer on the body. Small areas are treated with a sponge, whereas larger areas may be airbrushed.

Microskin was developed in Australia, where it was studied at a pediatric burn center to assess the product's impact on burn patients. The U.S. headquarters are located in New York, but consultations are often set up at various cities around the country throughout the year.

Microskin is is not a treatment or medication for skin conditions, but it can be another acceptable option for helping patients achieve cosmetic improvement.

More information may be found at microskincenter.com.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to [email protected].