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Hyperpigmentation and Skin of Color

By: Jennifer Linder, MD
Posted: August 23, 2010, from the September 2010 issue of Skin Inc. magazine.

Much of the world’s population is considered Fitzpatrick type IV–VI. (See Fitzpatrick Scale.) By 2050, according to the U.S. Census Bureau in 2000, 50% of Americans will be of darker-skinned racial backgrounds. One of the most common skin conditions in higher Fitzpatrick clients is hyperpigmentation. Although many of the popular treatments performed on a regular basis on Caucasians may be well-tolerated by clients with darker skin, special considerations need to be taken to ensure positive treatment outcomes for such clients. A deeper understanding of the causes of hyperpigmentation, and of the myriad of ingredients available for its treatment, will help spa professionals develop highly effective therapies for all of their clients, regardless of ethnicity.

Beyond black and white

Within any ethnic background, a variety of Fitzpatrick skin types can be identified. Darker skin can commonly be seen in Hispanics, Latinos, Africans, African-Americans, Caribbeans, Native Americans, Pacific Islanders, East Indians, Pakistanis, Eskimos, Koreans, Chinese, Vietnamese, Filipinos, Japanese, Thai, Cambodians, Malaysians, Indonesians and Aleuts, according to dermatologist Pearl Grimes, MD.1 With this broad global representation in mind, spa professionals should expect to see an increase in clients of one or mixed racial backgrounds with darker skin.

The most apparent difference in the skin of those from different ethnicities is, of course, the color, although there are also differences in skin thickness, vascularity, and predispositions to certain skin conditions and diseases. Hyperpigmentation can occur due to UV exposure, cutaneous trauma or hormonal fluctuations. Studies by dermatologist Susan Taylor in 2005 demonstrate that up to 86% of women of Latino, Asian and African descent are concerned about skin discolorations.2

Melanogenesis and skin color

Melanin is the complex molecule that is responsible for the pigment in the body; specifically eyes, hair and skin. Melanin works to protect by reducing the penetration of UV rays into the skin and, even more importantly, into the nuclei of cells where DNA resides. Those with both dark and light skin have the same number of melanocytes—the cells responsible for melanogenesis or melanin production—although their level of responsiveness differs. Clients whose genetic heredity is that of global regions with extreme UV exposure have melanocytes that will, out of protective necessity, instigate the process of melanin deposition much more quickly than someone with lighter skin. Some clients with mixed genetic heritage may have lighter skin, but still have a greater predisposition for hyperpigmentation than a typical Fitzpatrick skin type I or II.

As a result of inflammation or hormonal fluctuations, the following process is stimulated.