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Handling Post-inflammatory Hyperpigmentation

By: Christine Heathman
Posted: September 28, 2012, from the October 2012 issue of Skin Inc. magazine.

Global skin of color is the ultimate future snapshot of your skin care clientele. Skin care professionals who ignore the phenomenon of the multitude of skin races are out of touch with the reality concerning the trends that will dictate their esthetic careers in the near future, and will miss the opportunity to learn how to work with this ever-increasing population successfully. Skin care professionals must prepare for this prospect, and learn to recognize what is appropriate and inappropriate concerning skin treatments, ingredients and products for skin of color.

There are significant differences between global skin types. Just look at the rainbow of skin colors that make up the millions of skin types and where they originate. Cosmetically speaking, black skin has a wide range of color variations from a creamy light coffee color to deep ebony black. Asian skin exhibits colors that range from a light yellow hue to a dark golden tan. Native American skin colors vary with respect to different tribes, and have coloring that ranges from light to dark red-brown. Even white skin is misinterpreted visually and put into inaccurate categories. Caucasian skin ranges greatly from milky alabaster white to dark olive tones.

Darker global skin types are much more reactive to topical agents such as alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), trichloroacetic acid (TCA) and many different ingredients, and are more sensitive to these constituents than Caucasian skin. Unfortunately, many skin care professionals misunderstand the darker global skin combinations and treat skin of color as if it were Caucasian, being overzealous in their procedures and recommending improper skin care products, triggering an inflammatory response leading to unwanted problems. This can result in devastating side effects, such as hypopigmentation and hyperpigmentation. These very avoidable mistakes not only affect the client cosmetically and emotionally, but destroy the trust between client and professional.

Understanding color distinction

Melanocytes, melanin and pigmentation formulate the key color distinction of skin. The content of melanin within keratinocytes determines skin color, with deeply pigmented skin having the highest content of epidermal melanin. Melanin is a complex molecule responsible for the pigment in the skin, hair and eyes. This molecule works to protect by reducing the penetration of UV rays into the skin and subsequently into the nuclei of cells where DNA resides.

It is well-established that there are no racial differences in the number of melanocytes; however, the actual number of melanocytes does differ from one individual to another, and from one anatomical region of the body to another, with the head, neck and forearms having the highest number.