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Does Skin Tone Affect Skin Care?

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Our skin performs many roles. It helps manage body temperature, keeps out bacteria and other bugs, and is key to our sense of touch.

Skin unites us all in these common functions, but our skin also varies in ways that show up cosmetically.

Your skin tone can affect how soon you’ll develop wrinkles and sunspots. It can also influence whether you’re more prone to hyperpigmentation, darkened areas on your skin.

Skin tone isn’t simply a matter of race, since people from the same background can have widely varying skin color. Race and ethnicity usually aren’t an accurate reflection of skin tone, says Anna Chien, MD, an associate professor of dermatology at the Johns Hopkins University School of Medicine.

Doctors refer to “skin types” ranging from 1 to 6. Skin type 1 is the palest, which always burns and never tans. Mid-tones, such as type 4, are light brown, tan easily, and rarely burn. The darkest, Skin type 6, is deeply pigmented and never burns. This range of skin types is also called “Fitzpatrick skin typing,” named for the doctor who developed it. It’s based on how much pigment is in someone’s skin and how their skin reacts to sun exposure.

Learn from three dermatologists how skin tone can affect our skin care routines.

Sun Damage

Doctors call sun damage “photoaging,” which includes the wrinkles and sunspots that can come with sun exposure.

This tends to happen “a little more quickly” in people who have lighter skin types, Chien says. “And they are more prone to skin cancers.”

In contrast, people with darker skin tones “often do have delay in the signs of photoaging. And they also have a lower risk of skin cancer,” says Julia Mhlaba, MD, an assistant professor of dermatology at Northwestern University Feinberg School of Medicine. “That pigment actually provides sun protection.”

But it’s important to keep in mind that a lower risk of skin cancer doesn’t mean zero risk. “All skin can get skin cancer,” says Shani Francis, MD, a dermatologist in the Los Angeles area.

Misconceptions that people with darker skin don’t get skin cancer are dangerous because that can lead to a delayed diagnosis or misdiagnosis. “We definitely can see skin cancer in darker-skinned individuals,” Chien says. “And unfortunately, because this isn’t often talked about … the skin cancer may be found later when it’s much more progressed.”

In people with darker skin, cancers can also occur in places “where patients typically don’t get exposed to sun, like the bottoms of the hands and the feet,” Mhlaba says.

Universal Need: Sunscreen

All skin tones require sunscreen with an SPF of at least 30 – every day, rain or shine – to help prevent skin cancer and slow photoaging.

“We always recommend sun protection because even in darker-skinned individuals [and in] folks who say, ‘I never burn; I always tan,’ they’re still getting the damage in the skin,” Chien says.

If you’re outdoors for long periods, use at least an SPF of 60, Chien says. Reapply often, especially if you’re active, sweating, swimming, or getting wet.

Physical blocker sunscreens with zinc oxide or titanium dioxide offer the best protection, according to the experts. But on darker skin, these products aren’t always cosmetically elegant.

“It can cause white film on the skin, which is challenging for individuals with darker skin tone,” Chien says. She recommends tinted sunscreens that might better match their skin tone.

Tinted sunscreen may offer further benefits. In darker-skinned people, longer wavelengths beyond UV rays can be more damaging than in people with lighter complexions, Chien says. “The tint can actually protect against a little bit of the longer wavelength that their skin could be more sensitive to,” she explains.

Beyond Sunscreen

Don’t rely on sunscreen alone. “I always tell my patients sunscreens aren’t perfect,” Chien says. “We need to reapply and combine [it] with other measures.”

That includes wearing sunglasses and long-sleeved shirts, avoiding peak sun, looking for shade, and wearing wide-brimmed hats. She calls it a “multi-modal approach to sun protection.”

And don’t count on SPF in makeup alone to give you enough protection, Chien says. “The SPF they achieve in a lab setting – usually they’re applying a fairly thick amount of that makeup, so it doesn’t really mimic day-to-day use.”

What to Know About Retinol and Retinoids

Regular use of sunscreen and moisturizer can help slow signs of aging. And so can using a retinoid or retinol on your skin.

“These are vitamin A derivatives that can either be purchased in over-the- counter versions or they can be prescribed by a dermatologist at higher strengths,” Mhlaba says. “They do a lot of things: They’re used to treat acne. They can help with pigmentation. But they can also help in terms of smoothing out fine lines and preventing wrinkle formation.”

People with darker skin tones can use higher-strength retinoids but must start slowly to avoid irritating their skin, Mhlaba says. “If they do develop irritation, it can cause hyperpigmentation more easily than in patients with lighter skin types,” she explains.

Her advice: When you start using a retinol or retinoid, apply only a small amount to your face, and do that every few days at first. Follow up with a moisturizer to help curb any skin irritation.

Hyperpigmentation

Wearing sunscreen on the face not only slows photoaging, Mhlaba says, but can also help stop hyperpigmentation from getting worse.

Hyperpigmentation can happen in all skin types, but it’s more common in people of color, Mhlaba says.

“It can occur from acne scars or eczema or at sites of trauma, and then there are other conditions that lead to hyperpigmentation, like melasma,” she says. Melasma appears as darker patches of pigmentation, especially on the face.

Sun exposure can worsen hyperpigmentation – another reason why sunscreen is key. Products that can treat hyperpigmentation include vitamin C serum or vitamin C-containing products, glycolic acid, azelaic acid, and niacinamide, Mhlaba notes.

For melasma, dermatologists can also prescribe hydroquinone-based compounds or oral medications.

Dryness

Dry skin can affect all skin tones. “But if your skin is darker, dry skin is light white, and so there’s more contrast. It’s much more noticeable,” Francis says. That dry appearance comes from the scales of shedding skin.

Darker skin that becomes dry could benefit from “a really good, thick moisturizer, something that could help to rebuild the [skin] barrier,” Chien says.

Don’t judge a product by how thick it looks in the container. What matters more is how thick it is on your skin, Francis says. She suggests looking for ingredients such as ceramides, glycerin, castor oil, petroleum jelly, and hempseed oil.

Smooth moisturizer over damp skin after showering or bathing. “It will keep the water in the skin,” she says.

Sensitivity

People of all skin tones can have problems with sensitivity. “Stick with really bland products,” Chien says. Choose unscented products, and stay away from those labeled antibacterial.

“Keep the skin care regimen pretty simple: just a gentle face wash, a bland moisturizer, something with an SPF built in for the daytime, and just a plain moisturizer in the evening,” she says.

People with sensitive skin can spot-test a product behind their ear or upper inner arm to make sure they don’t react to the product, Chien says.

She recommends “not adding in a lot of serums or anti-aging products. A lot of those can be irritants.”

If people with sensitive skin want to exfoliate, “It’s a little more patient-specific in terms of what their skin will tolerate,” Mhlaba says. Physical exfoliators can be too harsh. But “if you’re talking about a chemical exfoliator, I would definitely recommend starting slowly and working up to using it daily, if needed. Sometimes, even just … once a week, depending on the product, could be enough.”

“Look for things with salicylic acid, glycolic acid,” she says. “A lot of topical creams will have that. That is a good way to exfoliate.”



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