Racial/Ethnic Variations in Skin Barrier: Implications for Skin Care Recommendations in Skin of Color
September 2021 | Volume 20 | Issue 9 | Original Article | 932 | Copyright © September 2021
Published online August 31, 2021
Andrew F. Alexis MD MPHa*, Heather Woolery-Lloyd MD FAADb*, Kiyanna Williams MD FAADc, Anneke Andriessen PhDd, Seemal Desai MD FAADe, George Han MD FAADf, Maritza Perez MD FAADg, Wendy Roberts MD FAADh, Susan Taylor MD FAADi
aWeill Cornell Medicine, New York, NY
bSkin of Color Division, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, FL
cSkin of Color Section, Department of Dermatology, Cleveland Clinic, Cleveland, OH
dRadboud UMC Nijmegen, Andriessen Consultants, Malden, NL
eDepartment of Dermatology, The University of Texas Southwestern Medical Center, Innovative Dermatology, PA, Dallas, TX
fDepartment of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY
gDepartment of Dermatology, University of Connecticut School of Medicine New Canaan, CT
hGeneral and Cosmetic Dermatology, Rancho Mirage, CA
iSandra J Lazarus, Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA Wynnewood, PA
Methods: A literature review followed by panel discussions and an online review process aimed to answer the questions: Are there racial/ethnic differences in the SC barrier structure and healthy skin barrier function? Is there a need for specific cleansers and moisturizers?
Results: Ethnic categories based on race and ethnicity are often not well defined and inconsistent across different studies. Studies comparing ethnic groups' physical and biochemical skin barrier properties have reported differences in transepidermal water loss (TEWL), skin lipid levels, pH, and mast cell granule size. However, these studies frequently had methodological flaws, mainly were small, and demonstrated conflicting results. The literature suggests racial/ethnic variations in ceramide content, SC structure, and filaggrin mutations. Furthermore, studies have shown a greater burden of pruritus and atopic dermatitis among Black populations. Data on barrier properties in Hispanic/LatinX and South Asian populations are lacking.
Conclusion: Robust comparative studies are needed to understand these basic concepts to help tailor skincare and skin of color patients' education.
J Drugs Dermatol. 2021;20(9):932-938. doi:10.36849/JDD.6312