INDIVIDUAL ARTICLE: Skincare in Skin of Color: A Comprehensive Approach to Preprocedure, Intraprocedure, and Postprocedure

August 2024 | Volume 23 | Issue 8 | 62041s5 | Copyright © August 2024


Published online July 30, 2024

Heather C. Woolery-Lloyd MD

Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL

Abstract
Hyperpigmentation, uneven skin tone, textural changes, and dull skin are common cosmetic concerns in skin of color. Other signs of aging, including fine lines, deeper wrinkles, and skin laxity, also occur but may present in later decades. In-office procedures such as laser treatments, energy devices, toxins, fillers, and chemical peels are useful options for addressing the most common cosmetic concerns in skin of color patients. Skincare can play an important role in improving cosmetic outcomes when used in conjunction with in-office procedures. With the availability of these approaches, clinicians can now integrate in-office procedures with skincare strategies to offer patients with skin of color a comprehensive treatment plan that meets their needs.

J Drugs Dermatol. 2024;23:8(Suppl 1):s5-10.
Importance of Assessing Skin of Color in the Clinic

Race and ethnicity are influenced by several factors, including geographic, social, and cultural influences.1,2 Skin conditions often present differently in patients with darker skin, and these differences can impact treatment options and clinical outcomes.3,4 Due to the unique presentation of certain dermatologic conditions in skin of color, skin tone should be considered when making clinical assessments and therapeutic decisions for this population.

Skin Color Approximation Scales in Use

The most widely used scale to classify skin color is the Fitzpatrick skin classification scale. The original Fitzpatrick Skin Type (FST) scale included skin types I to IV and was developed to help determine appropriate doses of ultraviolet (UV) light therapy for patients with psoriasis.5 Skin types I to IV were defined by the self-reported ability to tan or burn. Later, the FST was expanded to include types V (brown) and VI (dark).6,7

A newer scale, the Skin Color and Ethnicity scale, expands on the FST by further breaking down skin types IV and V into IVa and IVb, and Va and Vb, respectively (Figure 1).8 In this newly proposed scale, other characteristics are used to help define skin types, including freckling, fine wrinkles, and the presence of truncal nevi. For example, in this new scale, wrinkling is classified as more prominent in skin type IVa compared with skin type IVb. In another example, the scale describes skin type Va as having minimal truncal nevi compared with skin type Vb as having no truncal nevi.8 This scale also aims to better define the risk of postprocedure scarring and postinflammatory hyperpigmentation in different skin types, and may be useful in selecting certain cosmetic and surgical procedures.

Biological and Physical Characteristics Unique to Skin of Color

Skin color can influence the risks and outcomes of many cosmetic procedures. The risk of postinflammatory hyperpigmentation and scarring generally increases in darker skin types.9 Skin color is largely dictated by the distribution of melanosomes
Biological and Physical Characteristics Unique to Skin of Color

Skin color can influence the risks and outcomes of many cosmetic procedures. The risk of postinflammatory hyperpigmentation and scarring generally increases in darker skin types.9 Skin color is largely dictated by the distribution of melanosomes