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Asian Skin Care - Dealing with Asian Skin Care Types
Asians comprise more than half of the earth's population. With
changing demographics in the United States skincare professional
will come in contact with an increasing number of patients
exhibiting this ethnic skin type. An understanding of the cutaneous
problems exhibited by this increasing group of patients is of
paramount importance. Asian patients exhibit Fitzpatrick skin types
III-V and treating this population is rarely written about. When
evaluating the skin differences between the various ethnic groups
several bio-physical skin parameters are evaluated. The most obvious
difference between ethnic groups is skin color due to the presence
of the photo-protective pigment melanin. Other parameters to be
considered are thickness of the stratum corneum (SC) and
trans-epidermal water loss (TEWL).
Changes in the physical properties of the skin, (SC) and (TEWL),
show that with aging, darker skin types retain younger looking skin
properties than do lighter skinned individuals. This may be because
these ethnic skin groups have a more compact stratum corneum (SC)
and as a result have increased skin barrier function despite lower
ceramide levels. According to Rawlings et al, upon chemical and
mechanical challenge the SC barrier function is reported to be
stronger in subjects with darker skin. One has to remember that
barrier function relates to total skin architecture and not just
ceramide levels. Recent studies suggest that Asian skin types may be
more sensitive to exogenous chemicals probably due to a thinner SC
and a higher eccrine (sweat) gland density. It is therefore
important that consumers and skincare professionals evaluate the
types of products that are best suited as treatment options and for
daily use by these individuals.
Asians are prone to many of the pigmentary disorders seen in other
ethnic groups. Melasma, the so-called "mask of pregnancy", freckles
and lentigines are typical epidermal hyperpigmentary disorders,
while nevus of Ota and acquired bilateral nevus of Ota-like lesions
are common dermal hyperpigmentary disorders. The nevus of Ota was
originally described by Ota and Tanino in 1939 and is described as a
tumor like accumulation of melanocytes in the dermis. It occurs most
frequently in Asian populations with an estimated prevalence of
0.2%-0.6% for Japanese persons. It is uncommon in whites but may be
seen in Africans, African-Americans, and East Indians.
Clinically, it presents as a blue or grayish-blue patch on the face.
It may be congenital or acquired, and it follows the distribution of
the ophthalmic and maxillary branches of the trigeminal nerve.
Although its presence within the same family is rare, its prevalence
among different populations suggests genetic influences. Nevus of
Ota can cause facial disfiguration and in rare cases develop into
melanoma, which can be life threatening. This condition also varies
as to its onset. The earliest onset of this condition is in infancy
with as many as 50% occurring at birth. The second period of onset
is adolescence. Its appearance in adulthood and in the elderly is
rare.
Similar to the African-American population, the Asian-American
population is prone to post-inflammatory hyperpigmentation (PIH).
With increasing use of lasers for skin re-surfacing and other
cosmetic procedures, prevention of PIH is of great interest. Another
source of PIH in the Asian population is acne, which is common in
Asians. The goal in the treatment regimen of PIH is to eliminate the
offending source of the inflammation. One of the ideal treatments
for acne in this population are azelaic acid based products. Azelaic
acid is a natural product derived from grain that is an excellent
skin bleaching agent without the side effects seen with
hydroquinones. Other than its ability to lighten areas of PIH it is
also a first line treatment for adult acne as well as other skin
conditions like rosacea and eczema, and brown/age spots as a result
of sun damage. This acid works by inhibiting the action of the
enzyme tyrosinase which converts tyrosine into the skin pigment
melanin and thus lightens the affected area of hyperpigmentation. In
addition to its skin lightening ability azelaic acid is also
bactericidal for the Proprion bacillus, the bacteria responsible for
acne as well as an anti-DNA action that may reduce the scarring that
may follow outbreaks of acne. It is very important that the consumer
and health care professional choose the right type of azelaic acid
product. This acid, other than the above mentioned qualities, also
has antioxidant properties. As such, it is prone to oxidation and
deactivates on exposure to the air rendering in effective. Look for
products that are a single dose, individually sealed unit packaging.
In this way, you are guaranteed that the cream you are using is
going to be full strength each time it is applied.
In conclusion, every once in a while there exists a natural product
that does what it promises to do. Azelaic acid is a multi-functional
botanical that will lighten brown spots and even-out skin tone
similar to hydroquinones without any of the associated side effects.
It is effective against adult acne, rosacea, eczema, and in a few
human clinical studies it has been shown to be effective against
certain pre-malignant skin lesions like lentigo maligno. The
multi-functionality of azelaic acid makes it an excellent all-in-one
product that is both therapeutic and cost effective. In addition to
therapeutic treatments for hyperpigmentary disorders, it is very
important to protect the skin against the damaging effects of
environmental pollutants like the suns UV rays which can worsen
these lesions. Consumers should look for moisturizing products that
contain high levels of antioxidants, like pure lycopene, that
protect the skin from the aging effects of environmental
contaminants and contain sunscreens that protect the skin from the
damaging and aging effects of the sun's UVA and UVB rays.
About the Author:
Gary I Weinberger,MD is a Fellow of the American College of Surgeons and has held teaching positions at both the University Hospital at the NYU School of Medicine and the University of Buffalo School of Health Sciences. He is currently the Executive Director of Paphos Skincare and in charge of research and product development. His area of expertise is the role of topically applied antioxidants and natural skin lightening products. More information and answers to your skincare question may be obtained on the Paphos Skincare Blog
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