Acne in skin of color: Practical approaches to treatment

Shah, Sejal; Alexis, Andrew F.

doi:10.3109/09546630903401496

Cited by 33 publications

(19 citation statements)

References 29 publications

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“…While the U.S. prevalence of severe acne was not previously reported, patients with skin of colour have reportedly more severe disease related to post‐inflammatory hyperpigmentation . Previous international population‐based studies found conflicting results with respect to racial and ethnic differences of acne prevalence (reviewed in Bhate and Williams).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study

Silverberg

2014

Br J Dermatol

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SummaryBackground Little is known about the epidemiology of severe acne in the U.S. Objectives We sought to study the U.S. prevalence, determinants and comorbidities of severe acne in adolescence. Methods We analysed data from the 2007 National Health Interview Survey, a cross-sectional questionnaire-based study of 9417 children ages 0-17 years. Prevalence of severe acne, demographics and comorbid disorders were determined. Results The U.S. prevalence of severe acne was virtually nil in the first decade of life, but increased in a linear fashion from 11 years [1Á7% (95% confidence interval (CI) 0Á4-3Á0%)] to 17 years of age [12Á1% (95% CI 7Á8-16Á5%)] (RaoScott Chi-square, P < 0Á0001). Severe acne was more common in Whites compared with other racial groups at age 14-15 years (P = 0Á0004) and girls at age 11-13 (P = 0Á02). Severe acne was associated with a number of comorbid disorders. Sinopulmonary disease included sinus infection (P = 0Á0003), sore throat other than strep infection (P = 0Á0003), asthma (P = 0Á03) and nonasthmatic lung disease (P = 0Á03). Upper gastrointestinal comorbidities included reflux/ heartburn (P = 0Á0003), abdominal pain (P = 0Á03), nausea/vomiting (P = 0Á0001) and food/digestive allergy (P = 0Á01). Psychological comorbidities included depression (P = 0Á02), anxiety (P < 0Á0001), attention deficit disorder/ attention deficit hyperactivity disorder (P = 0Á01) and insomnia (P = 0Á02). Conclusions In conclusion, severe acne was more prevalent in older age, Whites, female sex and higher socioeconomic status. Future studies are needed to confirm the associations with sinopulmonary, upper gastrointestinal and psychological disorders in adolescents.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study

Silverberg

2014

Br J Dermatol

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“…However, an appropriate understanding of the sequelae of acne is the key distinguishing characteristic in women of color. Potential sequelae, such as PIH and keloid scarring, occur more frequently in individuals with skin of color (Shah and Alexis, 2010). More severe forms of acne (especially truncal) can be associated with keloids and may be long lasting or permanent (Shah and Alexis, 2010).…”

Section: Adult-female Acnementioning

confidence: 99%

“…Potential sequelae, such as PIH and keloid scarring, occur more frequently in individuals with skin of color (Shah and Alexis, 2010). More severe forms of acne (especially truncal) can be associated with keloids and may be long lasting or permanent (Shah and Alexis, 2010). Therefore, early and efficacious anti-inflammatory agents to minimize pigmentary abnormalities and keloid scarring must be balanced with their potential for adverse effects (e.g.…”

Section: Adult-female Acnementioning

confidence: 99%

“…Atrophic acne scarring is another potential sequela of acne in skin of color patients that presents a therapeutic challenge (Shah and Alexis, 2010). A study consisting of 30 subjects with atrophic ice pick scars was performed to assess the efficacy and safety of the chemical reconstruction of skin scars (CROSS) technique in FST IV and V using high strength trichloroacetic acid (TCA) focally into the depth of the scar to induce collagen production (Khunger et al, 2011).…”

Section: Adult-female Acnementioning

confidence: 99%

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Updates in the understanding and treatments of skin & hair disorders in women of color

Lawson

Hollinger

Sethi

et al. 2015

International Journal of Women's Dermatology

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Skin of color comprises a diverse and expanding population of individuals. In particular, women of color represent an increasing subset of patients who frequently seek dermatologic care. Acne, melasma, and alopecia are among the most common skin disorders seen in this patient population. Understanding the differences in the basic science of skin and hair is imperative in addressing their unique needs. Despite the paucity of conclusive data on racial and ethnic differences in skin of color, certain biologic differences do exist, which affect the disease presentations of several cutaneous disorders in pigmented skin. While the overall pathogenesis and treatments for acne in women of color are similar to Caucasian men and women, individuals with darker skin types present more frequently with dyschromias from acne, which can be difficult to manage. Melasma is an acquired pigmentary disorder seen commonly in women with darker skin types and is strongly associated with ultraviolet (UV) radiation, genetic factors, and hormonal influences. Lastly, certain hair care practices and hairstyles are unique among women of African descent, which may contribute to specific types of hair loss seen in this population, such as traction alopecia, trichorrhexis nodosa and central centrifugal cicatricial alopecia (CCCA).

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“…One study demonstrated improvement of PIH with AA 15 % gel used twice daily for 16 weeks [ 177 ]. Kojic acid may be appropriate for those who cannot tolerate hydroquinone [ 178 ].…”

Section: Dyspigmentationmentioning

confidence: 99%