Shades of Beauty
September 29, 2015, Nicole Altavilla
Discover why the treatment of ethnic skin is not always black and white.
Developed in 1975 by dermatologist Thomas B. Fitzpatrick as a way to classify a person’s genetic disposition and their skin’s response to ultraviolet light, the Fitzpatrick scale is the color range used primarily by dermatologists today. It places skin type into one of six categories, ranging from skin type I (very fair) to skin type VI (very dark). Within this scale, there is a wide range of human skin color variation.
The differences in skin—including tone, texture, sensitivities and reactions, thickness, moisture, and melanin levels—contribute to unique responses to the sun and environmental exposures and create different reactions to treatments and products, according to Bella Schneider, founder and owner of LaBelle Day Spas & Salons (multiple locations in CA) and Bella Schneider Beauty. “Keep in mind that within one ethnic group, there are different skin types, as well as many multiracial and mixed-race individuals, and the aesthetic goals of women vary based on their ethnic and cultural values of beauty,” she says. For example, many white clients look for a natural bronze skin color and enjoy sporting a tan, whereas Asian clients may prefer skin-whitening treatments. “When developing a skincare plan, one must remember that skin conditions are not only the result of ethnicity but are also contingent on multiple factors including diet, weather conditions where the individual lives, stress, hormones, gender, and maintenance practices,” says Schneider.
The main difference in skin color is the level of melanin, which gives skin its color. According to Kat Khadija Leverette, esthetician and ethnic skin expert at Clinically Clear Skin Rehab Center (Oakland, CA), the activity of melanocytes, which are melanin-producing cells located in the basal layer of the epidermis, provides skin color. “The complex process called melange makes skin cells produce melanin, the pigment that defines a natural dark or light skintone,” she says. “When disrupted, activation of these melanocytes, caused by stimuli including sun exposure, hormonal changes, or any event that causes inflammation, can trigger hyperpigmentation.”
Because ethnic skin contains higher levels of melanin, which help it absorb more of the sun’s rays, there is a misconception that it doesn’t burn. Not only is this not true, but ethnic skin can at times burn deeper than Caucasian skin, according to Katherine Tomasso, national director of education at Yon-Ka Paris. “With a Fitzpatrick of IV and higher, ethnic skin is often thought of as being more resilient and much less reactive than lighter skintones,” she says. “Yet, highly pigmented skin can suffer from a wide range of conditions that include sensitivity and reactivity.”
Skin Deep Concerns
Hyperpigmentation and uneven skintones are among the biggest concerns when it comes to ethnic skin. They can be caused by a reaction to the sun or skincare products, as well as hormone levels and environmental and lifestyle factors. Many of these spa-goers fear that a procedure or treatment will lead to pigment changes, either darkening or lightening skin. “Most people with ethnic skin who have had acne, or even a bug bite, understand that afterwards they are left with a shadow of where the mark was,” says Alicia J. Cool, M.D., dermatologist at Advanced Dermatology, P.C. (Brooklyn, NY). “For the most part, this is a temporary phenomenon and will self resolve over time, but even temporary hyperpigmentation of the skin is cosmetically unacceptable and can lead to unnecessary stress and dissatisfaction with appearance.”
Another common concern is dark patches and spots that can develop in areas that get scratched, scraped, scarred, or hit. “The brain has registered trauma, and the blood rushes to the point of impact to provide healing,” says Juliette Samuel, esthetician and CEO of Nyraju Skin Care. “On Caucasian skin, it’s possible this trauma will appear as bruised skin. On ethnic skin, not only will it appear bruised but it will also remain darker in this area for longer periods of time.” Other less common concerns include excessive oil production, which can lead to acne; vitiligo, a disease that causes loss of color in portions of skin; dry or ashy patches; and keloid scarring.
Also, unlike Caucasian skin, anti-aging and stimulating collagen is not always the need, desire, or goal of clients, according to Pamela R. Springer, licensed esthetician, certified laser technician, and product formulator for Global Skin Solutions corrective products. “Ethnic skin has a higher content of collagen, which is why it has the propensity to develop keloids,” she says. “The goal generally is to reduce hyperpigmentation; even skintone; diminish dry, ashy skin; and bring back the skin’s luminosity.”
Handle with Care
All skin, regardless of color, has basic conditions that need to be addressed, including dryness, acne, wrinkles, sun damage, uneven tone, rosacea, and sensitivity, says Elena Davidson, director of education at Christina Cosmeceuticals USA. “All of these conditions may present in any color skin,” she says. “However, darker tones are more likely to experience some issues than others. Ethnic skincare treatments can be challenging if not approached with care.”
It is imperative to prepare and treat the skin properly to cause the least amount of inflammation possible. This can be done by avoiding the use of harsh treatments and exfoliants, because the more trauma to the skin, the more inflammation produced, and the greater chance of post-inflammatory pigmentation changes, says Cool. Also, hot wax and certain treatments like lasers, intense pulsed light (IPL), and microdermabrasion can trigger hyperpigmentation.
To ensure proper treatment of the skin, a consultation should take place prior to all treatments. “Believe it or not, skincare therapists will often take a general approach to caring for ethnic skin,” says Samuel. “It’s a given that basic questions such as medications, family illnesses, and allergies are important, but what about family history of those with keloid skin or vitiligo? If skincare therapists can step outside of the traditional box of training, they will know from the interview with clients how to approach their treatment.”
According to Schneider, there are many approaches and techniques to correct and treat different skin conditions. “First and foremost, get to know the particulars of the individual’s environment, lifestyle, sun exposure, genetics, medications, ethnic group, stress levels, skincare goals, and concerns,” she says. “These are all just as important as skin color. The subgroups of each skin type—African American, Asian, Indian, Latino, Mediterranean, Middle Eastern, and others—can be treated equally well with products using top-of-the-line ingredients, proper state-of-the-art equipment, and experienced technicians.”
Key Ingredients
Just like certain treatments should be avoided on ethnic skin, certain ingredients should also be avoided. Leverette recommends sticking to a fragrance-free backbar and limiting the use of aromatherapy oils to ensure the product won’t irritate the skin. Instead, she recommends using mild, low-lathering cleansers, fragrance-free skincare, alcohol-free toners, topical alpha hydroxy acids and retinol in formulations containing melanin-suppressing skin brighteners, and diligent use of sheer, micronized mineral sunscreen suited to the client’s skin type. Products with alpha hydroxy acids and retinol should be introduced gradually, applied sparingly, and massaged into the skin, says Leverette, and active skin-brightening cocktails that contain l-ascorbate (vitamin C) and melanin-suppressants like alpha arbutin, azelaic acid, bearberry, emblica extract, hydroquinone, kojic acid dipalmitate, licorice extract, mandelic acid, mulberry extract, niacinamide (vitamin B3), and vitamin K should be patch-tested first and used exactly as directed and in the right formulation to avoid irritation or an allergic reaction.
Increase Awareness
Because individuals from the same ethnic background can have very different skin types, reactions, sensitivities, and skincare goals, it is important that spas make clients aware that they are trained to treat all skin types, so guests can relax and enjoy the spa experience without worry. When it comes to promoting treatments and products that are targeted toward ethnic skin, Luigi L. Polla, M.D., founder of Forever Laser Institut (Geneva) and Alchimie Forever, does not feel that marketing needs differ much, because “we are all looking for the same thing: a clear complexion, a reduction in the signs of aging, and overall radiance and beauty,” he says. However, to attract spa-goers of all ethnicities and gain their trust before booking treatments, it is a good idea to make spa-goers aware that the spa’s estheticians and therapists are knowledgeable about treating skin of all colors and types. “Let them know that your skin therapists are well-versed in the care of ethnic skin,” says Samuel. “Make them aware of the fact that your product line can be used on ethnic skin without damaging it, and reach out to ethnic groups and plan special events so that they can visit your establishment and see up-close-and-personal what you have to offer as a spa owner.”
Leverette recommends emphasizing that products and treatments are safe for all skintones and use descriptive marketing phrases for services like “skin-brightening peel,” “skin-brightening treatment,” and “illuminating,” as well as catchy phrases like “bright on,” and “lighten up.” She also suggests avoiding terms like “whiten,” “whitening,” and “skin bleaching,” which are inaccurate and can have a negative connotation.
You can showcase your spa’s commitment to personalized care and results by providing before-and-after photographs for a wide range of conditions and hosting educational events for clients featuring experts on the various topics of health, wellbeing, and skincare, says Tomasso. This is a good way to help clients view a spa visit as something more than a special occasion indulgence and also help skincare therapists recognize that there is no such thing as a one-size-fits-all approach to treating skin. Says Tomasso, “With the terrific advancements we’ve seen in botanical skincare, all skin types and ethnicities have an opportunity for professional and comprehensive treatments for their skincare needs—anyone can have true skin health.”