Issue link: https://www.ascpskindeepdigital.com/i/1507658
70 ASCP Skin Deep Autumn 2023 AGING IN ASIAN SKIN Pigmentation abnormalities are the primary manifestation of photoaging in individuals of Asian descent. These abnormalities may present as freckles, seborrheic keratoses, mottled pigmentation, or melasma. Wrinkling is considered to be a less prominent feature of photoaging in these populations. Solar Lentigines This form of lentigines is very common among individuals who've had chronic exposure to sunlight (see ASCP Skin Deep Summer 2023 "Too Much Fun in the Sun," page 35). The lesion is usually smaller in size (around 5 mm), has a depressed or flat surface, and is often divided by wrinkles. Typically, this type of lesion is brown, but it can also range from yellow to black, and sometimes smaller lesions combine to form larger patches. These lesions are most often found on sun- exposed regions of the face, the upper part of the body (such as shoulders and neck), arms, and hands. Pigmentary conditions are particularly common in individuals of Asian descent, but many of these conditions can be treated topically. Following are a list of common ingredients and topical products that can be used: • Aloe vera extract—contains aloin, a depigmenting agent that's highly effective against hyperpigmented lesions of all types. • Azelaic acid—helps reduce melanin pigment by inhibiting tyrosinase, which is the main enzyme needed to produce melanin pigment from melanocytes. It also has a direct, cytotoxic effect on the melanocytes and, therefore, a depigmenting effect on the skin. • Kojic acid—derived from certain types of fungi, including aspergillus, penicillium, and acetobacter. It helps inhibit the activity of tyrosinase. • Niacinamide—prevents the transfer of melanosome to keratinocytes and melanogenesis, resulting in depigmentation. • Vitamin C—topical application stops tyrosinase activity and reduces dopaquinone, an important compound in melanin production. AGING IN HISPANIC AND LATINO SKIN Photoaging in lighter-skinned individuals of Hispanic or Latino descent looks similar to that of lighter- skinned individuals of Northern European descent, wherein wrinkling is more common than abnormal pigmentation. Hispanic and Latino individuals with darker skin tend to develop photoaging conditions similar to those with Black and Asian skin. Photoaging is the third most common skin diagnosis in people of Hispanic descent. The primary manifestation for this group is wrinkling, appearing at the same age as it would for those of European descent and with less pigmentary changes. Hispanic skin types show photoaging similar to darker-skinned Asian and Black skin types. The manifested lesions are fine wrinkles, mottled pigmentation, dyschromia (light and dark spots), and textural changes, presenting most often between ages 40 and 60. Many of these manifestations can be prevented or slowed with the protection of sunscreen, as they are often the result of sun exposure. Studies have shown that the use of sunscreen is less prevalent among Black and Hispanic individuals due to misinformation that darker skin tones don't need as much protection as lighter skin tones. 4 Following is a summary of useful topical ingredients that can reduce the appearance of common anomalies seen in racially blended and darker skin tones: • Arbutin—has obvious pigmentation-reducing effects, and though there's no clear evidence of how well it stacks up against hydroquinone, reports note that it has fewer side effects. Arbutin appears to be a promising hydroquinone alternative, but more studies need to be done on its efficacy. • Azelaic acid—was initially used for the treatment of acne but was later found to have an effect on suppressing melanin production. Treating melasma and other hyperpigmentation problems with azelaic acid is a skin-brightening alternative. However, unlike hydroquinone, azelaic acid is not effective against freckles and age spots. Resources Alam, Murad et al. Cosmetic Dermatology for Skin of Color. McGraw Hill, 2009. Jablonski, Nina G. Living Color – The Biological and Social Meaning of Skin Color. University of California Press, 2014. Kelly, A. Paul, and Susan C. Taylor. Dermatology for Skin of Color. McGraw Hill, 2016. Springer, Pamela R. Don't Be Left in the Dark: Learn How to Master Chemical Peels & More . . . for a World of Diverse Skin Tones. Global Skin Solutions Publishing, 2020. Vashi, N. A., M. B. de Castro Maymone, and R. V. Kundu. "Aging Differences in Ethnic Skin." Journal of Clinical and Aesthetic Dermatology 9, no. 1 (2016): 31-8. ncbi.nlm.nih.gov/pmc/articles/PMC4756870.