Have you ever come across the term Skin of Color (SOC)? It's a broad term that encompasses a wide range of skin tones from people of diverse ethnicities and backgrounds. Why does this matter? Well, because skin conditions like acne, rosacea, and eczema can look very different in different skin tones! And in a country as diverse as the United States, where the population is a melting pot of cultures, the spectrum of skin tones is vast. 

So it's not a binary issue with SOC—either you have it or you don't—it's more of a nuance with shades and flavors of varying degrees! Since skin conditions can present differently in skin of color, healthcare professionals need to be aware of these variations to provide accurate diagnoses and appropriate treatments.

How is the awareness of Skin of Color changing skin care?

Today, there's a significant improvement in the representation of various skin tones in dermatology atlases and textbooks compared to when I was in training! This is so critical, as your dermatologist needs to be able to identify skin conditions in a variety of skin types. Did you know that rosacea in lighter Caucasian skin looks red and papular, while in darker skin types it can appear more purple (violaceous)? Without knowing this distinction, some SOC patients may experience a delay in the diagnosis and treatment of their chronic skin condition.

Skin cancers may present differently in individuals with skin of color (SOC). And yes, even if you have SOC, you can still develop skin cancers such as basal cell carcinomas, squamous cell carcinomas, and melanomas. It's important to apply sunscreen and take sun protection measures no matter the color of your skin! Sadly, due to the misconception that those with SOC are immune to skin cancers, many patients end up with more advanced lesions that may have been ignored or misdiagnosed as eczema or a benign condition.

So, how do we classify skin types?

In dermatology we use what's called the Fitzpatrick Skin Phototypes which were developed to determine how quickly individuals with lighter skin burn when exposed to ultraviolet radiation for phototherapy. However, this scale predominantly caters to lighter skin tones and falls short in addressing those with darker complexions.The classification of skin types, such as the Fitzpatrick scale, may not fully capture the genetic and environmental factors that affect different ethnicities, and a more precise classification system is needed.

Instead of using this 1-6 scale, we get a better idea of skin tone when we ask about different things like: 

• Do you burn easily?

• Do you tan easily?

• How do your scars appear? Are they brown, red, dark, thick, or white?

• Do you have dark creases on your palms? 

Do patients with SOC have special needs?

One of the most common skin concerns for patients with SOC is hyperpigmentation, particularly melasma, which can be persistent and challenging to treat. Dealing with this frustrating condition requires careful attention, patience, and gentle treatment approaches. Being too aggressive can worsen pigmentation or cause skin lightening. For conditions like melasma, a comprehensive approach involving sun protection, gentle skincare, and specific treatments can help manage and improve the condition.

What about aesthetics?

It's a misconception that darker skin types can't undergo laser or energy-based device treatments, but caution is necessary. Usually, longer wavelengths are preferred with lasers to preserve normal pigment in the skin, and settings must be carefully adjusted to ensure skin protection.

When it comes to aesthetic treatments, certain devices and techniques are safer for skin of color, and it is important to seek out board-certified dermatologists or plastic surgeons with expertise in treating diverse skin types.

Don't forget to listen to this week's podcast episode with Dr. Swati Kannan where she shares useful skincare tips for people with SOC.

 Find Dr. Kannan here:

https://www.instagram.com/drswatikannan/

https://www.swatikannanmd.com 

A new podcast episode drops every Monday!

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