Acne in skin of color: Practical Facts
Acne in skin of color: Practical Facts
Misconceptions:
- Benzoyle Peroxyde
- benzoyle peroxide does not bleach the skin but can cause dyschromia.
- it doesn’t act on tyrosinase activity but can create skin irritation ans subsequently inflammation (Post-inflammatory Hyperpigmentation (PIH))
- Minocycline
- minocycline causes hyperpigmentation in skin of color. But what we do not know, is if it is worse than other antibiotics
- minocycline induces more DRESS syndrome in patients of color* (drug reaction with eosinophilia and systemic syndromes)
- a lower risk of hyperpigmentation could be with combination with vitamin C at 0.1% of the daily dose.
Acne induced Post-inflammatory hyperpigmentation:
- treatments with 2% hydroquinone (but 6 to 10% may be componded)
- triple combination treatments (Hydroquinone, Steroids, Retinoids) may be tried steroid. (However more studies are needed especially to measure the longer term outcomes)
- continuing HQ despite irritation can lead to worsening of pigmentation (PIH (Post-inflammatory Hyperpigmentation))
- When applying hydroquinone (HQ) to avoid a halo of depigmentation around treated lesions, apply HQ with Q-tip and tretinoin then on whole face
- fluorinated steroids are used to bleach the skin but can induce steroid acne
*African Americans, Asians, Indians, Hispanics…
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Contributors:
Dr Christophe HSU – dermatologist. Geneva, Switzerland
Bibliography: Woolery Lloyd. Managing Acne and Rosacea in Skin of Color Patients. Skin of color. 70th Annual Meeting of the AAD (American Academy of Dermatology) – San Diego, California, United States of America (USA)
