Asian skin problems

Topic

Medical Dermatology

What are Common Asian Skin Problems?

What is different about Asian skin?

By: Kylee Wang and Dr. Calvin Sung MD

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Asians typically have a wide range of skin colors or phenotypes, from type III to type V on the Fitzpatrick’s classification scale. The amount of epidural melanin in the skin correlates to skin color, with darker skin having more melanocytes and thus more melanin production. In addition, Asian skin has a thinner stratum corneum, which is the outermost layer of the skin. This may be the reason why Asian skin is more prone to irritation from chemicals and environmental factors. Common skin conditions that affect Asians in particular include melasma, Hori’s nevus, post-inflammatory hyperpigmentation, atopic dermatitis, and acne.

Melasma

Melasma is a very common hyperpigmentation condition among Asians. It is especially prevalent in women, and while melasma is a benign condition, it can be psychologically debilitating. The Melasma Quality of Life Scale consists of 10 questions that measure melasma’s effects on one’s emotional well-being, with a scale of 1 being unaffected by the condition and a scale of 7 being extremely bothered. A study conducted with 51 melasma patients revealed that about 94% of patients were bothered by their skin condition and more than half were constantly bothered. One laser treatment that has been used for melasma is fractional photothermolysis. This treatment is a technique that produces microscopic treatment zones, which are small thermal wounds that do not injure surrounding tissue. It is a type of nonablative laser that can be used on any part of the body and has a relatively fast recovery time. Nonablative lasers promote collagen synthesis and can thus help improve the effects of photoaging like acne scars, wrinkles, and melasma. A study conducted on the effects of fractional photohermolysis for treating melasma showed improvement in 60% of patients and 44% after four weeks, but after 24 weeks, improvement decreased.

Post-inflammatory hyperpigmentation

Postinflammatory hyperpigmentation (PIH), a condition that affects both males and females, is a skin disorder where damage to the basal cell layer of the skin results in the production of extra melanin in the skin. This condition occurs due to inflammation from several skin conditions, such as acne and eczema, and therapy treatment options, including laser surgery and certain medications. Typically, people with darker skin are more commonly affected by PIH.

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Currently, there are limited options for treating PIH, but fractional photothermolysis has seen some success. Two case studies have demonstrated more than a 50% improvement in the patient’s PIH, with no observed side effects. However, it is known that fractional photothermolysis could lead to the development of PIH.

Solar lentigines

Solar lentigines are spots on the skin that result from exposure to the sun. They typically appear as flat, dark spots and are more commonly found on the hands or face. Laser surgery is one treatment option that could remove lentigines from the skin. A prospective cohort study was conducted using a 532 nm picosecond laser, which is a laser that delivers very short pulses to target pigmented skin spots like lentigines. After 12 weeks of treatment, 18 out of the 20 patients in the study experienced an improvement in the appearance of the lentigines on their skin.

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