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Razor Bumps African American Skin Changes
Acne Scarring FAQ's About African American Skin

From USA Today April 7, 2008 Patients need to seek out physicians
with education and interest in ethnic skin" read more....

Men and Women Skincare Tips 101

For Those with Acne: When to consult a doctor

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African American skin is very sensitive. It discolors quickly and scars easily because of active melanin and hyper pigmentation. Because your skin is paper-thin, minor trauma causes deep full thickness injury to the layers of the skin. This may result in hyperpigmentation.

Brown skin, Black skin, Yellow skin and all the shades between. That diversity makes our society so appealing. In Southern Asia, India has been referred to as a melting pot of skin tones with the native inhabitants of Northern India having lighter skin tones compared to the darker skin tones of Southern India and Sri Lanka. Indian skin is a prime example of the differences skin types that require differing care strategies within the same race. 

In Philadelphia, Dr Kirksey knows that the skincare concerns of african americans differ and it may sometimes be difficult to find an office that has a staff that is familiar with the unique qualities of black skin. Our staff is specially trained to deal with ethnic skin types, black, brown, yellow and all variations. Additionally, we have chosen lasers and products with the unique skincare concerns for black, brown, yellow and other sensitive skin types. I know that this is very important as we continue our mission to be a high quality provider of care to the diverse ethnic groups of Philadelphia.

Those differences in brown, yellow and black skin types present unique challenges that may be managed successfully when carefully considered. As co-founder of Shanti Medspa at The Institute for Advanced Skincare and Optimal Health, we recognize the need to celebrate our unique differences.

To achieve this goal, we carry unique skincare products and skincare lasers which permit treatment of these distinct differences. Our ability to treat brown skin, black skin or yellow skin is enhanced by these special tools. At Shanti Medspa at The Institute for Advanced Skincare, we are consistently able to treat these skin types safely and effectively

Get a free, no-obligation online consultation regarding your individual skincare concerns. Let our physician create a regimen that will address your unique concerns.

The Pigmentation in skin provides unique protection to the yellow, brown or black skin tone.

The presence of pigment is protective from the damaging effects of the sun. Brown, yellow and black skin types are also resistant to some of the wrinkle creating affects of sun exposure. Some common skin cancer types are relatively speaking, less common in brown skin, yellow skin or black skin individuals.

The Pigmentation in brown, black or yellow skin does respond to injury and stress in a slightly different manner. Lets look at the common disorder of acne. Over 60% of individuals suffer from some bout of acne after the age of 20. For most, it may be an occurrence that decreases in frequency with age, however the acute phase of acne may be physically and emotionally diconcerting. Black skin, brown skin and yellow skin tones respond to skin injury associated with acne differently. These skin types frequently develop hyperpigmentation as a response to acne injury. The hyperpigmentation/discoloration may be associated with acne scarring.

Our Pixel Resurfacing Laser is perfectly suited for the treatment of discoloration, hyperpigmentation, fine line and acne scarring. Another option for acne vulgaris or pustular acne is ALA (Amino levulonic Acic). Frequently, ALA allows us to get control over the acute acne flare in black skin, bron skin or yellow skin tones.

The most important means of avoiding the development of acne discoloration or hyperpigmentation is the aggressive treatment of bouts of acne. The common problem of acne treatment regimens is the propensity to over dry the skin. Poor hydration and drying of yellow skin, brown skin or black skin can worsen acne scarring and lead to more hyperpigmentation and discoloration. Its a viscious cycle. At The Institute, our Clear Skin System provides the appropriate balance of acne fighting treatment and moisturizing protection.  

At The Institute for Advanced Skincare, we recognize that no two skin types are ever alike. Our highly trained staff are experts in carefully identifying your skin type by our detailed Clear Skin System evaluation. It's our promise to you. So, if you have had failed at controlling your acne, please fill out our online acne questionnaire and submit it to get prompt, no obligation expert advice from our acne team. Dont let embarrassing Acne prevent you from living the life you want.

Get a free, no-obligation online consultation regarding your individual skincare concerns. Let our physician create a regimen that will address your unique concerns.

"The online skin consult helped me to really identify my particular skin concerns. The team created a basic program for me; and all in a no pressure online consult from the comfort of my home"

More About African American Skin

Razor Bumps and Men  

Hair - Pseudofolliculitis Barbae (PFB)-Razor Bumps

With the growing popularity and acceptance of longer, natural hairstyles in the workplace, such as dreadlocks and twists as well as facial hair and beards, some men now have more options for hair care than in times past. However, this trend has been slow to reach more conservative companies and organizations, so most of our brothers with brown skin still sport close-cut hairstyles or shaved heads and chins to work each day. Although the upkeep for these "clean" cuts is easier in many ways, it is not without its drawbacks.

One of the most common drawbacks of frequently cutting the hair on one’s head and face closely, is pseudofolliculitis barbae (PFB), or ingrown hairs, which subsequently form dark marks and bumps—more commonly referred to among men with brown skin as "razor bumps". These bumps may be small or large and commonly occur on the cheeks, chin, jawline, neck, submental (the area under the chin) areas and the scalp. This condition is quite common among men with brown skin, particularly those who are African American and Latino American, with tightly curled hair. The cause of pseudofolliculitis barbae is the hair emerging from the curved follicle, which grows almost parallel to the skin surface (instead of away from the skin), and then curves inward again. The inward-curving hair punctures the skin, causing an inflammatory reaction, irritation, pain and unsightly bumps.

Pseudofolliculitis Barbae (PFB) Resulting from Shaving

PFB can also result from shaving one’s beard and scalp, for all of the reasons mentioned above. The whole purpose for shaving is to cut close enough to obtain the desired (and in most professional settings, the required) look. But, if you cut too closely, which often happens with a double or triple edge blade, the cut hair with its pointy tip can retract below the surface of the skin, and pierce the hair follicle leading to further irritation and PFB. To avoid persistent bumps, some men of color simply choose to grow beards and never shave. Fortunately for those men who do not have this option, there are some shaving precautions that may minimize the development of bumps and irritation associated with PFB:

  • Shave daily with a sharp, single-blade razor. Dispose of razors every 2-3 days, as dull razors are more likely to cause irritation.
  • Use shaving cream very liberally. The cream softens the hair, making it easier to cut and less likely to curve and pierce the skin to grow inward.
  • Consider using a clipper instead of a razor. Although clippers do not give a close shave, they keep the hair long as a grain of rice, which is too long to curve and grow inward.

As mentioned, there is no cure for pseudofolliculitis barbae. However, there are several safe and effective treatments that your dermatologist can prescribe to treat the bumps and inflammation associated with PFB. These include:

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Prescription Creams

Topical antibiotics

  • Erythromycin or clindamycin
  • Clindamycin/benzoyl peroxide combination (Duac, Benzaclin) - A study of male subjects treated with a clindamycin/benzoyl peroxide combination cream revealed, for black patients, a mean percentage reductions in bumps ranging from 38.2% at week 2 to 63.9% at week 10.



  • Adapalene (Differin) - Adapalene gel 0.1% applied at bedtime decreased bumps and dark marks resulting from the bumps
  • Tretinoin (Retin-A) - In blacks, tretinoin 0.025% cream combined with hydrocortisone 2.5% cream twice daily for 8 weeks reduced bumps and dark marks
  • Tazarotene (Tazorac) - Fifty African American or Hispanic patients who applied tazarotene 0.05% or 0.1% gel once daily for 90 days had a significant decrease in overall PFB severity after 60 days.


  • Combination Fluocinolone acetonide 0.01%/ Hydroquinone 4%/Tretinoin 0.05 creams (TriLuma) – Ten African-American subjects who applied TriLuma nightly for 90 days had overall PFB improvement of 34.5% over baseline as well as improvement in the dark marks.

African American Skin Changes

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It is well known that melanin in brown skin provides protection from the ravages of aging due to ultraviolet light (UVL). In fact, the melanin in African American skin provides a natural sun protection factor (SPF) of about 13.4 as compared to 3.4 for white skin. This natural protection from the sun means less damage to the skin and fewer signs of aging. Therefore, melanin in the skin of African American women accounts for the fact that they often appear younger than Caucasian women of the same age. In addition, the changes that do occur as African American skin ages are often delayed so they occur at a later age as compared to whites. As would be expected, photoaging in African Americans is more pronounced in individuals with lighter skin hues. When aging changes do occur, most prominent are changes in the texture of the skin (roughness), the appearance of benign growths (dermatosis papulosa nigra), pigmentation changes (dark marks or discolorations) and a loss of the volume of the skin (sagging).

Skin Roughness
As African American skin matures, changes in the texture of the skin become noticeable. Skin that was once baby smooth and soft becomes rough and bumpy especially on sun exposed areas. The roughness is due to skin cells that stick together and do slough as they normally would. Black skin care is directed towards exfoliation either with topical agents, chemical peels or microdermabrasion.

Dermatosis Papulosa Nigra
Benign growths occur frequently in African American skin as it matures. Of the benign growths, seborrheic keratoses are the most common type that appears. Dermatosis papulosa nigra (DPN), a cluster of small seborrheic keratoses, are prominently located on the faces of both African American men and women. They are small, brown or black bumps that are sometimes mistaken for moles. It is felt that a combination of heredity, aging and exposure to the sun are factors in the development of DPNs.

Since DPNs are non-cancerous, they do not have to be treated. They do, however, increase in number and size as women mature and it is for these reasons that many women want them treated. Since there is no cream that has the ability to remove DPNs, treatment involves either excising (cutting) the lesions with as special surgical instrument, called a gradle scissor, or desiccating (burning) them with an electric needle. These procedures are well generally tolerated and healing generally occurs within one week. Side effects of removal may include light or dark skin discolorations which usually fade rapidly.

Pigmentation changes
Changes in the skin’s pigmentation occur as we age and are very prominent in African American skin. Exposure to both ultraviolet A (UVA) and ultraviolet B (UVB) light stimulates the production of melanin which most likely accounts for darkening of the skin. There are 4 commonly occurring types of darkening.

  • Localized areas on the face and neck
  • More generalized areas on the face and neck
  • Dark under eye circles
  • Uneven skin tone

The dark discolorations (hyperpigmentation) can be treated with topical creams, chemical peels or microdermabrasion.

Light areas (hypopigmentation) on the skin also occur as African American skin ages. A specific condition, idiopathic guttate hypomelanosis, which appears on the legs, lower abdomen and arms, is characterized by many small, white, confetti-like spots. The spots which are round and are painless, are unrelated to the disease vitiligo. To date, there is not treatment for idiopathic guttate hypomelanosis.

A loss of volume of the skin occurs as African Americans mature. Slow degradation of collagen in the dermal layer of the skin accounts for the loss of volume. This change leads to a hollowness of the face and sagging of the skin. The hollowness is most prominent on the cheeks just under the cheek bones. Sagging is especially prominent in the area between the nose and the outer corner of the mouth (nasolabial fold) and in the neck and jawline areas. The hollowness may be improved with the use of
dermal fillers. Sagging is most readily treated with surgical a facelift.

For Those with Acne: When to consult a doctor in order to prevent permanent, long-term damage to the skin

Acne is a skin condition that affects almost everyone at some point in his or her life. While many people only deal with the occasional pimple, others have to contend with regular outbreaks that can cause feelings of self-consciousness and misery. Fortunately, there are many effective treatments that can minimize or even eliminate acne problems. For some individuals, however, home treatments are not successful at treating acne and professional help is necessary. It is important to know when you should see a doctor about your acne in order to prevent long-term problems such as scarring or skin discoloration.

Hormones that lead to increased oil production are the main cause of acne. Bacteria then cause the oil to thicken and clog pores. This problem results in pimples and blackheads that are unattractive and can even be quite painful. Before consulting a doctor concerning your acne, try clearing up your skin with home treatments and remedies.

The first step in acne prevention and treatment is to use a good cleanser, washing your face no more than twice a day, once in the morning and once at night. It is important to use a good moisturizer in order to prevent skin from becoming overly dry, which will lead to increased oil production and more pimples. Once you have applied moisturizer, use an over the counter medication to treat the problem areas where outbreaks commonly occur. One of the best treatments is benzoyl peroxide lotion, which helps clear up the bacteria that causes acne.

Be cautious to use these treatments in moderation in order to avoid drying out the skin too much. Never squeeze or pick at pimples, which will only spread the acne-causing bacteria to the surrounding area and can lead to permanent scars.

If home treatments do not lead to a reduction in symptoms within two weeks, you should consult a doctor about how to best treat the problem. You should see a doctor if pimples become irritated or inflamed or if the problem worsens due to your home treatment. If either of your parents had severe acne or scarring as a result, you should consult your doctor as soon as possible. Your doctor may prescribe antibiotics that will kill the germs and bacteria that cause acne. Another commonly prescribed treatment is medicines that impact hormones amounts, leading to a reduction in the amount of oil the body produces. Your doctor may recommend other topical solutions that are stronger than those you can buy over the counter.

Before deciding on the treatment that is best for you, ask your doctor about the potential side effects of each option. Some hormonal treatments can lead to weight gain or moodiness, while topical solutions can cause skin irritation or allergic reactions. If your doctor recommends the drug Accutane, be sure to inquire about the drug's potential for psychiatric side effects such as depression or thoughts of suicide. Carefully watch for potential problems after you begin using a doctor prescribed treatment and be sure to report any undesired or unexpected results.

Acne can be more than just a minor annoyance for many people. Those with severe acne often experience depression, feelings of self-consciousness, and may avoid social situations due to embarrassment over the condition. It is important to take good care of your skin in order to minimize acne, but home treatments may not be effective for everyone. Consult a doctor for advice and treatment if home remedies are not helping, if your acne is worsening, or if you have a family history of severe acne. A professional can offer treatments that will minimize or eliminate the problem. It is vital to treat acne effectively in order to prevent long-term damage such as skin discoloration and scarring.


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