Skin Health is Affected by Ethnicity

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Modern medicine has long been a white man’s world — and I’m talking about patients, not doctors. Only relatively recently have medical researchers begun to study in detail how people of different ethnicities are affected differently by injuries and diseases — including, ironically, skin conditions. And it’s about time, because did you know that your particular skin color can play a major role in which skin conditions you develop, where and how they’re discovered, and the consequences they bring?

According to Nelson Lee Novick, MD, a clinical professor of dermatology at Mount Sinai School of Medicine and a dermatologist in private practice in New York City, most dermatologists lump patients into one of three broad skin categories — white, Asian and people of color (a broad category that includes African Americans, Hispanics, Native Americans, Indians, Hawaiians and others). There just isn’t enough research yet to make many distinctions that are more precise than that, he told me. But he’s optimistic about the future. “I can foresee a time when we’ll be able to address the differences between, say, Ethiopian skin, Kenyan skin and Nigerian skin,” Dr. Novick said.
If you’re a non-Caucasian, you’ll be happy to know that you have a lower overall risk of getting both serious and nonserious skin conditions, compared with whites, but make sure that you’re aware of the following trends that may affect you — whether you’re Asian or a person of color.
  • You’re at higher risk for certain types of skin cancer. Doctors aren’t sure why, but squamous cell carcinoma is the most common skin cancer in African Americans and Indians and, unlike in people with lighter skin, it tends to occur at sites where the skin has already been traumatized — in other words, in places where there’s already a scar. So if you’re a person of color, give extra scrutiny to skin that is scarred or has been otherwise damaged in the past. On the other hand, basal cell skin cancer (symptoms include waxy or pearly bumps, raised spots, nonhealing sores, color changes and flakiness) is the most common form of skin cancer in Hispanics, Chinese and Japanese and is the second most common skin malignancy in African Americans and Indians.
  • Cancer is likely to develop in different places. For unknown reasons, the very deadly skin cancer melanoma is more likely to occur on certain body parts, depending on your race. For example, Asians and people with dark brown skin (specifically those of African descent, Asians, Hawaiians and Native Americans) are more likely to get melanomas in the mouth or on the palms of the hands, soles of the feet or under the nails, compared with people of other ethnicities. In light-skinned Hispanics, however, melanomas are more often found on the trunk (torso) or legs, and on the feet in dark-skinned Hispanics, compared with people of other ethnicities.
  • Skin problems can be harder to spot. If you have darker skin, it can be harder to spot dangerous lesions… and of course when a condition is caught at a later stage, it can be more difficult to treat. In fact, when it comes to melanoma, blacks, specifically, are more likely to die from it. On average, their five-year survival rate is 59% compared with 85% in Caucasians — and that difference is probably almost entirely due to the fact that melanoma is typically caught in a later stage on dark skin, said Dr. Novick. That’s why he is very forceful in telling his dark-skinned patients to be vigilant — do self-exams at least once every other month and make sure that you get a full-body screening from a dermatologist at least once a year.
  • Acne and rosacea can have extra consequences. Dark-skinned people are more prone to developing what’s called postinflammatory hyperpigmentation(PIH) after getting pimples or after experiencing a flush, red face from a bout of rosacea. The telltale signs of PIH are dark spots (excess melanin production — not scars) that can linger for months or years or sometimes forever. If you have a pimple, you can reduce your chances of developing PIH by not picking at it and by wearing sunscreen over it (since sunlight can make PIH even darker). There are also over-the-counter and prescription “fade creams” that you can ask your doctor about. And you can work with your dermatologist to prevent pimples from forming in the first place. If you suspect that you have the skin condition rosacea — symptoms include a tendency to flush when drinking alcohol, eating spicy foods or spending time outdoors in the sun, wind or extreme temperatures — bring this concern to a dermatologist, because topical or oral prescription drugs may make the problem (and therefore the consequence of PIH) go away.
The bottom line: Conditions like cancer, especially melanomas, aren’t just skin deep — they can be life-threatening — so if you’re Asian or a person of color, take these precautions to heart to protect yourself. For more information on preventing and treating various skin conditions, visit the American Academy of Dermatology’s Web site at
Source:  Nelson Lee Novick, MD, clinical professor of dermatology, Mount Sinai School of Medicine, New York City.

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