Next Steps in Derm, in partnership with Skin of Color Update, interviewed Dr. Andrew Alexis, co-chair of Skin of Color Update, and vice-chair for diversity and inclusion for the Weill Cornell Medical College Department of Dermatology. Dr. Alexis points out that acne is the most common dermatologic condition for which patients with skin of color seek a dermatologist’s care. Hear why it’s important to also address post-inflammatory hyperpigmentation in your initial patient visit. Find out why it’s important to set realistic timelines for clearance. Plus hear from Dr. Alexis why retinoids are key.
Further Reading
If you want to read more about acne in patients with skin of color, check out the following articles published in the Journal of Drugs in Dermatology:
ABSTRACT
Background: Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Post-inflammatory hyperpigmentation (PIH) frequently occurs in patients with richly pigmented skin complexions and can frequently be the most bothersome aspect of acne in this population.
Methods: The project used a modified Delphi hybrid process comprising face-to-face discussions followed by an online follow-up. A structured literature search was conducted to identify publications on racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for skin of color (SOC) patients with acne . The advisors subsequently convened to review the results and draft an algorithm for the treatment and maintenance, including skincare recommendations, for SOC patients with acne. Online, the panel reviewed and adopted the algorithm using published evidence coupled with the panel’s expert opinion and clinical experience.
Results: Studies suggest that strategies for improving outcomes in patients with acne who have SOC include: the early initiation and maintenance of treatment regimens; careful consideration of the tolerability of active ingredients, vehicle formulations, and dosing; and the use of skin care (eg, pH balanced, non-irritating cleansers, and non-comedogenic moisturizers) to minimize irritation or dryness.
Conclusion: Acne treatment in patients with SOC involves unique therapeutic considerations, including management of PIH through efficacious longitudinal acne treatment, prevention of irritation, and potential active treatment of PIH. Skincare products are recommended as an adjunct to prescription therapy to maximize tolerability and may also play a role in maintenance therapy.
ABSTRACT
Background: Acne vulgaris is among the most common dermatologic diagnoses observed, including skin color (SOC) populations. This project sought to help clarify the existing published data and provide consensus statements on acne presentation, prevention, treatment, and maintenance in SOC populations to help improve patient outcomes.
Methods: Six SOC dermatologists convened for a virtual meeting and used a modified Delphi process to address: 1) Are there racial/ethnic differences in the clinical presentation and sequela of acne? 2) Are there racial/ethnic differences in the therapeutic endpoint of acne treatment and patient expectations? 3) Is there a need for specialized approaches to therapeutic options and skincare in acne patients with SOC? The results of a literature review and the outcome of discussions, coupled with the panel’s expert opinion and experience, are intended for health care providers caring for acne patients and clinician-researchers.
Results: Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Notwithstanding limitations in the number, size, and methodologies of studies to date, the available data suggest that strategies that improve outcomes in acne patients with SOC include: Early initiation and maintenance of treatment regimens and careful consideration of tolerability of active ingredients, vehicles, and dosing. Using pH-balanced, non-irritating cleansers and non-comedogenic ceramides containing moisturizers help minimize irritation or dryness.
Conclusions: There a need for specialized approaches to therapeutic options and skincare in acne patients with SOC. OTC skincare products are recommended before and during prescription therapy and as part of a maintenance regimen.
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TAGS ANDREW ALEXIS, MD, MPH; ACNE; SKIN OF COLOR
