New Ethnic Skin And Hair Clinic Provides Specialized Resource For People Of Color

Main Category: Dermatology
Article Date: 03 Jan 2007 - 0:00 PDT

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People of color have unique needs related to their skin and hair. To meet these needs, Rush University Medical Center has established an Ethnic Skin and Hair Clinic, bringing together a team of dermatology specialists with expertise in the evaluation and treatment of African Americans, Hispanics, Asians, and people of other ethnicities.

"People of color require highly individualized care because the skin is more sensitive and reacts differently to treatment depending on how deep in the skin the pigment is," said Dr. Ella L. Toombs, assistant professor and assistant attending dermatologist at Rush. "Getting the skin healed and back to its natural color is sometimes challenging. Conventional procedures commonly used with white patients may not work or could even cause damage."

Hyperpigmentation, which is darkening of the skin due to cuts, burns, or acne, is common in Asians, African Americans and others with darker skin tones. This is because melanocytes, the cells that give people darker skin, are created in large numbers during healing. As a result, newly healed skin may become darker than surrounding skin. The scar tissue may also spread beyond the size of the original wound creating keloids, which are raised nodules of tissue and essentially tumors.

"Not infrequently, the dark spots and keloids are more bothersome to the patient than the original insult," said Toombs.

Treatments include specially formulated creams or chemical peeling agents to remove superficial layers of the discolored skin. The creams are tailored specifically for each patient and include a combination of a bleaching agent, retinoid, and a steroid. The retinoid helps the skin to peel allowing the bleaching agent to penetrate. The steroid causes the skin to thin and look lighter.

"We have to be careful with chemical peeling agents," said Toombs. "We can’t use strong peels because they can cause hyperpigmentation or hypopigmentation, which is the destruction of pigment."

Men of color are especially at risk for pseudofolliculities barbae, or razor bumps. This occurs when curved hairs grow back into the skin causing bumps and even cysts that may hurt or itch. The end result is unsightly scarring. Shaving makes the condition worse. Growing a beard is the best treatment, but that is not an option for all men.  As an alternative, Toombs has created a topical beard cream to keep the problem under control.

Men of color also develop acne keloidalis nuchae. This is characterized by red, painful, itchy bumps on the back of the scalp that develop into large keloid scars. Experts at the Ethnic Skin and Hair Clinic have developed several treatment options to aid patients who suffer from this cosmetically disfiguring problem.

Hair problems aren’t limited to men. Hair breakage is a major problem for African-American women due to certain skin disorders, tight hairstyles, and harmful hot comb and chemical treatments to straighten hair. Toombs suggests patients stop relaxing the hair and wear it in more natural styles. Additionally, dermatologists at the Ethnic Skin and Hair Clinic have developed protocols to help patients who experience all different types of hair loss.

"Frequently African Americans will say their hair doesn’t grow. It only appears that way because it is breaking," said Toombs. "We advise patients to get their hair trimmed to eliminate split ends. Otherwise the hair continues to split to the scalp and breaks off."

Other remedies include applying lubricants to the hair while blow drying or using hot curlers.  Toombs also suggests special shampoos and conditioners for dry, broken or brittle hair.

During the discussion on hair and skin, the specialists at the Ethnic Skin and Hair clinic will ask patients a question they didn’t expect. It’s a question that could save a life. Patients are asked to take off their shoes for a skin cancer check. In people of color, some cancers are more likely to occur on the palms and the soles.  This is very different than the Caucasian population.

"There is a need for higher awareness about skin cancer in African Americans by patients and doctors," said Toombs.  "Skin cancer is less common, but more deadly, in those with darker skin."

Checking skin regularly, not just during warm months, is important. Toombs encourages patients to pay special attention to hard-to-see areas, such as the scalp and between the toes, and report any suspicious growths or moles to a doctor.

"Our patients are grateful to receive care and advice from specialists that have first-hand knowledge of what it’s like to have non-Caucasian skin and hair," said Toombs. "We identify with our patients because we have had some of the same hair and skin concerns as they have."

www.rush.edu