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Skin of Color: Ethnic Differences in Skin Architecture

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Other differences are summarized in the following tables:

Objective Differences in Skin Structure and Physiology Based on Race (Semin. Cut. Med. Surg. 2009;28:115-2)

Evidence supports: Insufficient evidence* for: Inconclusive:
• Increased melanin content and melanosomal dispersion in persons of color
• Multinucleated and larger fibroblasts in black persons compared with white persons
• pH black < white skin
• Larger mast cell granules, increased parallel-linear striations, and increased tryptase localized to parallel-linear striations in black compared to white skin
• Variable racial blood vessel reactivity
Racial differences in:
• Skin elastic recovery/extensibility
• Skin microflora
• Facial pore size**
Racial differences in:
• Transepidermal water loss
• Water content
• Corneocyte desquamation
• Lipid content

* Skin elastic recovery/extensibility, skin microflora, and pore size were labeled as ‘insufficient evidence for’ racial differences rather than 'inconclusive' because only two studies or less examined these variables

** Ethnic differences in the structural properties of facial skin. (J. Dermatol. Sci. 2009;53135-9)

Therapeutic Implications of Key Biologic Differences Between Races

Biologic factor Therapeutic implications
Epidermis

•Increased melanin content, melanosomal dispersion in people with skin of color

•Lower rates of skin cancer in people of color
•Less pronounced photoaging
•Pigmentation disorders
Dermis

•Multinucleated and larger fibroblasts in black persons compared with white persons

•Greater incidence of keloid formation in black persons compared with white persons
Hair

•Curved hair follicle/spiral hairtype in black persons
•Fewer elastic fibers anchoring hair follicles to dermis in black persons compared with white persons

•Pseudofolliculitis in black persons who shave compared with white persons
•Use of hair products (e.g. relaxers) that may lead to hair and scalp disorders in black persons
•Alopecia

Ethnic Differences in Skin Properties. Textbook of Cosmetic Dermatology, 4th edition. 2010, p. 395-404

The bottom line is that differences in ethnic groups do exist, and research is still being done to elucidate what these differences are.

- Naissan Wesley, M.D.

Do you have questions about treating patients with darker skin? If so, send them to sknews@elsevier.com.