Ethnic variations in skin barrier function
Reactivity to contact irritants, types of filaggrin mutations, and ceramide levels vary between skin types, contributing to differences in disease prevalence and presentation (1,300 words, 7 minutes)
There are differences in the structure and biochemistry of the skin barrier across ethnic groups, Dr. Monica K. Li reported during a presentation at the 8th annual Skin Spectrum Summit. Because of this, skin conditions may present differently in these populations, and different groups are more likely to develop certain conditions or experience certain sequelae.
Dr. Li is a cosmetic and medical dermatologist in practice in Vancouver and Surrey, B.C. She is also a clinical instructor in the Department of Dermatology and Skin Science at the University of British Columbia.
In her presentation, Dr. Li said some studies have shown there are differences in the skin barrier function across racial and ethnic categories, including in transepidermal water loss (TEWL), skin lipid levels and concentrations, pH, and mast cell granule size.
Some of the differences in skin barrier function include:
Asian skin is the most reactive to contact irritants, such as fragrances
Black skin has the lowest level of ceramides
East Asian patients with atopic dermatitis are less likely to have filaggrin mutations than White patients
East Asian patients with atopic dermatitis and filaggrin mutations typically have different mutations than White patients
Because Black patients have lower levels of ceramides, she recommended prescribing ceramide-containing moisturizers to Black patients receiving potentially irritating topical treatments for conditions such as acne.
She noted that the differences in skin function in Asian patients with atopic dermatitis lead to more perifollicular accentuation. These patients may also have more post-inflammatory hyperpigmentation due to scratching. This can lead disproportionately to prurigo nodularis or lichen simplex chronicus in darker-skinned patients, Dr. Li said.
Seborrheic dermatitis may present differently in patients with darker skin, said Dr. Li. Instead of the redness seen in Caucasian patients, there may be hypopigmentation due to inflammation, there may be larger flakes and children may not have the cradle cap appearance normally shown in textbooks.
Bottom Line: There are differences in the skin barrier between racial and ethnic groups. These differences can change the presentation of skin conditions and may require varying moisturizer recommendations to achieve the best outcomes.
From the literature on skin barrier in skin of colour
Can microneedle fractional radiofrequency system treatment impair the skin barrier function in Chinese patients? A prospective clinical trial
This study was conducted to evaluate whether microneedle fractional radiofrequency system (MFRS) treatment, which is an invasive procedure, might impair skin barrier function. Impairment was assessed through skin sensitivity and exacerbation of melasma.
Researchers enrolled a total of 20 patients (Fitzpatrick skin types III to IV) with facial conditions treated with MFRS.
The investigators found that in the first three days after treatment, transepidermal water loss gradually increased to a peak, and then returned to normal levels by day seven. They observed no significant difference in TEWL from baseline to follow-up visits one, three, and six months after treatment. They also did not see any significant changes in the thickness or density of the epidermis.
Researchers also observed no significant difference in the melanin index, melasma area and severity index, and the 10-item Sensitive Scale (SS-10) scores before and after MFRS treatment.
Hair oils may worsen seborrheic dermatitis in Black patients
In this letter, the authors examine the literature and discuss the potential association between the use of hair oils in Black patients and seborrheic dermatitis (SD). They write that the traditional practice of lubricating the scalp for perceived hair health and to conceal scale may be contributing to the severity and chronicity of SD.
However, they suggest that more research is needed to evaluate the effects of different hair oils and oil vehicles in SD.
They recommend that medical providers should counsel patients to avoid oils on the scalp and instead focus on the distal hair shafts.
Trends in health care utilization among United States children with eczema by age, sex, race, and Hispanic ethnicity: National Health Interview Survey 2006-2018
This survey was conducted to determine healthcare utilization trends among children with eczema across sociodemographic factors.
Researchers included data on children (0-17 years old) from the U.S. National Health Interview Survey 2006-2018. They broke the data down by race (White, Black, American Indian/Alaska Native, Asian, and multiracial), Hispanic ethnicity (yes/no), age (0-5, 6-10, 11-17), and gender (male/female). Investigators also compared children with and without eczema.
Among the 149,379 children included, there was higher healthcare utilization in children with eczema than in those without.
However, when the researchers compared the average annual percentage change (AAPC), White children had a significantly higher AAPC of “attending a well-child checkup” than Black children. In addition, only White children showed a significantly increasing trend in being “seen by a medical specialist.” The authors observed stagnant trends for all other minority race subgroups.
Investigators saw an increasing trend in being “seen by a mental health professional” only for the male and non-Hispanic subgroups.
Evaluation of personalized skincare through in-silico gene interactive networks and cellular responses to UVR and oxidative stress
Researchers conducted this study to identify the likely biomarkers and molecular signatures expressed in skin cells of different ethnic backgrounds, to support the design of personalized skin products based on specific demands.
Using a combination of data mining and in-silico modelling, investigators analyzed and compared the association of single-nucleotide polymorphism (SNP)-affected genes with three major skin types of European, Asian, and African origin.
They then subjected cultured dermal fibroblasts to ultraviolet radiation and oxidative stress and analyzed the cells for DNA damage and senescent markers. As well, the researchers validated the protective applications of two cosmetic ingredients, Resveratrol and Quercetin, in both cellular and in-silico models.
Researchers found each skin type was characterized by the presence of SNPs in the genes controlling facultative and constitutive pigmentation. These SNP variations could also underlie the major differences in responses to photodamage, such as oxidative stress, inflammation, and barrier homeostasis, they write.
They observed that skin-type-specific dermal fibroblasts cultured in-vitro demonstrated distinctive sensitivities to ultraviolet radiation and oxidative stress. These sensitivities could be modulated further by the bioactive compounds studied.
VIDEO: Damaged skin barrier? Skin of colour, Brown or Black skin—Dr. Vanita Rattan, Ealing, U.K.
At the intersection of skin and society
Audio streaming service Spotify has invited Winnipeg-based “Anishinaabe DJ” and producer “Boogey the Beat” to curate an Indigenous music channel throughout June, in recognition of National Indigenous History Month.
As reported in The Winnipeg Free Press, Boogey has chosen 31 songs for the playlist. Selections include tracks from Boogey’s May 2023 album, “Cousins”, as well as songs from DJ Shub, Sebastian Gaskin, Handsome Tiger, Ila Barker, Winnipeg’s Most and Leonard Sumner, all of whom started their music careers in Manitoba.
“I tried to include a couple of Manitoba people, close to home for me, especially Leonard Sumner. Me and him go way back producing rap beats for Winnipeg artists,” Boogey says of the Rez Poetry singer-songwriter in the Free Press article. “Any chance I can get to shine a light on some of my favourite Indigenous artists, I’m glad to [do it].
Boogey narrowed his selections to the 31 requested by Spotify from an initial list of nearly 300 songs.
“I could have went way longer, because the Indigenous talent we have across Canada, it’s thriving,” he said. “We’re on the main stages at festivals, we’re creating this great music and I’m proud to be part of this community.”
According to the article, Boogey the Beat grew up as Les Boulanger in Winnipeg’s Weston neighbourhood and learned about his Anishinaabe heritage from his family. They are from Berens River First Nation in Treaty 5 territory, roughly 360 kilometres north of the city on the eastern shore of Lake Winnipeg.
“I was fortunate enough to be raised by my mom and my aunties, and they held onto their language and held onto their ceremonies,” he said. “They brought me when I was a kid, to powwows and sweat lodges and ceremonies, and I still carry those teachings with me today, especially when I’m making new music.”
“I was fortunate enough to be raised by my mom and my aunties, and they held onto their language and held onto their ceremonies.”
This week
June 20 is World Refugee Day
June 21 is National Indigenous Peoples Day in Canada
June 25 is World Vitiligo Day
Something to think about in the week ahead…
Esther Williams, U.S. actor, 1921-2013
Next week
Dermatologist Dr. Jeanine Downie, director of Image Dermatology in Montclair, N.J. and other dermatologists discuss the best sunscreens for people with skin of colour.
If you like Skin Spectrum Weekly, why not check out Chronicle’s other publications, podcasts, and portal?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper print providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Dr. Jerry Tan (Windsor, Ont.) discusses recent findings on the presentation and prevalence of truncal acne
Drs. Jaggi Rao (Edmonton), Maxwell Sauder (Toronto), and Jason Rivers (Vancouver) discuss skin cancer prevention and how to increase the adoption of sun-safe habits among the population.
An essay from Dr. Munirah Aljaser (Montreal) submitted to the 2022 Dermatology Industry Taskforce on Inclusion, Diversity and Equity (DiTiDE) short essay contest. Dr. Aljaser wrote on the challenge of changing the cultural perception that lighter-coloured skin is more beautiful.
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Season two of the Shear Listening Pleasure podcast with Dr. Neil Shear has launched. Listen to the eighth episode here, where Dr. Shear speaks with dermatologist Dr. Sonja Molin (Kingston, Ont.) about allergology, patch testing, and the growth of Queen’s University’s dermatology division.
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