Looking back at 2023, the year in skin health
Reviewing the three most-read and discussed articles in Skin Spectrum Weekly during the past year (1,400 words, 7 minutes)
As we enter the holiday season, Skin Spectrum Weekly looks back at another significant year covering the science of skin health in all skin types and the social and cultural factors that affect outcomes. In this edition, we highlight the three most-viewed posts of 2023, based on feedback and reshares from our readers and subscribers.
The top edition of the year was “Promoting sun protective behaviour for people with darker skin tones,” published on July 10.
That edition listed several tips on what makes a good sunscreen, from Dr. Lisa Shen, Boston Medical Center associate director of pediatric dermatology and Boston University School of Medicine assistant professor of dermatology.
Her tips include:
Chemical sunscreens containing agents such as avobenzone, oxybenzone, and octinoxate tend to be more water- and sweat-resistant
Physical, or mineral, sunscreens containing zinc oxide and titanium dioxide are gentler on pores and overall better for sensitive skin
Tinted sunscreens—which can protect against visible light—can be difficult to find in non-white shades. Dr. Shen mentioned Black Girl Sunscreen, Fenty Beauty, and Melé. Anthelios from La Roche-Posay is another option.
Sunscreens will expire. Patients should check expiry dates and replace them as needed.
“Identifying top priorities for Canadian Indigenous skin health” from Dec. 4 was our second most viewed post of the year. The edition covered the presentation by Dr. Rachel Asiniwasis at the 2023 Skin Spectrum Summit. Dr. Asiniwasis discussed how atopic dermatitis, bacterial skin infections, and diabetic skin complications are the three top dermatology priorities that need management, research, and funding for the Canadian Indigenous population.
The third top post of 2023 was “Scalp psoriasis in Afro-textured hair” from July 17. Dr. Yvette Miller-Monthrope described the higher incidence of scalp psoriasis in patients of colour and how variants such as follicular psoriasis are more common in this population. She also discussed cultural scalp and hair care practices that should be considered when advising patients with scalp psoriasis.
From the literature on dermatology in skin of colour
Availability of adequate photoprotection for skin of colour
The authors of this paper reviewed commercially available sunscreen products available in suncare and sun protection displays in local stores, pharmacies, and grocery stores in Philadelphia. The ingredients of these products were reviewed for the presence of iron oxides.
Of 410 commercially available sunscreen products cataloged, 1.7% of facial sunscreen products available offered iron oxides, and 0.5% of non-lip products offered shade matching.
In their conclusion, the researchers write that with the small percentage of commercially available facial sunscreen products offering iron oxides in addition to traditional broad-spectrum UV protection, there is a clear gap in the market for iron oxide-containing sunscreen products to meet the photoprotection needs for the skin of colour population.
Sun protection practices in India: Preliminary findings from a nationally representative sample
This survey was conducted to understand the frequency of sun protection practices in India, and the investigators also examined associations between demographic covariates and sun safe behaviours.
Researchers surveyed a representative sample of 1,560 individuals from the Indian population in Nov. 2022. The study variables included sun safe behaviours, sunburn experience, demographic information, and skin tone. The authors used descriptive and regression analyses to examine the prevalence of behaviours and their associations.
The survey results revealed more than half of the participants (64.2%) routinely performed at least one sun safe behaviour, with only 4.9% of the sample reporting no engagement with sun safe behaviours in the last 12 months. Physical protection (e.g., long sleeves, shade/umbrella) was more common than sunscreen use. Regression analysis showed that higher subjective social status, being younger, and living in one of the Eastern Indian states were the strongest predictors of sun protection practices.
In their conclusions, the authors note these findings highlight an urgent need for public sun safety education, and that scalable and targeted interventions are needed to promote sun safety awareness and practices.
Teledermatology in remote Indigenous populations: Lessons learned and paths to explore, an experience from Canada (Québec) and Australia
This study assessed approaches, challenges, solutions, and outcomes in implementing teledermatology in rural Indigenous communities of Australia and Canada.
Researchers performed a narrative review using journal articles and grey literature to assess challenges encountered in Canadian and Australian teledermatology programs in rural Indigenous communities. The authors then conducted a focused search to identify solutions and outcomes to these challenges, identifying four main areas of focus for implementing teledermatology: financial, cultural, legal, and provider competency.
The main financial concerns the investigators identified were the cost-to-benefit ratio of teledermatology and the financial benefits of the store-and-forward system compared to videoconferencing.
As well, the authors found the delivery of teledermatology through culturally considerate services is crucial to mend the mistrust felt by Indigenous people toward mainstream health services.
They note that patient confidentiality and physician liability must be considered when developing teledermatology platforms, and a uniform platform and physician competency in both telemedicine and dermatology are needed to ensure the standard of care.
Dermoscopy of hair and scalp disorders (trichoscopy) in skin of colour: A systematic review by the International Dermoscopy Society "Imaging in Skin of Color" Task Force
This systematic literature review summarizes the published data on trichoscopy of hair and scalp diseases, focusing on trichoscopic findings, used setting, pathological correlation, and the level of evidence in the studies.
The authors assessed a total of 60 papers addressing 19 different disorders: eight non-cicatricial alopecias, nine cicatricial alopecias, and two hair shaft disorders. This totalled 2,636 instances of disorders. The papers assessed included one cross-sectional analysis, 20 case-control studies, 25 case series, and 14 single case reports, so the level of evidence was V and IV in 65% and 33% of cases, respectively, with only one study showing a level of evidence of III.
In their conclusion, the authors note that while there is a considerable body of literature on trichoscopy of hair and scalp diseases, their review underlined that potentially significant variables such as disease stage or hair texture are often not taken into account in published analyses, with possible biases on trichoscopic patterns, especially when it comes to hair shaft changes.
VIDEO: Best and worst hair oils for skin of colour
London, U.K.-based physician and cosmetic formulator Dr. Vanita Rattan discusses the cultural practice of scalp or hair oiling, and rates products used in this application.
At the intersection of skin and society
A new bilingual exhibit in Punjabi and English at the Hockey For All Centre in Winnipeg has opened to help South Asian kids feel that they belong in the world of hockey, reports CBC News. The exhibit also addresses issues of decolonization and privilege in sports. The Centre is the practice space for the Winnipeg Jets and Manitoba Moose hockey teams.
The exhibit, titled “We Are Hockey,” was unveiled on Dec. 6, 2023, by Sikh Heritage Manitoba.
Primary translator Sheena Gurm is quoted saying there were many sleepless nights learning how to translate words such as “decolonization” and “inclusion,” which are not often used in the Punjabi language.
However, “this is a really great opportunity to promote the language, to promote the culture and … intersect both hockey culture and Punjabi culture,” Gurm said.
“That will go a long way to attract younger people to the sport, making them feel like they belong,” said Gurm, who added she didn't know anything about ice hockey when she moved to Canada from India at age 12.
The exhibit was curated by Satwinder Kaur Bains, an associate professor who is director of the South Asian Studies Institute at the University of the Fraser Valley in B.C.
It features roughly 15 panels describing the history of hockey in Manitoba dating back to the 1800s, including biographies of National Hockey League players of various ethnic backgrounds.
The exhibit highlights the accomplishments and contributions of members from diverse communities, said Ganni Maan, a member of the Winnipeg Jets advisory council.
“A lot of people don't know how to find their place in hockey,” but there is value in making sure the sport is accessible to all communities, he said, since all children should see themselves represented in those spaces.
This week
Dec. 18 is International Migrants Day
Dec. 20 is International Human Solidarity Day
Dec. 21 is National Homeless Persons Remembrance Day in the U.S.
Something to think about in the week ahead. . .
—Paul Cezanne, French artist (1839-1906)
Happy Holidays to all our readers
Thank you for another great year. Skin Spectrum Weekly will return on Jan. 8, 2024.
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 providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Drs. Lauren Lam (Calgary), Sam Hanna (Toronto), Benjamin Barankin (Toronto), and Renée A. Beach, (Toronto) discuss many of the new therapeutic options that arrived in 2023.
Dr. Andrew F. Alexis (New York) details pigmentary disorders in patients with skin of colour.
An essay from Dr. Sheila Wang (Montreal) submitted to the 2022 Dermatology Industry Taskforce on Inclusion, Diversity and Equity (DiTiDE) short essay contest. Dr. Wang wrote about the development of new imaging technology to detect and assess ‘beneath-the-skin’ inflammation, perfusion, and tissue oxygenation in any skin phototype.
Plus regular features, including the popular column “Vender on Psoriasis” by dermatologist Dr. Ron Vender
Read a recent digital edition of The Chronicle of Skin & Allergy here. To apply for a complimentary* subscription or to receive a sample copy, please email health@chronicle.org with your contact information.
The Women in Dermatology e-newsletter updates new findings concerning dermatologic issues that affect women and the female dermatologists who care for them. Read the current issue here.
Season three of the Vender on Psoriasis podcast with Dr. Ron Vender has begun. Listen to the new season here. In episode five, Dr. Vender discusses whether or not vitamin D has any impact on psoriasis severity, sex differences in psoriatic inflammation itch, and the risk of psychiatric disorders associated with acitretin.
And if you’re looking for a web destination for all things derm, visit derm.city, “Where Dermatology Lives.” Please like, rate, review, and share it with your colleagues.