Acne in skin of color: Practical Facts

Misconceptions:

• Benzoyle Peroxyde

1. benzoyle peroxide does not bleach the skin but can cause dyschromia.
2. it doesn’t act on tyrosinase activity but can create skin irritation ans subsequently inflammation (Post-inflammatory Hyperpigmentation (PIH))

• Minocycline

1. minocycline causes hyperpigmentation in skin of color. But what we do not know, is if it is worse than other antibiotics
2. minocycline induces more DRESS syndrome in patients of color* (drug reaction with eosinophilia and systemic syndromes)
3. a lower risk of hyperpigmentation could be with combination with vitamin C at 0.1% of the daily dose.

Acne induced Post-inflammatory hyperpigmentation:

• treatments with 2% hydroquinone (but 6 to 10% may be compounded)
• triple combination treatments (Hydroquinone, Steroids, Retinoids) may be tried steroid. (However more studies are needed especially to measure the longer term outcomes)
• continuing HQ despite irritation can lead to worsening of pigmentation (PIH (Post-inflammatory Hyperpigmentation))
• When applying hydroquinone (HQ) to avoid a halo of depigmentation around treated lesions, apply HQ with Q-tip and tretinoin then on whole face
• fluorinated steroids are used to bleach the skin but can induce steroid acne

*African Americans, Asians, Indians, Hispanics…

Bibliography: Woolery Lloyd. Managing Acne and Rosacea in Skin of Color Patients. Skin of color.  70th Annual Meeting of the AAD (American Academy of Dermatology) – San Diego, California, United States of America (USA)

Source of information: here