Aging in Ethnic Skin (United States)

Who’s who ?

-Caucasians: European descent
–Ethnic population: Blacks (African-Americans), Asians, Hispanics, Native Americans

Introduction
-In the US a quarter of the population is non-caucasian
-This will increase and will become a minority in 2014 with hispanics becoming the biggest growp

Characteristics
–Melanocytes are more reactive and pigmentary changes are more of a problem
–Fibroblasts are more reactive and keloids are more frequent in blacks and asians
–Face changes are different in groups (mixed individuals, genetic features), but patients have to be evaluated individually

Wrinkles on Ethnic skin
–Higher phototypes have less wrinkling as increased photo protection by melanin
–Less severe and delayed of crows feet and horizontal lines. Wrinkling and volume loss is delayed in all subgroups in comparison with caucasian women. Black women are less affected in terms in age of onset and overall severity where changes appear 10 years later
-Blacks (African-Americans) hardly develop crows feet and wrinkling is minimal

In our opinion, Fitzpatrick photo types are more predictive of aging related changes. Secondarily, genetic factors can be taken into account
The problems related to aging on ethnic skin
–Pigment changes, benign facial neoplasms, textural irregularities and volume related changes are more ethnic-related changes.

Wrinkles and Pigment changes in Asian women

-In 2 studies: French women vs Chinese and Japanese women

• wrinkling is delayed by 10 years but in the Asian population, pigment changes appear first.
• Seborrheic Keratosis (SK) ks are more frequent in ethnic groups: flat in Asian women, raised in Asian men (Blacks have a variant of SK called Dermatosis Papulos Nigra (DPN))

Aging changes in the Black population (African Americans)

• lowering of infraorbital fat pads
• tear trough deformity (in French: “vallée des larmes”)
  deepening of nasolabial folds
• neck laxicity
• enlarged pore size and textural changes (DPN)

Bibliography: S007 – Alexis. Ethnicity and aging skin. Aging Gracefully. AAD 2016 – Washington DC, United States USA