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INTRODUCTION

KEY POINTS

  • Aging changes in individuals with skin of color age typically occur 10 to 20 years later than those of age-matched white counterparts.

  • Common clinical signs of photoaging in darker skinned individuals include lentigines, rhytides, telangiectasias, and loss of elasticity.

  • Cleansers with lubricating products that contain emollients should also be employed, and appropriate photoprotection should be practiced.

  • Maturational dyschromia (uneven skin tone) was a chief complaint in more than one-third of women with dark skin of color.

In humans, aging refers to a multidimensional process of physical, psychological, and social change. Aging is an important part of all human societies reflecting not only biologic changes but also influences of cultural and societal standards. Although age is measured chronologically, the term aging is somewhat ambiguous, an organic process of growing older while showing the effects of increasing age. Understanding the fundamentals of mature skin is important to an aging population where individuals are expected to be productive into later years and hold a strong desire to maintain a youthful appearance.

RACIAL DIFFERENCES IN AGING

Across all skin types, the aging process involves photodamage, fat redistribution, bone shifting, and the loss of connective tissue. As life expectancy continues to increase, almost doubling over the past century, an aged appearance is often a presenting complaint for the Caucasian population. This particular group is often affected by the secondary effects of photoaging including fine lines, deep furrows, and age spots. Individuals with skin of color is less susceptible to sun-induced damage, so these clinical manifestations of aging are less severe and typically occur 10 to 20 years later than those of age-matched fairer-skinned counterparts.1 Individuals with dark skin of color are overall thought to have firmer and smoother skin than individuals with lighter skin of the same age.2

STRUCTURAL AND FUNCTIONAL DIFFERENCES

Melanin is the major determinant of color in the skin, and the concentration of epidermal melanin in melanosomes is double in darker skin types compared to lightly pigmented skin types.3 In addition, melanosome degradation within the keratinocyte is slower in darkly pigmented skin when compared to lightly pigmented skin. The melanin content and melanosomal dispersion pattern is thought to confer protection from accelerated aging induced by ultraviolet (UV) radiation.1,4 Kaidbey et al1 demonstrated that the epidermis of dark skin of color, on average, provided a sun protection factor (SPF) of 13.4, which provides a scientific basis for the observation of better aging in terms of reduced number of fine lines and wrinkles. Although the increased melanin provides protection from many harmful effects of UV radiation including photodamage and skin cancers, it also makes darkly pigmented skin more vulnerable to postinflammatory dyspigmentation. Therefore, more so than textural changes, inconsistent pigmentation with both hypopigmentation and hyperpigmentation is a sign of photoaging in people with skin of color.

Aging ...

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