For example, two best friends, Valerie, a medium-skintoned brunette, and Dana, a dark-skinned woman, came in for back-to back appointments. After they each took the questionnaire and tabulated their results, they were surprised to discover that they shared the same Skin Type. They were both “P,” Pigmented Skin Types, which gave both Valerie and Dana a tendency to develop pigmentation issues. And each of them did have a problem with pigmentation. That’s why they came to my office. Valerie had an area of dark skin discoloration (called melasma) on her cheek, and Dana had dark spots in areas where she had once had pimples. Although I recommended that they follow the exact same protocol and use the same kinds of products, there was one key difference. Valerie could benefit from an advanced cosmetic procedure that uses light instruments or lasers to treat pigment problems like hers, while Dana would benefit most from prescription products used daily and should not undergo laser treatment since this can cause discoloration in people with darker skin tones.

 A Dermatologist’s Story

“A patient came to see me because of skin discoloration on her chin and cheeks. An African-American with oily skin, Sylvia never guessed that the skin scrub she’d picked up at the Neiman Marcus beauty department was causing this problem. Anyone with highly pigmented skin (like many dark skinned people) must stay away from all ingredients and procedures that cause inflammation. Yet, not knowing her SkinType, Sylvia had no idea that her choice of skin product stimulated the inflammatory response, which in turn led to dark spots. I taught Sylvia what to look for on product ingredient labels. Common ingredients, like vitamin C, AHA, and alpha lipoic acid, can create inflammation, as do buff pu ffs and strong scrubs. She was surprised to learn that hair removal formulas, like Nair, and hot wax products may also cause inflammation. In using wax or a chemical depilatory to remove facial hair, Sylvia wound up with unsightly dark patches that looked far worse than the hair she was trying to remove. Now she knew to avoid them. Once she became aware of the needs of her Skin Type, she was able to make changes that helped reduce the dark spots considerably. In addition, I recommended she use products containing oatmeal, feverfew, chamomile, or licochalone, which are known to have anti-inflammatory properties.” Dr. Leslie Baumann, M.D.

THE BIOLOGY OF THE SKIN

The top layer of the skin, called the epidermis, is made up of four distinct layers. When you look at someone’s skin, you see the very top layer, made up of cells that reflect light. When that top layer is smooth, it reflects light evenly so that the skin looks more uniform and radiant than it does when the surface is rougher.

At the lowest portion of the epidermis are “mother cells,” called basal cells, which produce all the other skin cells. They divide into “daughter cells,” which rise up to the higher levels of the epidermis. As they travel, they age and eventually die, so that the top layer consists of dead cells which naturally exfoliate off in a process called the “cell cycle,” which can take anywhere from twenty-six to forty-two days. Between the third and eighth decades of life, the cell cycle slows from 30 to 50 percent of its pace in youth. That means that older skin renews itself much more slowly, forming a rough surface of cells, rather than a smooth surface. The uppermost cells contain a natural moisturizing factor (NMF), which holds moisture. The body responds to a dry environment by producing more NMF, but it takes several days for production to rev up, so your skin may become quite dehydrated before help comes. That’s why it’s important to moisturize your skin in any dry environment. Substances released by the cells in the middle of the epidermis form a protective film made of lipids (fats) that surrounds skin cells and helps keep the skin hydrated. Your fingers and toes contain fewer lipids and are therefore not as “watertight” as your legs, which is why your fingers and toes look shriveled after immersion in water but your legs do not. Your skin cracks in cold weather because the chilled lipids become stiffer and less able to adjust to movement. The goal of the best moisturizers is to increase the amount of these important lipids, helping your skin to hold moisture.