Is There Really Such a Thing as Hispanic Acne Care?
Dr. Vivian Bucay is a cosmetic surgeon in San Antonio, Texas. Over half of her patients come from various locations in Mexico because of her expertise in Hispanic skin care. But is there really such a thing as Hispanic skin, or Hispanic skin acne care?
The Many Shades of Hispanic Skin
There is a stereotype of the Hispanic skin type as olive to dark brown, smooth, and maybe just a little oily. Like many stereotypes, this idea of what “Hispanic” skin should be has a connection to truth.
In Latin America and southern Europe many people do in fact have olive to dark brown complexions with smooth and oily skin is more common than dry. There is not, however, any single skin type that is shared by absolutely all people who describe themselves as Hispanic, especially not in Latin America.
The Americas were populated by indigenous peoples long before the “discovery” of the New World by the explorer Christopher Columbus. Vast numbers of people North, Central, and South America trace their ancestry in whole or in part to the native Americans, who tend to have an Asian skin type.
More Latin Americans than not, however, have both native and European ancestors. There are also large populations of Japanese-Latin Americans in Peru and Brazil and a large number of people who have fair skin, blond hair, and blue eyes throughout both continents. And because both the Spanish and the Portuguese brought slaves to the Americas, many Latin Americans have African ancestors.
Latin America has a diverse gene pool. Every kind of acne that can be found anywhere else in the world can be found in Latin America, but the sunny climate of most of Latin America causes a consequence of acne that is not as common in the rest of the world, hyperpigmentation. No matter what their ancestry, Latin Americans from Poughkeepsie to Patagonia tend to develop brown spots on their skin where acne heals.
Hyperpigmentation and Hispanic Skin
Most of the United States and almost all of Latin America suffer from harsh summer sun. In extreme southern South America, summers tend to be cloudy and cool, but the thinning of the Antarctic ozone layer results in unusually high levels of UV radiation.
For people who have acne, lots of sun exposure results in lots of skin pigmentation. As acne heals, the pigment-producing melanocytes in the skin make melanin to serve as an antioxidant to reduce inflammation. The melanin remains in the skin and causes brown spots. In Hispanic women, and occasionally even in Hispanic men, fluctuations in hormones cause the formation of melasma, multiple brown spots that appear in drifts on the face, neck, torso, and hands.
In many Hispanics, two factors make hyperpigmentation worse. Especially in Mexico and the United States, many people of Hispanic heritage develop type 2 diabetes at a relatively young age, sometimes even as children. People who have type 2 diabetes tend to get darker and more widespread brown spots as acne heals.
Also, an unusually large number of Hispanics are sensitive to the world’s most commonly prescribed acne treatment, benzoyl peroxide. Even on Hispanic skin, benzoyl peroxide kills acne bacteria. Certain brown and olive skin types, however, are unusually sensitive to benzoyl peroxide. The skin becomes severely irritated, and makes melanin to heal itself. Because the skin is already making relatively large amounts of brown pigment, the brown spots occurring after acne treatment with benzoyl peroxide can be especially dark.
Sunblocks Are Tricky, Too
Another problem for many Hispanics is choosing the right sunblock. Especially in Chile and Argentina, people of all ethnic origins need protection from the UV-A and UV-B rays of the sun. Products that contain the mineral ingredients zinc oxide and titanium dioxide block UV-A and UV-B without chemicals changes in the skin and without triggering allergies.
On brown or black skin, however, both zinc oxide and titanium oxide can leave a whitewash-like tint even when they are washed off. The new nanoparticle sunblocks—available in Latin America without government restriction—can work their way into the lower levels of the skin and form tiny clumps that create white spots on the skin that cannot be washed away.
Sunblocks are also a problem for Hispanics because of their effects on the body’s ability to make vitamin D. The darker the skin, the more sunlight it needs to make this essential vitamin that protects the body against, among other health problems, skin cancer. Many experts believe that one of the most important reasons skin cancer is on the rise throughout Central and South America is that more and more people are following doctor recommendations to use sunblock, which leads to vitamin D deficiency and increased vulnerability to skin cancer that is not triggered by exposure to sunlight, such as the deadly form of skin cancer known as melanoma.
Dr. Bucay usually recommends her Hispanic patients use sunblocks containing zinc oxide and titanium oxide that are ground into micronized particles. Sometimes manufacturers explain the process of making micronized particles as “additional milling.” These are particles of sunblock that are small enough to lodge over pores and to protect the delicate acne-prone skin inside them, but large enough that they do not travel into the skin and aggregate into cosmetically objectionable lumps. It is helpful for Hispanics to spend about 20 minutes a day in the sun before putting on sunblock to give the skin to make needed vitamin D, or to take 1,000 IU per day of a vitamin D supplement.
Cystic Acne and Hispanics
Other dermatologists have noticed that more than any other ethnic group, Hispanics tend to get cystic acne. Many Hispanics who escape teenage acne develop cystic acne in their early 20’s, and the condition is very hard to treat without causing the inflammation that can permanently discolor the skin. In cystic acne, healthy but pink skin grows over pockets of bacterial infection that cause constant irritation to the skin but cannot be drained because the pore no longer exists.
That’s why it is important that Hispanics, both male and female, pay special attention to acne skin care even when they aren’t teenagers any more, or especially when they aren’t teenagers any more. When mild to moderate acne is treated promptly with a minimum of irritation—using salicylic acid scrubs and peels and tea tree oil instead of benzoyl peroxide, for instance—the risk of cystic acne is lower and naturally beautiful brown skin may escape scarring and melasma.