Before you try all those creams and treatments that promise flawless skin, here's the real deal on some of our peskiest problems.
Facial & Body Hair
That wiry stray hair sprouting from your chin or toes wasn't there yesterday. Don't panic, you're not alone
Hormonal changes and age may be the culprit. The good thing is that removal can be quick and easy. Just keep in mind that "people of color usually have curlier strands, so techniques such as waxing, threading or even shaving can create painful ingrown hairs," explains Andréa Young, owner of Beam Laser Spa in New York City.
The Rx: Waxing, threading and sugaring are all viable ways to get rid of hair, but they can possibly damage the delicate layer of skin, causing hyperpigmentation, breakouts and, in some cases, allergic reactions to the wax. Also, these methods are not a permanent solution. Laser treatments, which are best for those prone to ingrowns, last the longest. Do your research. Make sure that the practitioner has a successful history of working with brown skin because it can scar and darken with the wrong laser. The Nd: YAG laser is best for skin of color because it has the appropriate wavelength. For effective results you'll probably need 12 sessions, which can run you about $2,400. No matter what treatment you choose, remember to apply a high SPF sunblock—it helps prevent discoloration and irritation.
Freckles are cute. Acne scars and uneven skin tone? Not so much
Anything that disrupts the skin (acne, waxing, shaving or a mosquito bite) causes inflammation, which often results in discoloration for women of color. Although brown skin has builtin sun protection, excess sun exposure can intensify hyperpigmentation.
The Rx: "There's what we call a gold standard in hyperpigmentation treatment—hydroquinone," says Cheryl Burgess, M.D., a Washington, D.C.-based dermatologist and Black Opal Cosmetics skin expert. Although its usage has been controversial (some countries in Europe and Africa have banned hydroquinone), it has proved to be the most effective and fastest method of treatment. For example, spots closer to the skin's surface can sometimes fade in about two to four weeks. Hydroquinone-free products like Black Opal Tri-Complex Skintone Brightening Gel ($14, drugstores) may contain brightening ingredients such as licorice, vitamin C, retinol and kojic acid. These alternatives can help clear up discoloration, but they often require a longer commitment. For faster results they can be used with hydroquinone. Ask your dermatologist before combining too many treatments, and remember sunscreen is a must. Sun exposure ramps up melanin production, which is the last thing you need when trying to rid skin of dark spots.
Those raised spots you thought were moles are taking on a life of their own
Skin tags are usually the result of friction," says Burgess. Commonly they can be found around the eyes, on the neck, under the armpits, in the groin, and on the upper and inner thighs. Those are areas where the skin rubs against skin, jewelry or clothing. Tags around the eyes can be a result of constant eye rubbing. Fleshier and flabbier than a mole, a skin tag may look like a tick on the skin. "It is usually flesh-colored, but in some Black patients it may be more brown and is typically on a stalk where you can almost grab it," says Burgess.
The Rx: Although skin tags can be unsightly, they're harmless. If you're uncertain whether it's a tag or a mole, visit a dermatologist. Your doctor can easily remove the tags by numbing the area with a topical anesthetic and snipping them off.
You couldn't resist picking that pimple and now there's a scar to show for it
The Rx: "If you know that you get scarring from your acne—meaning a change of texture, not just discoloration—then even one new pimple a month means 12 new scars a year," says Doris Day, M.D., clinical associate professor of dermatology at New York University's Langone Medical Center. Get professional help to treat the acne so you can avoid scarring. If the damage is already done, a device like the eMatrix laser is a great choice for skin of color. The laser uses radio frequencies to reform the collagen underneath the skin. The therapy increases cell turnover, so you'll get a fresh and smooth new layer of skin. Each treatment takes about ten minutes and you'll need three to five sessions for optimal results. Craterlike scars can be treated with a laser "Deeper scars are a lot more difficult to treat. Nothing really helps them," says Day. "With acne scars you have to be very careful. I never say the scarring will be gone; I just say it will be better."
You've spent months slathering on creams to banish the lumps, but have yet to see any results
Unfortunately cellulite is an issue that goes much deeper than any topical cream can treat. "Cellulite is an architectural problem in the skin," explains Neil Sadick, M.D., clinical professor of dermatology at Weill Cornell Medical College in New York City. It is genetic and can be estrogen-related. "If the lining around the fat cells are in a vertical position instead of a normal horizontal position, the fat cells can protrude into the dermis layer of the skin, causing puckering and bumpiness," Sadick adds. It is not preventable, and it tends to increase in slightly heavier people, but not always. "I've seen marathon runners with cellulite," says Bruce E. Katz, M.D., director of the Juva Skin & Laser Center in New York City.
The Rx: Professional treatments can significantly improve the appearance of cellulite. Lasers like Cellulaze remove the lining around fat cells, decrease their quantity and remodel the dermis, pushing fat back into the compartments. "We're also doing research on a new injectable drug for cellulite called Xiaflex," says Sadick. "It chemically dissolves the linings around the fat cells." Some doctors treat the condition with injectable fillers (typically used for expression lines). "Most skin of color has greater elasticity, but if there is a pivot or hole, fillers will work perfectly on it," says New York City-based cosmetic dermatologist Paul Jarrod Frank, M.D.
So you fell prey to the freshman 15, and it's still handing on ten years later
The Rx: Fat removal has come a long way from when that vibrating belly machine was supposed to get rid of the pounds while you stood in place. These days, fat can really be reduced; it just depends on whether you prefer an invasive or a noninvasive procedure. Over the past few years, with the advent of laser and radio frequency devices like Vanquish, doctors are now able to break down fat and tighten the skin with minimal incisions and practically no downtime for recovery. "There's also a new FDA-approved therapy called UltraShape. It's a noninvasive ultrasound that uses a transducer on the skin's surface to melt away fat," says Katz.
Aaron Rollins, M.D., a cosmetic surgeon and founder of Elite Body Sculpture in Los Angeles, has created a proprietary technology called AirSculpt Laser Liposculpture. Unlike traditional techniques, it takes out more fat and doesn't use needles or a scalpel. The hour-long procedure is done while you're awake: "A device is used to make a two-millimeter circle, the size of a mole. A tiny tube is attached to an air compressor that moves the tube back and forth over 1,000 times a minute to buff out the fat." If you just need a jump start to shed the pounds or if you've hit a weight loss plateau, you may want to consider low-level laser therapy, like i-LipoXcell. It stimulates the natural process of releasing fat. "When fat cells are exposed to laser light, they shrink and in turn, you shrink. Each session takes about 20 minutes and sheds about 300 calories," explains Jamé Heskett, M.D., founder and medical director of The Wellpath center in New York City.
Bathing yourself in body oil every night has your skin glowing, but it's done nothing for those lines
It's all about the type of skin you have. "Skin that isn't very elastic when it stretches tears the collagen," explains Katz.
The Rx: All the derms we spoke with agreed that creams don't work. "The only creams that have a mild or minimal effect are the ones containing Retin-A or a vitamin A derivative, such as the dermatologist-prescribed Retin-A Micro or Tazorac," says Sadick. Vascular laser therapies like the pulsed dye laser or Excel V heat and shrink blood vessels to make darker marks less visible. Lighter marks can be treated with targeted Levia laser therapy, which stimulates new melanin. It's possible to see a 20 to 90 percent improvement.
This article was orignally published in the August 2014 issue of ESSENCE, on newsstands now.