5 Questions about Skin of Color with Dr. Julius Few M.D.

Outside of appearance, there are some fundamental differences between different skin tones and skin types. But, what exactly is different, and what should be considered when creating a skincare regimen if you have darker skin or skin of color? We asked plastic surgeon and Aforé’s founder, Dr. Julius Few M.D. about the differences between skin types, and how those differences manifest in his daily practice as a surgeon and his skincare product formulations.

Q: What are some differences between skin of color and lighter skin types?

“Skin of color has up to 10 times or more sun protective factor, which leads to much less photo/sun damage over time compared to lighter skin individuals. Skin of color, like mine, is very sensitive to heavy oils found in many skincare products. Any cleanser or cream that has a heavy oil base, like Shea Butter, is likely to make many with skin of color have a severe breakout of acne, which has happened to me in the past.

Despite the natural sun protective factor found in skin of color, it is very important to still use sunscreen. If not for aging concerns, then for pigment concerns, and most importantly for skin cancer prevention. Skin of color is susceptible to skin cancer, just like lighter skin types, and should take similar precautions with adequate sun protection. In addition, many topical agents used for all skin types have components in them that may lead to sun-induced irritation, and possible sunburn if a sunscreen is not being used.

Many common applications like the Clarisonic device can cause great irritation, and then associated discoloration if used too often or too aggressively for skin of color.”

Q: What’s different about skin care that works for all skin types?

“As a child and then young adult, I was extremely disappointed and frustrated by the lack of universal skin care offerings. The reality back then was there was little interest in products that were truly effective for all skin tones and types.

Skin care products, especially for the face, should have more water-holding ingredients than oil-holding. Hyaluronic acid containing products work extremely well because they hold water in a universal skin fashion, being able to hold many times its weight in water. Glycolic acid is another great example of a product, especially as a cleanser, to help balance the water to oil ratio on the skin surface. This is particularly important for people with pigmented skin who will be more likely to hyper-secrete oil on the face. At the same time, gentle preparations that are medical-grade are excellent for lighter skin as well because they help for better exfoliation and clearing of debris on the skin’s surface.”

Q: What inspired you to start Aforé, and create products that work for all skin types?

“In my youth, being forever self-conscious about my skin that broke out easily with just about any product, I always wanted to have a skin care line that would work for my sensitive skin, but at the same time would be truly effective for what it was supposed to do. Aforé, by its meaning (meaning before the problem exists) and its specific design is intended to be an innovative approach to medical-grade skin care. Like all aspects of technology and medicine, we are striving to make a better product year after year, incorporating the latest advances in dermatology and plastic surgery. The lessons learned in the clinic are brought straight to our lab to make the highest grade skin care that is free of harmful agents and artificial additives, while also never being tested on animals. Bottom line, Aforé is skincare for all skin.”

Q: What needs to be taken into account when treating skin of color and darker skin types?

“Skin of color has many key advantages when it comes to the external environment, including built-in sun protection. That said, it is also extremely reactive to external insults and/or trauma. This is the reason we see a much greater risk of keloid and hypertrophic scarring, but also see much more youthful appearing skin with aging. The deep layer of the skin, called the basal layer, is where inflammation in skin of color can lead to hyperactivity of the melanocytes – the producers of melanin. This hyperactivity can be triggered by topical agents that produce inflammation or irritation in the skin. Skin of color tends to have more sebaceous activity and as such, external creams, soaps, or rejuvenating agents that obstruct the natural flow of sebum (oil) in the skin can lead to acne formation, which is associated with inflammation in the basal layer, and then we see post-inflammatory hyperpigmentation (or dark spots).”

Q: What are some misconceptions/myths about darker skin types and skin of color?

“The biggest misconception for darker skin is that sunscreen isn’t necessary. My answer above explains why this is not the case. Darker skin types still need sunscreen to avoid pigmentation issues and exacerbated irritation from other skincare ingredients. And, most importantly, sunscreen is pivotal for skin cancer prevention.

The second big misconception for skin of color is that ingredients don’t matter, and any skin care works. I have seen hundreds of people over my more than 20 years in Plastic Surgery with adult acne and acne scarring/hyperpigmentation that is the direct result of the products they were using. Simply changing their skin care led to a dramatic improvement and resolution without fancy plastic surgery intervention, just medical-grade skincare.

The last misconception is that skin of color does not age. This is completely false. While it is true that skin of color shows sun damage much later in life, skin loses volume over time, regardless of skin tone. This loss of volume and weathering leads to skin that looks worse than it should. With the simple addition of medical-grade skin care, we can help to make sure that your best face is seen by the world. With this fact in mind, it’s important to remember the skin of the body, as well. The principles listed above are important considerations, and the reason why we often prescribe agents that are used on the face for the body to control acne formation.”