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African-American Skin: Ask the Dermatologist

Dermatologist Nicole Rogers, MD, answers your questions about African-American skin.

Question:
I am a 53-year-old woman. I have excess hair growing on my lower cheek and my chin, and I have to shave daily. What can I do to get rid of this hair permanently? Could the fact that I suffer from hypothyroidism be the cause of this hair growth?
Answer:

It is unlikely that your unwanted hair growth is related to your hypothyroidism. More likely, you have either inherited this from a family member, or as you progress through menopause, your male hormones (androgens) have been unmasked by your declining estrogen levels. This does not usually appear as lab abnormalities, but can contribute to unwanted hair growth and/or acne breakouts. If you are having any other symptoms, such as deepening of the voice, you should see your doctor for additional lab work and evaluation.

Question:
My eyelids are starting to droop. As a woman with a darker complexion, what can I do to tighten them back up without risking excess scarring or hyperpigmentation?
Answer:

Topical retinoids remain one of the best skin treatments for shrinking and tightening pores under the eyes. Try a gentle over-the-counter retinol cream first. If that doesn't irritate your skin, you may progress to a prescription strength retinoid. Other tightening procedures include treatment with radiofrequency devices, such as the Exilis.

Question:
I have a scar on my lip from a fever blister. I hate it! How, if at all, can it be removed safely?
Answer:

Depending on the nature of the scar, you may have a few different options for removal. Silicon dioxide-based creams can be very helpful in resolving scars. If the scar is thick or itchy your dermatologist may inject it with a steroid to soften it. If it is flat and depressed your dermatologist may be able to fill it in with a hyaluronic acid product.

Question:
What products or treatments should I try to get rid of hair bumps and the skin discoloration I have from shaving?
Answer:

Look for products containing retinol, which helps unclog pores and increase the turnover rate of cells to prevent hairs from ingrowing. You might also try skin-lightening agents such as azelaic acid, kojic acid, hydroquinone, and glycolic acid.

Question:
What OTC products are available for getting rid of dark under-eye circles? I have a medium skin tone.
Answer:

You may try a variety of skin lightening and brightening agents, such as products containing kojic acid, azelaic acid, or topical retinoids. Start with gentle formulations of each first.

Question:
I'm 45 and I have severe acne. I've used numerous products to minimize it. But nothing has worked. What can I do?
Answer:

Your next step may be to consider an oral medication called isotretinoin. This remains one of dermatologists’ most powerful tools in treating acne. It will completely remodel your skin cells, and you may have dry skin and lips during course of the six month treatment. See your dermatologist for more advice and treatment recommendations.

Question:
I am 64 years old and my body has been itching all over for 4 months -- from my head to my feet. I have tried everything my doctor has prescribed but my skin continues to itch. What could be wrong and how can I get some relief?
Answer:

First, see your internist to be sure you are not suffering from diabetes, liver disease, or kidney disease, because all of these conditions may cause itching. Next, take a look at the medications you're using. Some pain medicines can cause severe itching. Finally, see your dermatologist to help address what may be as simple as itching due to dry skin. You may need topical steroids to help cool the itch until the skin barrier can be repaired.

Question:
How can pockmarks be repaired?
Answer:

Presumably, you mean acne scars. These can be very difficult to treat. The most effective method is usually to add volume to depressed skin areas with fillers containing hyaluronic acid. Next, you may benefit from being treated with fractionated lasers in order to even out any textural irregularities. Microdermabrasion and chemical peels can sometimes be helpful, too.

Question:
I am 44 years old and of mixed race. I'm approaching menopause and maintain a vegan diet. What can I do to naturally reduce my very deep laugh lines and forehead wrinkles?
Answer:

Unfortunately, there is no easy or "natural" solution for deep laugh lines and forehead wrinkles. You may start with topical retinoid creams, which are vitamin A derivatives. You can get them from your dermatologist or over the counter as "retinol" creams. However, your best results may be obtained with botulinum toxin injections and/or laser skin resurfacing.

Question:
I have a rash on my neck. I was told that omega-3 fish oil is good for treating itchy rashes. But it hasn't worked for me and the rash seems to be getting worse. What do you suggest I do to get rid of this rash?
Answer:

Omega-3 fish oils have been found to help with certain inflammatory skin conditions such as psoriasis. However, you should probably see a dermatologist to make sure this is not a yeast or fungal infection, or scabies, which can be very itchy and contagious. Once those possible causes are ruled out, you may benefit from a topical steroid cream or moisturizer to help relieve the itch.

Question:
I am a black man with no facial hair. What kind of products can I use to make my face look fresh?
Answer:

You may benefit from a variety of products. Topical vitamin C and E products can help brighten the skin and provide antioxidant effects. Ultrasonic cleansing brushes, combined with glycolic or salicylic acid cleansers, can help exfoliate dead skin cells. At night, topical retinoids are still one of our best treatment options. And don’t underestimate the importance of using a great sunscreen every morning.

Question:
I have tiny hair bumps on the top of my legs, but they don't produce hair. What can I do to remove them?
Answer:

This is likely a condition called keratosis pilaris, which is a thickening of the skin around the hair follicles. It occurs on the backs of the upper arms as well as the tops of the thighs. Unfortunately, there is no cure for this condition. But you may be able to smooth the area with cleansers and/or creams containing glycolic acid or lactic acid.

Question:
I have seborrheic dermatitis on my face, specifically around the lower half of my face, mouth, and chin. I use a prescription drug for flare-ups but it leaves my skin discolored. Is there a facial cleanser and moisturizer I can use to balance the dryness with moisture. Is there some way to restore or correct the damage caused by this condition?
Answer:

My first-line treatment for seborrheic dermatitis is topical ketoconazole shampoo used as a face wash, and a mild topical steroid cream such as hydrocortisone or desonide. You may want to switch to a non-steroid cream such as pimecrolimus. Try to avoid heavy moisturizers such as petroleum jelly because they may worsen the condition.

Question:
I have very oily skin, especially on my forehead and nose. What is the best kind of over-the-counter product I could use to get rid of some of this oil on my face? I'm a man, so makeup isn't an option.
Answer:

First, try a topical retinol cream or gel. These products will shrink and tighten pores and reduce oil secretion.

There are also mattifying gel products on the market that contain micro-particles that can trap and absorb excess oils from your skin for over an eight-hour period. These products are well-liked by most of my patients with oilier skin.

Question:
Dermatosis papulosa nigra runs in my family, and I want to have my moles removed. What kind of questions should I ask to determine whether or not my local dermatologist is qualified to treat this condition?
Answer:

This is an easy condition to treat. Most dermatologists use a hyfrecator instrument to gently cauterize the lesions from your skin at very low heat. Removing them with a blade or liquid nitrogen can increase the risk of leaving you with light or white spots on your skin.

Question:
I am an African-American woman and I have dark spots on my face. I visited a dermatologist and she prescribed bleaching cream and sunscreen, which helped. She also told me not to use toner because it has alcohol in it. Is this true for all toners? Is using alcohol on the skin something everyone should avoid or just me because of my dark spots?
Answer:

Toners come in a variety of formulations and serve a number of different purposes. There are very gentle versions which contain almost no alcohol and serve to return the skin's pH to what it was before cleansing. Others can contain at least 20% alcohol and may be irritating to the skin. Your dermatologist was probably erring on the side of caution to be sure that your skin does not get further irritated, which could result in further inflammation and more dark marks.

Question:
What can I do to get rid of the stretch marks on my stomach? My skin is a caramel color.
Answer:

Stretch marks are almost impossible to make disappear. Certain lasers, such as fractionated technology, may help even out some of the textural irregularity. Applying topical retinoids may also help.

Question:
What can I put on my dry, chapped legs to get rid of the burning, itchy sensation? Regular lotion doesn’t help.
Answer:

First, try a little over-the-counter hydrocortisone lotion to help with the itch. Next, try seeing your dermatologist because you may have eczema or atopic dermatitis that would require prescription topical steroids.

Question:
I'm 36 and trying to get rid of the whiteheads that only pop up on my chin. What do you suggest?
Answer:

You may benefit from using a topical or oral acne medicine. When breakouts occur on the lower face or around one’s menses, this suggests a hormonal influence. Spironolactone is an oral medicine that works well for this type of acne. But it can only be used if you are not pregnant. See your dermatologist to discuss this and other possible treatment options.

Question:
I recently noticed that the pores on my face appear to be larger. Does this happen with age? I just turned 45. How can I shrink them, or at least stop them from getting any bigger?
Answer:

Topical retinoids (OTC retinol or prescription) have been shown to be our best option for shrinking and tightening pores.

Question:
I have dark marks on my chin from tweezing and shaving. What can I do to get rid of them?
Answer:

These marks are pigmentation resulting from the trauma of tweezing and shaving. You can lighten them with bleaching creams such as hydroquinone. But the best treatment is prevention. Consider trying other methods of removal such as laser hair removal, topical eflornithine cream, electrolysis, or depilatories.

Thank you for joining us for WebMD Ask the Dermatologist. Be sure to come back on April 12 at 1 p.m. ET, when we will discuss "Warding Off Wrinkles." Sign up if you'd like an email reminder the day before our next event.

WebMD Ask the Specialist Transcript

Reviewed by Nicole Rogers, MD on March 05, 2012

The opinions expressed in this section are of the Specialist and the Specialist alone. They do not reflect the opinions of WebMD and they have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance or objectivity. WebMD is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your doctor or other qualified health provider because of something you have read on WebMD. 

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