2007 ANNUAL SCIENTIFIC MEETING 177 ETHNIC SKIN: UNIQUE PROPERTIES, CHALLENGES AND SOLUTIONS Victoria Holloway Barbosa, MD Dermal Insights, Inc. The ability to address the skin care needs of people of different ethnicities has never been more important, as both the United States becomes more diverse and as international companies make products that serve people from more countries around the world. In order to successfully meet these needs, the cosmetic chemist must first understand them. This includes having knowledge of the similarities and the scientifically proven differences in the skin of people of different origins. It also requires insight into the different desires and challenges of people from different cultures, both within the US and around the world. Finally, one must be familiar with the current product offerings in order to know the unmet needs. This presentation will review the published literature and recent reports on the differences in skin across ethnicities. Structural and functional differences will be discussed. The differences that are of cosmetic relevance will be highlighted. In addition to covering normal skin, common skin conditions and diseases of significance to people of color will be discussed. Problems with pigmentation provide one of the greatest challenges for people with skin of color. Problems including normal variation in facial pigmentation (especially around the eyes and in the beard region), conditions such as postinflammatory hyper- and hypopigmentation, and diseases such as melasma and vitiligo will be described. A review of the effects of acne in pigmented skin, dry skin, eczema will also be provided, as will a review of the skin challenges associated with facial hair growth. Allergic reactions and sensitive skin will also be discussed. For the conditions, a description of the underlying cause will be given and clinical examples will be shown. There are many skin care products currently available that address some of the skin care needs of consumers from diverse ethnic backgrounds. However, there are still many unmet needs which translate into opportunities for the cosmetic chemist. Some of the products are developed for and/or marketed specifically to people of color. Other products are mainstream products but are particularly effective or appealing to people of color. This presentation will review existing brands, products and active ingredients. Finally, a needs analysis will be given based on what we know about the skin and what is currently offered. These need-gaps will be presented as challenges to the cosmetic chemist. At the end of the presentation, the chemist should have a good understanding of ethnic skin, its specific properties, and conditions and diseases that are relevant to its skin care needs. He or she will be aware of products that are currently available, and opportunities for improvements in current offerings.

178 JOURNAL OF COSMETIC SCIENCE SCALP AND HAIR IN THE AFRICAN AMERICAN PATIENT: NORMAL STATE AND IN DISEASE Amy J. McMichael, MD Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 amcmicha@wfubmc.edu Introduction Hair and scalp disorders in African Americans present interesting dilemmas since all the general disorders seen in the general population are seen in this group as well as those that are traditionally seen primarily in deeply pigmented patients Seborrheic dermatitis, and folliculitis are the most encountered scalp disorders. The next most common disorders include those that are more common in patients of color they are folliculitis decalvans/dissecting cellulitis, acne keloidalis nuchae, and scarring alopecia which may be a result of the above diagnoses or other primary processes to include: discoid lesions of lupus, traction/trauma, and tinea capitis. Seborrheic dermatitis Seborrheic dermatitis is a scaling, inflammatory, often pruritic, eruption that is common on the scalp, oily facial areas, and the mid-chest. Often, pruritus is so persistent that some patients begin to assume it is a natural state. Topical pomades may be used by patients to cover the scaling and alleviate itching. There is no single correct regimen to treat seborrheic dermatitis. Treatments include: anti- dandruff shampoo can be used followed by a moisturizing conditioner. Zinc, tar, and selenium sulfide shampoo, and ketoconazole can be rotated with prescription mid-potency shampoo in an every other week fashion. There are over-the-counter zinc-based conditioners on the market that are formulated specifically for African American patients. Topical steroids may be used in various vehicles for treatment as well. Dissecting cellulitis Perifolliculitis capitis abscedens et suffodiens, also known as dissecting cellulitis, is a chronic inflammatory disorder of the scalp that occurs in both men and women, but is most common in African American men. Large, tender, fluctuant cysts and sinus tracts on the vertex and occipital scalp characterize the disorder. Hair loss can be permanent in this disorder secondary to the severity and chronicity of inflammation of the scalp. The disorder may also eventuate into hypertrophic scarring and keloids on the scalp. Treatment regimens can include oral antibiotics, short courses of oral steroid tapers, intralesional steroids, and incision and drainage of specific fluctuant nodules. oral zinc therapy, oral isotretinoin, and wide local resection of the involved scalp. Acne Keloidalis Nuchae Acne keloidalis is a chronic condition most often seen in African American men, although there are reported cases among African American women. Clinical examination reveals skin-colored to hyperpigrnented follicullarly-based papules on the nape of the neck and occipital scalp. Pustule formation, hypertrophic scarring, and severe keloid formation is often observed. Approach to this disorder is much like that for dissecting cellulitis. First, decrease active inflammation, then attempt maintenance treatment. Topical and oral antibiotics will work well, especially when accompanied by intralesional corticosteroid injections. For severe involvement, local excision and carbon dioxide laser have also been used. Hair removal laser can also be used in the nuchal region. Scarring Alopecia The scarring alopecias are a group of diseases that occur frequently in African Americans, often with no known etiology. These entities include discoid lesions of lupus, lichen planopilaris, idiopathic scarring in African American women, and sequelae to dissecting cellulitis, traction/trauma to the hair follicle, or fo!liculitis.