Seborrhoisches Ekzem
Helle Flecken im Gesicht- Was kann dahinterstecken?
Das seborrhoische Ekzem gehört definitiv zu den häufigsten Diagnosen und kann im Säuglingsalter aber auch bei Erwachsene auftreten.
Während auf heller Haut rote, leicht schuppende Areale im Bereich der Augenbrauen und der Nasolabialfalte (bei Männern auch im Bartbereich) zu sehen sind, kommt es bei dunkler Haut zu hellen Flecken ( Hypopigmentierung)! Ganz genau- helle Flecken sind das klinische Zeichen für die Entzündung.
Da dies statistische häufig bei Afro-AmerikanerInnen aufritt, sehe ich das seborrhoische Ekzem aktuell hier in der Praxis in NY sehr oft!
Die Ursache ist nicht einheitlich geklärt. Eine genetische Prädisposition , erhöhte Talgproduktion, Stress und erhöhter Alkoholkonsum sind mögliche Gründe.
Die Therapie umfasst topische Cremes, die die Entzündung beseitigen sowie ggf. ein Anti Pilz Shampoo. In unklaren Fällen sollten noch andere Ursachen für eine Hypopigmentierung ausgeschlossen werden.
Dazu gibt es bald mehr.
Happy Black History Month
Xx Ephsona
Rosacea: The practical guide
Symptomes, causes, treatment and what to expect in darker skin
Rosacea is a very common skin condition, especially in European and Celtic ethnicities.
If you notice persistent red flush on your check, burning sensations, little red vessels, and always tend to experience redness you might have rosacea.
I always like to explain to my patients that rosacea is like a skin type! There are treatment options but you will always have to look out when buying skincare that certain products could also make it worse again.
What is Rosacea?
A chronic skin condition that causes redness focusing on the central face. However, it can involve the eyes too!
Further clinical aspects are papules and pustules without comedones (black and white heads). Comedones are typical findings in acne.
Cause of Rosacea
We still have not fully understood the cause yet. At this point, genetics, neurovascular inflammation, the environment, and microorganism like demodex mites play a role. Sun exposure is the most common trigger. For others heat, stress, alcohol or spicy food can provoke new flare ups.
Rosacea in darker skin types
The goal you and your dermatologist should set is to achieve clean skin ! The CLEAR-Study showed that the quality of life improves and that these patients also experience less flare-ups in the future.
Even though rosacea occurs more often in lighter skin types rosacea might be underreported in skin of color.
With redness (erythema) sometimes difficult to see experts notice delayed diagnosis and greater morbidity, meaning that these patients might be in more severe stages of this skin condition.
A granulomatous subtype with perioral (lip swelling) and periocular ( eyes) manifestation is more frequent while ocular manifestation (eyes) is found more often in patients from Saudi Arabia, Italy, and Korea.
How to diagnose:
Patients self-report:
Warm, burning sensation
do you recognize redness?
positive family history
can you identify specific triggers?
Practical tips for the diagnose:
causing the skin for blanching by using a magnifying glass can show redness even in darker skin
also look for lesions in the central area of the face
being able to identify non-comedonal papules rules out acne
How to treat
Basics treatment regimens are equal for all skin tones, however, in darker skin types we need to address post-inflammatory hyperpigmentation (PIH) and dyschromia.
The goal is always CLEAR, meaning complete clearance should be the goal your dermatologist and you want to achieve because studies showed that quality of life will increase while flare-ups will decrease.
Typical topicals that will be prescribed to you according to your clinical status: Metronidazole, Ivermectin or Doxycyclin
What can you do ?
Practical tips:
gentle cleanser fragnance-free (foam, creams might be less irritating)
light make up (preferably powder)
physical and mineral sunblock (eg with zinc oxide)
Products to avoid:
Alkohol-based cleansers or abrasive harsh exfoliators
for some: chemical sunscreens
My source for this article:
The clinical spectrum of rosacea, highlighting skin of color: Review and clinical practice experience written by Dermatologist Andrew Alexis and further colleagues will be summarized in this chapter:
Is the Beauty Industry still failing BIPOC Women?
Hi friends,
the past weekend I was part of an exciting panel talk hosted by informed as part of The Ground Festival in Berlin. This is a new format introduced this summer with many Pop-ups, DJ sets,Talk, and even a Ballroom-Happening.
My IG was buzzing and I just had to share so much, however, I decided to give you a quick overview of the thoughts and research I have done for my topic:
Is the beauty Industry still failing BIPOC Women?
Recent studies in the US showed that Black brands make up only 2.5 percent of all beauty products sold in the industry, yet Black people are the highest group to spend on beauty (11.1 percent). This is an incredible high mismatch that still has to be met.
This shoot was taken by informed.
Underrepresentation also leads to misinformation!
Mismatch: Low supply, high consumer demand
Furthermore, we have to consider the much higher burden for black founders to enter the start-up scene and get investors when there is a lack of representation.
Racial inequity and underrepresentation of BIPOCs among retailers, large influential brands, and even investors make it difficult for young businesses to be seen and supported. Data about the demand and needs of underrepresented ethnic groups often do not exist. This is crucial because good data supports the necessity of that one brand and identifies gaps in supply.
Since I always like to think positively and see how far we have come (even though I believe getting good haircare in drugstores in Germany is still difficult) I wanted to point out the NGO Fifteen Percent Pledge ( found by Aurora James in 2020) which urges retailers to dedicate at least 15 percent of their shelves to black-owned or black-founded brands.
I hope you're all enjoying your summer.
A short notice on cosmetic procedures
Talking about injectables is something my caucasian friends and I easily do at brunch for example. I must say that this topic almost never comes up when I am around my black friends. Maybe now.. just because I am a Dermatologist they also sometimes like to hear my opinion on certain procedures … talking privately. But why?
The lack of representation in clinical research and in marketing made a lot of darker skin types hesitate about getting Botox, Filler and other cosmetic treatments because one could not tell them if it was also safe for them. Social media platforms where Dermatologist, aesthetician and individuals speak about different procedures provided a lot of clarity with noticeable increase of the demand.
If marketing mainly focuses on caucasian skin promoting injectables for lip and cheek treatments , others won’t think this is also a service available for them.
One could also argue that for example black individuals often already have full lips so they will not think that injectables could still be serving them (probably other areas). especially since lips treatments was and probably still is one of the most popular request. On the other hand you might have noticed that marketing for cosmetic procedures is now aimed at people of color while practitioners are starting to offer more services for all their potential clients.
BUT only because your local Dermatologist or aesthetician has a new ad showing laser treatments on a Fitzpatrick V model does not necessary mean they are experts in treating dark skin.
Do PoC need an different approach to injectables and other cosmetic procedures ?
Yes and No. Thinking about the fact that hyperpigmentations post brusing for example plays a bigger role, it is super important how your physician administers the material and handles your skin type. Also your doctor should have an idea for ethnic variation, history and culture appreciation to understand what you might want and for desirable outcomes (think of lip proportion in caucasian vs asian and black population).
CHECK these boxes to have more confidence before getting a treatment since marketing unfortunately can be misleading:
Simply ask if they treat patients with your skin tone to get an overall impression on how experienced they are
Read reviews form other patients of color about their experience
Check out their website: Do they seem to be inclusive? What kind of people do they treat on their social media platforms?
The lack of examples of work on non-white people can be an indicator – let them show you their work
With more invasive treatments I can only recommend to only see board-certified physicians who studied anatomy and can handle complications
Is the person offering filler or botox legally qualified? Especially in Berlin one can get great deals on almost every street corner. However, going to a doctor ensures a qualification which also means to be able to handle complications. A first consultation should be held by the doctor and not a nurse working at the front desk... I’m not making this up (it all happened before)
All hyaluronic acids are not the same! Not every filler is the right choice for any patient and any augmentation.
This topic comes from a personal experience I recently made…
I went for a facial and the woman which I knew before talked me into a new superficial-medium peel ( the ad pictured 3 different skin tones and said it was safe for all). At the end I left with burning skin areas and the peeling process was visible for the next 3-4 days. I needed down time but she did not tell me! I was not prepared since I had to go to work and secondly some of the brusing left me with hypopigmentations that stayed for several months... luckily my skin is forgiving! I felt the urge to go back and let her know how irresponsible she behaved.
Asking her for the concentrations of AHA and BHA she used on me, she could not give me an answer... she clearly didn’t now what she was doing…
Simply put: You’ll mostly get what you paid for!
I hope you enjoyed reading this.
Merry Christmas !
X Mimi