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Straightforward Advice for Skin of Color

Dr. Fran E. Cook-Bolden, M.D., Director of the Skin Specialty Group and the Ethnic Skin Specialty Group

A look at her own skin is just a clue to the type of magic Dr. Fran E. Cook-Bolden, renowned dermatologist whose specialty is the treatment of skin of color, can work. It's no wonder as the Birmingham, Alabama, native has been operating a thriving NYC dermatological practice for several years, regularly participates in clinical studies as well as tours domestically and internationally to speak about her cutting-edge research. As Founding Associate Director of the Skin of Color Center and Director of the Ethnic Skin Specialty Group she has written many journal articles and her advice on skincare and skin diseases has appeared in many publications including InStyle, Real Simple, Essence and Lucky. This talented sister-doc along with Dr. Jeanine Downie, another well-respected black dermatologist, published the book Beautiful Skin of Color: A Comprehensive Guide to Asian, Olive, and Dark Skin.

Dr. Cook-Bolden offers COCOACHiC a sample of the book's wealth of information on skin of color and advice on the basics for keeping our cocoa complexions looking good.

Skin of Color

CHiC: How has the dermatology field progressed with regards to treatments and understanding skin of color?

Dr. Cook-Bolden: There has been a revolution of interest in the treatment of skin of color. Almost immediately after I founded my practice, patients were flooding my office mainly due to previous experiences with physicians that were inexperienced with treating skin of color. That was more than several years ago and even today; there is still a growing need for physicians trained to treat skin of all ethnicities. In recent years there has been a resurgence of institutions that have skin of color as their focus or area of expertise. This is a positive development, one in which the pharmaceutical and the Health and Beauty industries have made great strides to keep pace with through research, treatments and education.

CHiC: Do people with skin of color have different skin care needs than those with fairer skin tones?

Dr. Cook-Bolden: First and foremost, every individual has unique skin care needs, but as a group, skin of color also has unique needs. For example, the way skin of color responds to the healing process to certain skin conditions or external trauma will be different than those with fairer skin complexions or Caucasians. Or depending on the particular condition the treatment may have to be altered due to factors like the difference in pigmentation.

Professional Care

CHiC: What are some of the biggest mistakes people with skin of color make when it comes to caring for their skin?

Dr. Cook-Bolden: The biggest mistakes people with skin of color have made in caring for their skin is not consulting a professional, delaying medical treatment, and lacking trust in and commitment to the healing process. Oftentimes, patients will use their friends and family as their major resource for treating conditions of the skin and scalp. Certainly, mother's wisdom is often a pearl and family traditions are often very effective, however, when you are unsure or are not noticing a positive change, don't continue to delay and don't give up. Seek out the advice of a dermatologist or other skin care professional with expertise in skin of color. Trust your health care provider and partner with them. Learn as much about your condition, be patient and never hesitate to ask questions.

Worsening Acne & Dark Marks
Delay in the proper treatment of acne affects optimal results, especially for the dark marks from acne that remain long after the acne has healed. Treating yourself with at-home treatments and home remedies can be effective for mild cases, but don't delay if the problem is getting worse or no improvement is visible.

Extensive Hair Loss & Scalp Scaling
When treating hair loss issues and scaling of the scalp, like psoriasis, patients will often try every remedy under the sun, along with cover-ups and camouflages until the condition has significantly progressed or the hair loss is extensive. At this stage, what may have been a reversible condition can result in permanent scarring due to time loss.

CHiC: When is it necessary to consult a dermatologist and should this be a doctor you visit regularly?

Dr. Cook-Bolden: If by chance you develop sensitivities, obtain undesirable results or experience lack of results despite following the instructions, or are just plain unsure, see your dermatologist. If you are undergoing treatment in partnership with a dermatologist, it is vital to do follow-up as scheduled, even if things are going fine. The use of some medications prescribed by a dermatologist should be limited and/or monitored, thus it is important to keep your follow-up visits. Yearly visits to a dermatologist for a total body examination to evaluate new or unusual moles is a good practice for all skin types. The rate of skin cancer is increasing in all skin types, even in pigmented skin like ours.

CHiC: Is it necessary for someone with skin of color to seek out a dermatologist that is also an expert in skin of color?

Dr. Cook-Bolden: Despite the awareness of the unique needs of skin of color, sadly there is still a lack of dermatologists of color and dermatologists with expertise in treating skin of color. I feel it is important that all dermatologists who treat patients of color become comfortable with and knowledgeable about treating all skin types including skin of color and this includes cultural sensitivity. By all means, if there are experts available in your area, go for it!

Skin Care System

CHiC: There are numerous skin care products - creams, peels, serums, masks, scrubs etc. - to treat a variety of skin care issues from wrinkles to acne. It can be quite confusing for the average consumer to wade through all the clutter to decipher what products are right. Please offer some advice on how to select products to suite your skin type and/or concern.

Dr. Cook-Bolden: If you have determined your skin type, chosen your skin care and special needs products carefully, it is perfectly fine to begin your skin care regimen on your own.

Determine skin type
Check how your skin feels in the middle of the day: oily or dry. If you really don't notice your skin midday, it is probably normal. Even if your skin is normal, if there are dry areas and it is wintertime, you will probably benefit from a skin care routine geared towards dry skin.

Select a cleanser, moisturizer and sunscreen
When selecting skin care products, start with the basics. Choose product by skin type. Many can limit their skin care products to a cleanser and a moisturizing sunscreen. The fewer products, the greater the likelihood that you will be able to adhere to the skin care regimen and achieve success.

Determine if you have a special need
After the basic products are chosen, then determine special needs or concerns, such as excessive oiliness, dryness or sensitive skin, rosacea sufferer (a skin disease that causes constant redness of the chin, forehead, and lower half of the nose), acne-prone, and aging skin, to name a few. The addition of a product to address a special need can be tremendously beneficial.

Select formula
The formulation - gel, lotion, solution, cream, spray - of the special need product can match that of the basic products. Thankfully, many multifunctional skin care systems have been developed that can be very effective for special needs and also do a lot of the same work as basic products.

A skin care system is not always necessary, but is a way to assure that the different products are in harmony with one another.

CHiC: On average how many and what skin care products are necessary to keep skin healthy. Does this change as you age, encounter skin care problems or seasonally?

Dr. Cook-Bolden: I recommend that skin care regimens be limited to 2 to 3 products and 4 maximum if there is a special need -- cleanser, moisturizer, sunscreen and a special need product. This is year around. Beyond this, the chances of you sticking to a regimen is not likely. Again, when it comes to your skin, less does more. Multiple purpose products are also great to minimize the number of skincare products, like a moisturizing sunscreen.

Therapeutic Skin Care Treatments - Facials, Chemical Peels, Microdermabrasion

CHiC: Are facials, chemical peels, and microdermabrasion harmful, helpful or unnecessary?

Dr. Cook-Bolden: All of the above can provide benefits to the skin. Unfortunately, we tend to see and hear about the negative, i.e., disasters or side effects of botched treatments. There are many, many types of facials and all are not created equal based on the ingredients, products used as well as the skill of the aesthetician providing the treatment. I utilize facials primarily for their pampering and relaxing benefits, although many can be therapeutic. Choose wisely if going for a therapeutic treatment. Getting a recommendation from someone you trust, with similar skin to yours, and an endorsement of the aesthetician they use is a great way to begin your search. Chemical peels and microdermabrasion can accomplish specific therapeutic benefits in the treatment of acne, pigmentary disorders like hyperpigmentation caused by acne, melasma, hair bumps, and facial scarring.

Understanding Ingredients to Avoid & Labels

CHiC: Are there treatments or ingredients that people with skin of color should avoid?

Dr. Cook-Bolden: Most skin care ingredients obtained in reputable skin care products and treatments are safe and effective for skin of color. Fortunately, because of regulations and standards, most products will state if there is a specific harm known to skin of color. Additionally, avoid treatments you are wary of, as I said earlier, get a recommendation or seek the advice of a dermatologist before going in for a therapeutic treatment.

As far as certain ingredients to avoid and any adverse reaction, that depends on the individual's skin type and physiology as well as other products being used, and medication being taken. If ever you have any doubt, as always seek the advice of a skin care professional.

CHiC: How does someone understand an ingredients label or treatment contents in simpler terms?

Click here to read the Clinique Consumer Awareness Guide "Understanding Your Cosmetic Label".

The Acne "Cure"

CHiC: Acne is one of the most prevalent skin care issues that people of all skin tones battle. Is there anything that can cure acne?

Dr. Cook-Bolden: There is no real "cure" for acne and it is still the most prevalent skin care concern for all skin types. Partnered with the often inevitable dark marks that can last much longer than the acne itself in skin of color, it is one of the most emotionally devastating, especially when occurring on the face and other areas that are difficult to cover or camouflage. Isotretinoin (commonly known as and one brand name is Accutane) is the closet thing there is to a cure. It is generally prescribed for those who have severe acne, have been unsuccessful with other treatments, and for those who can adhere to the protocols for treatment. This in many cases is a last resort as there are many side effects with the use of this drug and should be used with great caution.

Make an appointment for a consultation with Dr. Cook-Bolden or one of her qualified associates at www.cookboldenskinandlaser.com.

By K'era Morgan

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