Asian Skin and Acne

Treating Acne in Asian Skin

Asian skin and acne

Article Summary

As with all ethnicities, acne among people of Asian descent is very common. The limited research that has been performed points toward a tentative possibility that both Asian teens and adults may experience lower incidence of acne when compared to other ethnicities. However, as with all non-Caucasian ethnicities, Asian skin is more prone to hyperpigmentation (dark/red marks left behind after acne lesions heal) and raised/keloid scarring

Asian Skin and Acne


Overview

Acne is a very common issue for people of Asian descent. Unfortunately, few studies have been performed specifically on people with Asian skin.

Percentage with Acne by Ethnicity

Very few studies have looked at the prevalence of acne in Asian people compared to people of other ethnicities. The results of these studies have been mixed. While one study concluded that acne is less common in Asian skin compared with Caucasian or African-American skin, another study found that it all depends on the type of acne.1-4



Percentage of Specific Types of Acne by Ethnicity


What Is Different about Asian skin? 

Journal of the American Academy of Dermatology (JAAD)

Several features of Asian skin make it different from skin of other ethnicities and pose special challenges in treating acne. A study published in the Journal of the American Academy of Dermatology (see table below) in 2002 reported that Asian people had the least incidence of cystic lesions, the most severe type of acne lesion. The cohort of Asian people was small, however, so this report should be viewed as preliminary.5

Types of Acne by Ethnicity
 
Journal of Cutaneous and Aesthetic Surgery

People with Asian skin tend to have a bigger issue with marks left behind after acne lesions heal.6-9These marks, scientifically referred to as post-inflammatory hyperpigmentation, can be stubborn, staying on the skin for a longer time in people with Asian skin and can be challenging to treat. See the hyperpigmentation page for more on these marks and treatment options. In addition to hyperpigmentation, people with Asian skin have a somewhat higher incidence of raised (keloid) scarring from acne. Next, Asians may respond differently to hormone therapy, but again, research is limited in this area.10Lastly, Asian skin is thought to be thinner than other skin types, making it more sensitive, as outlined in this 2016 article in the Journal of Cutaneous and Aesthetic Surgery:

Asian Skin More Prone to Irritation


How to Treat Acne in Asian Skin 

Acne develops in the same way regardless of skin color, and acne is treated in the same way in people of every ethnicity. Acne can be effectively treated with topical medications, particularly with a properly applied benzoyl peroxide regimen. Doctors sometimes prescribe the oral medication Accutane (isotretinoin) to people with severe, widespread, and scarring acne as well.11-14Because of the severe side effects of Accutane, including birth defects that Accutane can cause, authorities in Japan have banned its use in that country.

In 2014, a group of leading dermatology experts from six Asian countries (SASA) assessed the differences between Asian and Caucasian skin and formulated guidelines for treating acne specific for Asian skin. Lending further credibility to the argument that all acne is treated similarly no matter the ethnicity, the guidelines for Asian skin bear a striking resemblance to those for any other ethnicity, with the possible exception noted that due to cultural norms, oral contraceptives may not be as acceptable to people of African descent.15

Post-inflammatory Hyperpigmentation from Acne


The Bottom Line

Prevention is key. Get yourself completely cleared up so you are actively preventing future acne lesions, hyperpigmentation, and scarring. Then, if you so desire, you may try one of the various methods to treat hyperpigmentation.

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The Experts at Acne.org

Our team of medical doctors, biology & chemistry PhDs, and acne experts work hand-in-hand with Dan (Acne.org founder) to provide the most complete information on all things acne. If you find any errors in this article, kindly use this Feedback Form and let us know.

References:

  1. Tan, H. H., Tan, A. W., Barkham, T., Yan, X. Y. & Zhu, M. Community-based study of acne vulgaris in adolescents in Singapore. Br. J. Dermatol. 157, 547–551 (2007).
  2. Shen, Y. et al. Prevalence of acne vulgaris in Chinese adolescents and adults: a community-based study of 17,345 subjects in six cities. Acta Derm. Venereol. 92, 40–44 (2012).
  3. Henderson, M. D. et al. Skin-of-color epidemiology: a report of the most common skin conditions by race. Pediatr. Dermatol. 29, 584–589 (2012).
  4. Perkins, A. C., Cheng, C. E., Hillebrand, G. G., Miyamoto, K. & Kimball, A. B. Comparison of the epidemiology of acne vulgaris among Caucasian, Asian, Continental Indian and African American women. J. Eur. Acad. Dermatol. Venereol. 25, 1054–1060 (2011).
  5. Taylor, S. C., Cook-Bolden, F., Rahman, Z. & Strachan, D. Acne vulgaris in skin of color. J. Am. Acad. Dermatol. 46, S98–106 (2002).
  6. Alexis, A. F. & Lamb, A. Concomitant therapy for acne in patients with skin of color: a case-based approach. Dermatol. Nurs. 21, 33–36 (2009).
  7. Shah, S. K. & Alexis, A. F. Acne in skin of color: practical approaches to treatment. J. Dermatolog. Treat. 21, 206–211 (2010).
  8. Kim, S. & Cho, K. H. Treatment of facial postinflammatory hyperpigmentation with facial acne in Asian patients using a Q-switched neodymium-doped yttrium aluminum garnet laser. Dermatol. Surg. 36, 1374–1380 (2010).
  9. Ho, S. G. et al. A retrospective analysis of the management of acne post-inflammatory hyperpigmentation using topical treatment, laser treatment, or combination topical and laser treatments in oriental patients. Lasers Surg. Med. 43, 1–7 (2011).
  10. Yeung, C. K., Teo, L. H., Xiang, L. H. & Chan, H. H. A community-based epidemiological study of acne vulgaris in Hong Kong adolescents. Acta Derm. Venereol. 82, 104–107 (2002).
  11. Goh, C. L. et al. Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy. J. Cutan. Aesthet. Surg. 9, 85–92 (2016).
  12. Ahn, H. H. & Kim, I. H. Whitening effect of salicylic acid peels in Asian patients. Dermatol. Surg. 32, 372–375; discussion 375 (2006).
  13. Lee, H. S. & Kim, I. H. Salicylic acid peels for the treatment of acne vulgaris in Asian patients. Dermatol. Surg. 29, 1196–1199; discussion 1199 (2003).
  14. Gan, E. Y. et al. Isotretinoin is safe and efficacious in Asians with acne vulgaris. J. Dermatolog. Treat. 24, 387–391 (2013).
  15. Goh, C. L. et al. South-East Asia study alliance guidelines on the management of acne vulgaris in South-East Asian patients. J. Dermatol. 42, 945–953 (2015).
See More References

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