Acne in Skin of Color Alexis

Acne in Skin of Color: What’s New and What’s to Come

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At Skin of Color Update 2019, our co-chair and co-founder, Andrew Alexis, MD, MPH  gave a lecture on Acne: What’s New and What’s to Come?  Our onsite correspondent, Kimberly Huerth, MD, M. Ed, provided the following recap of this is insightful session.  The read the full article, please visit Next Steps in Derm website.   Missed Skin of Color Update 2019? Purchase lectures like this on-demand

By: Kimberly Huerth, MD, M. Ed

I still treat my acne twice daily with a whole cabinet full of various topicals. I’ve tried and failed doxycycline because it disrupts every single molecule of bacterial flora in my body. I’ve tried and failed spironolactone because I was the poster child for nearly all of its annoying and inconvenient side effects. I’ve tried and failed several OCPs because my body was a little too convinced by the estrogen and progesterone that it was actually pregnant, and decided to make me persistently sleepy and nauseous. I could put the 650-microsecond Nd:YAG that we have in clinic to use, but can’t bring myself to bother my co-rezzys (or myself) at the end of a long day seeing patients. And yes, I’ve already done a course of isotretinoin…two courses in fact. And no, I don’t have PCOS. So when I settled in to hear Dr. Andrew Alexis’s lecture on Acne in Skin of Color: What’s new and what’s to come?, I was excited for some new strategies with which to help my patients, and myself.

Dr. Alexis not only shared expert insights and strategies on how to optimize treatment for acne in skin of color (SOC) patients, but he also laid out an overview of some of the new and emerging acne treatments that we will presently be able to add to our armamentarium!

This article will provide an overview of the following:

  • Understanding the unique presentation and needs of SOC patients with acne
  • Sarecycline, a new tetracycline class antibiotic
  • New topical acne medications in the pipeline

But first, let me share a few of the “A-ha” moments that I experienced during Dr. Alexis’s lecture, in the hope that they will entice you to read on…

Read more.

 

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SOC Update Launches On-Demand Package

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New York (Nov. 5, 2019) Skin of Color Update launches on-demand video package. Skin of Color Update, the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI expands educational offerings to include on-demand videos.

The demand for skin of color dermatology education is greater than Skin of Color Update’s ability to accommodate onsite. Therefore, SanovaWorks has produced and launched a Best of Skin of Color Update video package.  The video content is comprised of the highest attendee rated sessions of Skin of Color Update 2019.  On-demand videos include top-rated faculty lectures in-sync with PPT slides with accompanying audio files.

On-demand Lectures include:

  • Pearls for the Diagnosis and Treatment of Atopic Dermatitis and Eczema with Andrew Alexis, MD, MPH
  • Complex Medical Cases with Andrew Alexis, MD, MPH and Ted Rosen, MD
  • Surgical Approaches for Keloids with Maritza Perez, MD
  • Hair & Scalp Disorders Treatment Strategies: What, How and When? with Heather Woolery-Lloyd, MD
  • Pearls and Strategies for Preventing Laser Complications with Eliot F. Battle, Jr., MD.

The video content focuses on expert techniques, real-life clinical cases and expert pearls immediately useful in the practice.  For a video preview, click here.

Purchase the on-demand Best of Skin of Color Update video package and start learning from the experts today.

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Aesthetic Skin of Color

Consensus and Misconceptions Regarding the Aesthetic Skin of Color Consumer

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Each month the Journal of Drugs in Dermatology JDD Podcast discusses a current issue in dermatology. During the month of September, podcast host Dr. Adam Friedman sat down with Skin of Color Update 2019 co-chair and co-founder,  Dr. Andrew Alexis, Chair of Dermatology at Mt. Sinai St. Lukes and Mount Sinai West to discuss misconceptions regarding the aesthetic skin of color consumer.

Dr. Angela Hou, PGY-3 dermatology resident at George Washington University School of Medicine and Health Sciences, shares key takeaways from Dr. Alexis’ JDD podcast titled ‘Capturing Consensus and Cutting Out misconceptions regarding the Aesthetic Skin of Color Consumer’.

Here is an excerpt recently published on our media partner, Next Steps in Dermatology.

Key Takeaways

  • There has been a rapid increase in the past 10 years in Fitzpatrick Skin Type IV-VI patient’s seeking aesthetic skin care, however the guidelines for skin of color is limited and more clarification and guidance is needed
  • This article helps reduce the gap in knowledge in regard to skin of color. This was difficult given the lack of evidence-based studies, therefore expert consensus was necessary for deciding on recommendations.
  • A common myth is that darker-skinned patients of African descent do not seek or need injectable fillers of the lips. Although lip enhancement is less common than in other populations, restoration of lip volume is still an important aesthetic concern, albeit at an older age than among Caucasian patients
  • Another knowledge gap is regarding skin of color patients with a history of keloids and the risks of developing keloids after filler injections. However, per the expert consensus, there are no known cases of keloids induced by soft tissue filler injections. Therefore, keloids should not be an absolute contraindication to fillers and should be evaluated on a case-by-case basis.
  • To read more of the key takeaways and words from the investigator, read the full article here.

To hear the JDD podcast, click here.

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Hair and scalp at skin of color

Hair and Scalp Disorders at the 2019 Skin of Color Update

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Heather Woolery-Lloyd, MD lectured on hair and scalp disorders at Skin of Color Update 2019.  Kimberly Huerth, MD, M Ed, provided top tips and salient pearls from the lecture in the Next Steps in Derm article.  Missed this lecture? Purchase it on-demand

Treatment Strategies for Hair and Scalp Disorders: Biotin & Beyond

By: Kimberly Huerth, MD, M Ed

A full head of hair. This is how I came away from Dr. Heather Woolery-Lloyd’s lecture on hair and scalp disorders at the 2019 Skin of Color Update. There were many aspects of her talk that challenged me to rethink how I approach the management of hair loss in my patients. In this post we will cover biotin’s role in treating alopecia, and important considerations in the treatment of central centrifugal cicatricial alopecia (CCCA)—two topics that Dr. Woolery-Lloyd took a deep dive into during her lecture.

So I have a potentially hair raising confession to make…I might start recommending biotin again to my alopecia patients! I have previously written about the use of biotin in the treatment hair loss, the gist of it being—don’t. The don’t is because most individuals are not biotin deficient, there are potential risks associated with supplementation (such as effects on the results of thyroid function and troponin testing), and scientific data supporting the use of biotin to promote hair growth are weak unless there is a proven biotin deficiency. But Dr. Woolery-Lloyd discussed the results of a recent study out of Switzerland that lead me to question whether I might want to rethink my previous stance on biotin—Bad hair day for me!

Biotin is a coenzyme that plays a role in protein synthesis, including the production of keratin (which explains its contribution to healthy nail and hair growth). Primary and secondary biotin deficiencies are both considered very rare. Secondary biotin deficiency is thought to be rare because our intestinal flora produce more than our daily requirement. However, there are certain risk factors that may predispose an individual to a secondary biotin deficiency, including gastrointestinal disease, certain medications (isotretinoin, antibiotics, anti-epileptics), smoking, alcoholism, advanced age, extreme athleticism, pregnancy, and lactation. Moreover, serum biotin levels can demonstrate daily fluctuations of up to 100%, which is important to keep in mind when trying to identify which patients have suboptimal or deficient levels of biotin.

Let’s examine this study with a fine toothed comb. Read more on NextStepsinDerm.com 

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Eliot Battle discusses Skin of Color Updates in 2019

Skin of Color Update 2019 Press Coverage

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NEW YORK (Oct. 16, 2019) Skin of Color Update 2019 continues to receive media coverage from various publications after producing a sold out event.  Skin of Color Update, Sept. 7 & 8, 2019, held at the Crowne Plaza Times Square, hosted an expert faculty with 2 days education, networking and discovery.  This 2-day event attracted over 300 dermatology providers from all over the US. Purchase Skin of Color Update On-demand here.

See what the media has to say about the event and register for Skin of Color Update 2020 before it sells out.

  • The Dermatologist covered Wendy Roberts, MD session on Hair and Scalp Disorders: A Review of Alternative Therapies
  • In an interview with The Dermatologist, Skin of Color Update presenter Cheryl M. Burgess, MD, discusses her lecture on common cosmetic concerns among patients with skin of color and the importance of recognizing adverse reactions. Read more.
  • Sun protection in Skin of Color patients still matters. Find out what Henry Lim, MD had to say in an interview with The Dermatologist regarding his lecture at Skin of Color Update 2019.  Read more.
  • Skin of Color Update speaker Theodore Rosen, MD presented on hidradenitis suppurativa in the black community and the improvement of disease control.  Read an overview of his session here.
  • Andrew Alexis, MD presented clinical findings on new drugs that particularly benefit skin of color patients with acne. Read the overview on Dermatology News.
  • Skin of color poses some unique challenges when it comes to diagnosing atopic dermatitis (AD). In a recent interview, co-founder and co-chair Andrew Alexis, MD discusses his challenges and pearls for treating AD in skin of color.  Read more.
  • Dermatology News recently covered Wendy Roberts, MD Skin of Color Update 2019 presentation on combination treatments for pseudofolliculitis barbae.  Read the interview and more here.
  • Whitening of skin remained charged topic at the recent Skin of Color Update, co-founder and co-chair Eliot F. Battle, Jr. MD lead the discussion with an interesting expert opinion on the topic.  Read more.

Register for Skin of Color Update at the Sheridan Times Square, September 12 and 13, 2020.

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Andrew Alexis atopic dermatitis skin of color lecture

Treating Atopic Dermatitis in Patients With Skin of Color

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The Dermatologist recently featured an interview with Dr. Andrew Alexis, Skin of Color Update co-founder and co-chair, regarding his lecture on challenges and pearls of treating atopic dermatitis (AD) inpatients with skin of color.

Associate Editor, Melissa Weiss posed the following questions:

  • What are some of the challenges for diagnosing AD in patients with skin of color?
  • What are your recommendations for clinically assessing AD in patients with skin of color?
  • What are your recommendations and treatment considerations for AD?
  • Do you discuss options for a patient who want to treat AD-associated pigmentary changes?
  • Are there any other key takeaways you would like dermatologists to leave our audience with?

 

Visit The Dermatologist to read Dr. Alexis’s answers and more.

Missed Skin of Color Update 2019? Purchase this lecture and more on-demand.

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Skin Lightening at Skin of Color Update Eliot Battle

Skin Lightening in Skin of Color Remains Charged Topic

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We recently hosted an expert panel discussion on the topic of skin lightening in skin of color at the 2019 Skin of Color Update.  Skin of Color Update co-chair and co-founder, Eliot F. Battle, MD took an informal audience poll and the results will surprise you.

“How many of you think total body skin whitening is wrong?” Dr. Battle asked the audience for a show of hands.  The majority of the audience raised their hand.

“How many think breast augmentation is wrong?” he asked. “How many think changing your hair color is wrong? Before we cast judgment, let’s think a little about how our patients feel.”

Should physicians provide total body skin whitening for cosmetic purposes or should skin lightening be provided only for clinical indications, like melasma?

Dr. Pearl Grimes and Dr. Cheryl Burgess weighed in on this charged topic to provide compelling commentary.  Read their insights and more here. Coverage provided by MDedge |Dermatology.

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Journal of Drugs in Dermatology Andrew Alexis MD MPH Skin of color Update Award from JDD

ANDREW F. ALEXIS, MD, MPH, PRESENTED WITH INNOVATIONS AWARD

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NEW YORK (Sept. 9, 2019)– The Journal of Drugs in Dermatology (JDD) presented dermatologist Andrew F. Alexis, MD, MPH, with the Innovations in Dermatology Award at Skin of Color Update, held September 7 and 8 in New York. The award recognizes individuals who have fostered innovation and improvement in dermatology through increased emphasis on education and research.

“Andrew F. Alexis, MD, MPH is committed and passionate — not only about being the best dermatologist he can be – but also about bringing skin of color education to dermatology,” said Shelley Tanner, CEO and president of SanovaWorks, which produces the JDD and Skin of Color Update. “Through his efforts, the changing landscape of patients can now thrive through treatment and management plans that address their specific needs.”

“Dr. Alexis is the top innovator in the dermatologic and cosmetic treatment of patients with skin of color,” said dermatologist Eliot F. Battle, MD, co-chair of Skin of Color Update along with Dr. Alexis. “His decades of pioneering research in dermatology have led to the development of new procedures and products that address a wide range of dermatologic conditions. He compassionately treats his patients, shares his expertise by presenting throughout the world and gives back through mentoring the next generation of dermatologists and researchers. I am honored to serve alongside this distinguished innovator.”

Dr. Alexis is chair of the department of dermatology and director of the Skin of Color Center at Mount Sinai St. Luke’s and Mount Sinai West, New York. As such, he is actively involved in advancing patient care, research and education pertaining to dermatologic disorders that are prevalent in ethnic skin. He is also professor of dermatology at the Icahn School of Medicine at Mount Sinai.

Dr. Alexis is the co-founder and co-chair of SOCU, now in it’s 10th year.

Read more.

 

Diversity in Dermatology Residency application Process

Diversity in the Specialty of Dermatology

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Dermatology has the most expensive residency application process.  Refinery29 recently published an editorial article on diversity in dermatology, looking at medical school, residency and training. Nathan Rojek, MD and Next Steps in Dermatology reviewed the dermatology residency application process and put the statistics into numbers.

Dermatology is at high risk of becoming a specialty comprised of physicians that do not come close to representing the socio-economic diversity of the patients in this country. It is critical that those of us in the dermatology community make the necessary changes to attract the most promising medical students from all walks of life; otherwise we risk alienating the people we’ve vowed to help.

 

Read more.

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Excerpt provided with permission. Originally published by Next Steps in Dermatology. All rights reserved.

Annual Skin of Color Issue from the Journal of Drugs in Dermatology (JDD)

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US Dermatologists, Dermatology Residents and Dermatology NP and PAs can create a free account on JDDonline.com to read the following Skin of Color annual issue highlights:

Patient-focused Solutions in Rosacea Management: Treatment Challenges in Special Patient Groups by Ahuva Cices MD and Andrew F. Alexis MD MPH aims to expand awareness of the impact of rosacea on QoL of patients of all ages, genders, and skin types. (CE credit is available)

Myths and Knowledge Gaps in the Aesthetic Treatment of Patients With Skin of Color, Andrew Alexis, MD et al.,  identifies knowledge gaps and myths concerning facial aesthetic treatment in individuals with SOC.

An online study was designed to survey facial aesthetic concerns, treatment priorities, and future treatment considerations in 2 companion articles, Understanding the Female Hispanic and Latino American Facial Aesthetic Patient and Understanding the Female Asian American Facial Aesthetic Patient.

In Vitro and In Vivo Efficacy and Tolerability of a Non-Hydroquinone, Multi-Action Skin Tone Correcting Cream Pearl Grimes, MD evaluates an alternative to HQ for improving skin tone.

A Survey-Based Comparison of Sun Safety Practices in a Representative Cohort of the General Public Versus Attendees of a Skin Cancer Screening examines sun-protection practices.

Topical Ozenoxacin Cream 1% for Impetigo: A Review explores the challenges of treating impetigo and growing concern of antimicrobial resistance.

Uncommon localizations of PLEVA pose a diagnostic challenge in An Atypical Presentation of PLEVA: Case Report and Review of the Literature

 

Dermatology Concerns In Skin of Color Patients

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During the 16th Annual ODAC Dermatology, Aesthetics and Surgical Conference, I had the pleasure of taking part in the Resident Career Development Mentorship Program (a program supported by an educational grant from Sun Pharmaceutical Industries, Inc.). and was paired with Dr. Andrew Alexis, Chair of Dermatology at Mount Sinai St. Luke’s and Mount Sinai West in New York City.

During a 45-minute working group session, Dr. Alexis covered three main themes: common dermatologic disorders with unique manifestations in skin of color, disorders that disproportionately affect patients of color and therapeutic nuances and unique treatment concerns in skin of color. Here are the main takeaways and pearls from this session.

Common Disorders With Unique Manifestations

Acne

Post-inflammatory hyperpigmentation is a major concern in patients of color and many times more bothersome than acne itself.  It is important to use agents that will treat both acne and PIH. Retinoids can be very effective –tretinoin, tazarotene and adapalene have been shown effect for PIH. Azelaic acid can be a good add on for patients with PIH.

Dr. Alexis doesn’t use much hydroquinone for these patients – the macules left behind by acne are usually too small to avoid creating halos around the lesion.  Chemical peels have been demonstrated to improve PIH in small studies.  The risks are higher in skin of color, so it advisable to stick to superficial peeling agents. Avoiding irritation is essential since it can lead to more dyspigmentation.

Maximize tolerability – adapalene and low concentration tretinoin or tazarotene are a good starting point.  Eliminate any irritating scrubs and other skincare products.  Use noncomedogenic moisturizers concurrently.

Disorders That Disproportionately Affect Patients of Color

Pseudofolliculitis barbae

Findings consist of papules and prominent hyperpigmentation.  This process can also trigger keloid formation. While more common in men, women with hirsutism may also develop PFB. It results from a foreign body reaction to hair reentering the dermis.

A very effective strategy is to discontinue shaving.  You may have to write letters to some patients’ employers in order to excuse them from shaving (Dr. Alexis keeps a form letter on file in his practice).

Chemical depilatory agents are a decent option.  Barium sulfide powder and calcium thioglycolate cream can be used every 2-4 days.  However, they can cause irritant dermatitis. Some patients may also find success by modifying their shaving practices.  Don’t assume your patients know how to shave – educate them.  Electric clippers are a good option – have patients leave 0.5-1 mm stubble. Traditionally single blade manual razors have been recommended.

One study sought to quantify the impact of blade number on PFB – 90 African American men were assigned to shave with a different number of blades.  There was no difference between any of the groups and everyone got better.

A small study showed decreased severity of PFB with daily shaving vs twice weekly shaving.

Dr. Alexis has a handout for patients with shaving instructions: before shaving use a mild cleanser and use a wash cloth in a circular motion to free hairs.  Use clean and sharp razor, shaving in the direction of hair growth.  Use topicals after such as clindamycin lotion or topical dapsone.  Apply a topical retinoid nightly. Avoid pulling or plucking embedded hairs, shaving against the grain.

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Skin of Color Update Announces 2019 Didactic, Case-Based Lectures, Hands-On-Training and Live Demonstrations

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The medical education event focused on the dermatologic treatment of skin of color has a new name. Skin of Color Update, previously the Skin of Color Seminar Series, provides dermatologists with evidence-based research and practical pearls in treating skin of color, including patients with multiracial backgrounds.

“Just as the treatment of skin of color has evolved, this event has also evolved,” says Skin of Color Update co-chair and founding dermatologist Eliot Battle, MD. “Thanks to audience feedback, nearly all general sessions will have additional time for Q&A, making this year’s event the most interactive yet.”

Skin of Color Update will now be held annually in the fall. The 2019 event will be held September 7 and 8 at the Crowne Plaza Times Square in New York.

Skin of Color Update uses a didactic, case-based approach through lectures, hands-on-training and live demonstrations. Co-founding dermatologist Andrew Alexis, MD, also serves as an event co-chair. Common skin, hair and nail conditions in diverse populations will be covered. In addition, advanced treatment protocols for pigmentary and hair disorders will be shared during mini symposiums.

Sessions will address medical, surgical and cosmetic dermatology. New sessions include:

  • “Challenging Challenges: Hidradenitis Suppurativa and the Skin of Color Patient” with Ted Rosen, MD
  • “Current Understanding and Novel Innovations in Photoprotection” with Henry Lim, MD
  • “Diagnosis and Management of Vitiligo in Skin of Color Patients: Where Do We Stand?” with Pearl Grimes, MD
  • Laser and Device-Based Treatment of Scars” with Paul Friedman, MD
  • “Surgical Approaches for Keloids” with Maritza Perez, MD

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View the full agenda

Patient Buzz: At-Home Laser Hair Removal – The Expert Weighs In

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Marie Clairerecently posted a list of the magazine’s top devices for at-home laser hair removal, noting their budget-friendly appeal. But are these devices safe and effective? How should you counsel your patients?

For an expert opinion, I consulted dermatologist Eliot F. Battle Jr., MD, CEO and co-founder of Cultura Dermatology & Laser Center in Washington, D.C., clinical instructor in the Howard University Department of Dermatology, and Co-Chair of the Skin of Color Update.

How do at-home laser hair removal devices compare in effectiveness with in-office laser hair removal?

At-home laser hair removal devices have now been available for more than a decade. Just like most gadgets, you get what you pay for, so buyer beware. The devices range from using an intense pulsed light source to using actual diode lasers, although with a much lower energy source then office-based devices. Regardless of which device patients choose, at-home devices do not compare with the efficacy and speed of office-based laser systems. At-home devices are very slow. Because of the amount of time it takes to treat an area and their decrease in efficacy as compared with office-based lasers, I view at-home devices more as “hair-growth delay” devices than “hair-reduction” devices. They can be used alone or as maintenance treatments to office-based hair removal. The main limitations are they are best utilized on smaller areas and are contraindicated on patients with skin of color or tanned skin.

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Skin of Color Update Co-Chair Dr. Eliot Battle Shares Insights into 2019 Faculty and Topics

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Skin of Color Update Co-Chair, Dr. Eliot Battle, discusses the elite faculty lineup and topics planned this year including hair loss, keloids, rosacea, acne, lasers, aesthetic treatments, skin cancer, medical dermatology, melasma, hyperpigmentation, vitiligo, inflammatory diseases and much, much more!

Skin of Color Update 2019 (previously Skin of Color Seminar Series) is the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI. Attendees leave with critical annual updates and fresh practical pearls in skin of color dermatology.

Join us this year in New York City, September 7-8, 2019! Register today at https://skinofcolorupdate.com/registration-hotel-2019/

Co-Chair Dr. Alexis Shares the Exciting 2019 Program Highlights

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Skin of Color Update 2019 (previously Skin of Color Seminar Series) is the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI. Attendees leave with critical annual updates and fresh practical pearls in skin of color dermatology. Earn CE in New York City with direct access to elite experts and an experience unmatched by any other event in dermatology.