What is the Best Skin Care for Asians/Pacific Islanders?

Skin Care
FutureDerm Nicki Zevola and Friends

My friend Boeui, left, and me on a recent Girl’s Night Out.

I think I’ve alluded to growing up Asian in America before in my Follow Friday columns – as a child, it could be difficult at times being one of only a few Asian kids at school. Nowadays, I’ve grown into my own skin, but it’s still easy to sometimes feel overlooked at the skin care and cosmetics counters. It seems everything is geared towards your blonde-haired, blue-eyed beauty. And while I absolutely adore our amazing staff journalist (and Reese Witherspoon doppelganger) Jen Schuchart, it’s easy to feel a little jealous at how many skin care products are geared towards her skin care needs and not mine!

When I speak of “Asian” skin in this article, I am indicating those of descent from China, Vietnam, Korea, Japan, Singapore, Taiwan, and the Phillippines, and countries encased within these boundaries. For those with South Asian skin, such as those from Indian or Burmese descent, I will include that in a future article.

That said, here is a guide for East Asian skin types:

How Asian Skin is Different

Asian Skin Differences

1.) When acne is present, it tends to be worse in Asians than Caucasians.

Believe it or not, acne in Asians tends to be worse than in Caucasians. This is because Asians produce deeper acne pustules/papules than Caucasians (American Academy of Dermatology, 2010) and have more  post-inflammatory hyperpigmentation (PIH). Asians get more PIH simply because they have more melanin, and hence their skin is more sensitive to producing melanin after any trauma or inflammation. This can be a terrible, seemingly endless loop for Asians who do suffer from acne: Deep pustules/papules appear, harsh acne-treating agents are applied, acne goes away and sometimes turns into sunspots, harsh hyperpigmentation-treating agents are applied; the skin may or may not break out again. Just a terrible loop!

2.) Asian skin is less prone to fine lines, wrinkles, and sagging than Caucasian skin, but wrinkles and sags more readily than African skin.

Melanin is produced in the skin as its natural pigment. Different ethnicities produce varied levels of melanin upon UV light exposure. Though this melanin can take years to appear (that’s right – years), some pigment is triggered and visible within days. (I have one enviable friend of Hispanic descent who can tan her shoulders over the course of a sun-filled lunch by sitting next windows in a strapless top). This melanin provides protection against the sun: In general, the more melanin you have, the darker your skin, the more “natural” SPF your skin has. This offers quantifiable protection against skin cancer (Photochemistry and Photobiology, 2008), as well as fine lines and wrinkles. So Asians have more protection against skin cancer and fine lines/wrinkles than Caucasians, but less than those with darker African skin. Interestingly enough, even though Asians have more of a “golden” glow to their skin, and Indians/Africans a “brownish” hue, it is all owing to different mixtures of varied colors of the same type of pigment – eumelanin, all with similar chemical function within the skin.

3.) Asian skin is more prone to port-wine stains, age spots and hyperpigmentation, including melasma (“the mask of pregnancy”).

Unfortunately melanin is a double-edged sword. While it protects against fine lines, wrinkles, and skin cancer, it also makes it more prone to disorders of hyperpigmentation. Why? Several reasons. First reason is simple: the more of something you produce, the harder it is to control. Think about children! It’s certainly harder to keep track of five children for the afternoon than one, which is why it is also harder for your cells to regulate the production of melanin perfectly in a person with five times the melanin in her cells. Secondly, people of Asian and African ethnicities are more prone to produce melanin upon sun exposure of any kind. So whether than exposure is evenly distributed across your body, or a single spot from a sunbeam that blares in through the windshield of your car, your cells will produce melanin more readily wherever the sun has landed. More often than not, this results in uneven spots, especially on the nose, cheeks, forehead, shoulders, upper chest, and hands.

4.) Asians produce more oil in warmer temperatures or humidity than most Caucasians do.

This is a bold generalized statement to make, but it is true. Even spicy food has been found to cause Asians to produce more oil (Skin Research and Technology, 2006). The adrenal glands produce more hormones during and following exposure of stressors, such as warmer temperatures, increased humidity, and eating certain spicy-hot foods, but Asian skin has been found to be especially susceptible to responding to these adrenal hormones, producing tons of oil. (I can tell you honestly – my forehead can look like an oil slick after a few hours in a warm climate!) So it is important to know that you may have these tendencies to stressful environments, and to bring along oil-control methods, such as blotting papers.

5.) Asian skin is sometimes less responsive to lasers than Caucasian skin.

You don’t often see Asians or Africans with freckles. You do, however, see Asians and Africans with other hyperpigmentation issues and issues like port-wine stains. These tricky issues are treated when they do occur in Caucasians with lasers, typically a fractional CO2 laser like Fraxel. However, higher concentrations of melanin in Asians can simply diffuse and absorb the laser radiation, inhibiting light absorption by the skin. This results in either no or lessened effects from the laser. In a similar manner, melanin can complicate laser treatment of other dermatological conditions in people with darker skin, especially with ochronosis, a condition in which the skin reflexively produces more pigment after trauma. While ochronosis is very rare and typically occurs in African skin, Asians are also (to a much lesser extent) susceptible. It is important to start with low doses of laser treatment, and to only repeat sessions when it is known you: a.) can get some results from the treatment to begin with, and b.) don’t get negative side effects associated with reflexive hyperpigmentation.

The Top 10 Products for Asians

1.) A retinol serum (at least 0.5% retinol)

FutureDerm Time-Release Retinol 0.5

Oh yes, I know you’re thinking, she sells a 0.5% retinol serum. (And a damn good one, I might add).

That said, as much as I love our FutureDerm Time-Release Retinol 0.5, I’m not going to make this post a sales pitch. Asian skin needs a retinol serum that is concentrated and ideally time-release for better efficacy. Some of the retinol treatments on the market go as low as 0.025% retinol, but twenty times that amount – 0.5% or more – is typically used in dermatological studies to verify the efficacy of retinol! If they don’t specify the concentration or if retinol isn’t listed as one of the first 5 ingredients, I don’t buy it. As far as time-release goes, it just makes products more gentle, as there isn’t that all-in full impact at once, and more efficacious, because it works slowly for that much longer. Most time-release systems work for up to 8 hours, with a trickle-down effect over that time, meaning hour 2 has more going on than, say, hour 6. That said, I recommend FutureDerm Time-Release Retinol 0.5 (concentrated and time-release) or Skinceuticals Retinol 0.5 (concentrated) or Green Cream 1.0 (higher concentration).

2.) A daily vitamin CE serum (at least 15% vitamin C and 1% vitamin E)

FutureDerm Vitamin CE Caffeic Silk Serum 16+2

Yep, I make one of these too. But hear me out: I actually made FutureDerm CE Caffeic Silk Serum 16+2 because I was tired of running out of Skinceuticals CE Ferulic, spending $140 every month, and having the vitamin C oxidize and crystallize by the time I got to the bottom of the bottle. So I made my own version with microencapsulated vitamin C, to protect the solution from light and air.

However, again, this is not a sales post. FutureDerm CE Caffeic Silk Serum 16+2 is my baby, but I also still hold Skinceuticals CE Ferulic in high regard. The research is everywhere: If you want to decompose melanin, prevent sunspots, and enhance sun protection, use a serum with vitamin C and E (International Journal of Pharmaceuticals). The key again is concentration: This is where databases like the Environmental Working Group’s Skin Deep Database go so wrong. Concentration of ingredients matters! A little bit of something might have no effect, a medium concentration may produce excellent results, and a huge dose could be toxic. Ask any scientist: The concentration of a substance used in any reaction matters!

That said, look for a serum with at least 15% vitamin C. I love FutureDerm CE Caffeic Silk Serum 16+2 or Skinceuticals CE Ferulic. If you go with the latter, keep it stored in a cool, dark place, and recap tightly after opening.

3.) Blotting papers

Tatcha Original Aburatorigami

As previously stated, Asian skin tends to produce more oil than other ethnicities when exposed to conditions like heat, humidity, or stress. To combat this, it’s a great idea to keep blotting papers in your purse or pocket. The absorbancy of the blotting paper matters, and will vary depending on the material used. For lighter amounts of oil, fashion cult favorite Tatcha Original Aburaorigami ($12.99, Amazon.com) are sufficient and luxurious to use. Tatcha Original Aburaorigami are made of banana leaf, which has fair absorbancy of oil.

Clean and Clear Oil Absorbing Sheets

For higher amounts of oil, I prefer Clean and Clear Oil Absorbing Sheets ($12.99, Amazon.com), which are much more utilitarian but lap up oil like it’s their job (oh wait, it is! Oh!). All silliness aside, either set is sufficient for most skin types, though Clean and Clear Oil Absorbing Sheets are better for very oily or acne-prone skin.

4.) A combined oil-water cleansing method

A basic law of chemistry: Like dissolves like. So oily substances, like wax-based makeup, dissolve best in oil. On the other hand, watery substances, like the vitamin E in skin sebum, will dissolve in water. Some substances, like silicones, will eventually dissolve in both.

Since Asian skin is more prone to oil, it’s no wonder that Japanese women commonly cleanse their faces in two steps: Facial cleansing oil is first applied to remove all traces of dirt and makeup, followed by a water-based facial cleansing wash. The result is a more thorough cleanse than with a single type of cleanser. I adore the Amore Pacific Cleansing System, as well as the cleansing system from Japanese company Love Renaissance.

5.) Sunscreen, sunscreen, sunscreen!!! (Choose zinc oxide.)

Oh, sunscreen. Back when I started FutureDerm, I almost did The Sunscreen Blog instead. But one of my close friends told me that she thought that might be too limiting. (Good advice.)

That said, I prefer physical sunscreens like zinc oxide or titanium oxide to chemical sunscreens like avobenzone, oxybenzone, or Parsol 1789. The reason? Physical sunscreens prevent the sun from hitting your skin to begin with. No UV rays, no interaction with your skin, finis finit finito. Done. On the other hand, chemical sunscreens like avobenzone, oxybenzone, or Parsol 1789 will allow the UV rays to hit your skin. However, upon contact, your chemically-treated skin will transfer the UV energy into a different form of energy, like heat or a different wavelength of light, that is non-harming to your skin.

I also prefer zinc oxide to titanium oxide. Zinc oxide blocks a significantly longer portion of UVA rays than titanium oxide – and long-wavelength UVA rays are most associated with signs of aging long-term (Skin Pharmacology and Physiology, 2005). On the other hand, short UVB wavelengths are associated with inflammation and sunburn, but zinc oxide protects against those as well.

6.) Hydroquinone as an on-the-spot treatment only (patch-test first)

Melloderm Hydroquinone 4% Treatment Melasma and Freckles

People don’t like to hear this, but it’s still true: Hydroquinone is the gold standard of treating age spots and melasma. Hydroquinone inhibits an enzyme, tyrosinase, that is an essential part of the reaction that creates melanin within the skin. Once your skin cells stop producing melanin at the location of the age spot, guess what – your age spots disappear. Almost like magic, but a lot slower.

Unfortunately, hydroquinone has also been associated with reflexive hyperpigmentation, or increased melanin production, in certain individuals with darker skin. While Africans are most susceptible, it has occurred in a few Asians. With that said, patch-test first, and only continue use if your skin has no negative reaction. I also do not recommend that Asians or Africans or anyone else with heightened pigmentation use hydroquinone all over the face. As for hydroquinone treatments, I like prescription or something like Melloderm HQ 4% ($26.15, amazon.com), which is 4% hydroquinone and available through Amazon.

7.) Lip treatment with SPF

Sure, my eyes are smaller than your average Caucasian’s. But my lips? I’ve got some serious lip real estate, and I’m not alone: Asians, in general, have fuller lips than Caucasians (Journal of Plastic, Reconstructive, and Aesthetic Surgery, 2010).

Again, however, this is a double-edged sword. On the one hand, you get fewer lip injections. On the other hand, the lips are a location that is often hit by the sun. As pointed out by Miami dermatologist Dr. Leslie Baumann, M.D., use of a non-SPF lip gloss can result in an increased risk of skin cancer, because of all of the UV light reflecting off of your shiny lips and bouncing all over your face. The risk is heightened even further when your lips are fuller.

FRESH Sugar Lip Treatment SPF 15

So, the message is clear: Use a lip treatment with SPF. I love Fresh Lip Sugar SPF 15 ($14.93, Amazon.com). It comes in all different shades, it feels sensational on the lips, and it actually protects all day. I’m a fan.

8.) 2% salicyclic acid treatment, for when acne strikes 

Advanced Skin Technology Unagel Calming Acne Treatment

Since Asian acne runs deeper (literally) than other races (American Academy of Dermatology, 2010), I especially like salicyclic acid, because it can penetrate the skin deeply. Unlike alpha hydroxy acids, salicyclic acid is oil-soluble, which makes it perfect for those with very oily or acne-prone skin in managing oil levels. Salicyclic acid also has been found to loosen dry scaly skin, increase cell turnover rates, and prevent clogging of the pores when used regularly over time. While it is available in prescription products, like Diprosalic®, in concentrations of 10% or higher solely for the treatment of warts, it is available over the counter up to 2% for acne and oil regulation. I like Unagel Calming Acne Treatment ($35, amazon.com) — it is a 2% salicyclic acid gel for use after cleansing. Since it’s the only salicylic acid formulated at a neutral pH, it can be used under a retinoid. It also layers well under an oil-free moisturizer.

9.) 10% benzoyl peroxide on-the-spot treatment, for when acne strikes

One way in which benzoyl peroxide is believed to work is by causing oxidation within the follicle. Antioxidants, as you may remember, were invented to reverse this very process – oxidation. So why some experts recommend treatments where you put uncoated benzoyl peroxide all over your face is beyond me. Granted, some all-over facial treatments have benzoyl peroxide delivered to the skin in such a way that it never gets very far into the skin, but then that makes you wonder how efficacious it could be in the first place!

Dr. Sheffield's 10% Benzoyl Peroxide Treatment & Dr. Dennis Gross Colloidal Sulfur Mask

So let benzoyl peroxide do its thing, but only where you have a pimple. The highest concentration available in an on-the-spot treatment is 10%; I love something cheap and simple, like Dr. Sheffield’s 10% benzoyl peroxide treatment ($4.17, Amazon.com), followed by a treatment with sulfur, like Dr. Dennis Gross Colloidal Sulfur Mask ($41.47, Amazon.com).

10.) Soothing treatments with oatmeal, green tea, rice extract, and other anti-inflammatory goodies

Dermalogica Clinical Colloidal Oatmeal Masque

Asian skin is reactive: Reactive to UV light, heat, humidity, stress, and harsh all-over facial skin treatments. So what’s the solution? Simple: Soothing anti-inflammatory agents. One of my best discoveries was the Dermalogica Clinical Colloidal Oatmeal Masque ($67.00 for salon size, Amazon.com). Oh, it’s everything a good facial masque should be: Goopy, thick, and totally scary to look at while you have it on. (Definitely not a time to have guests over, and might be a good time to lock the bathroom door if you don’t live alone). But the results! So glorious! It leaves your skin soft, soothed, and calm. I love it for the body after getting bug bites or poison ivy, and I use it nearly every time I take a bath. Leave it on for about 15 minutes, and rinse off thoroughly. Beautiful.

Bottom Line

Asian skin is not like Caucasian or African skin. Unlike Caucasian skin, Asian skin is less prone to fine lines and wrinkles, but more prone to age spots, melasma, and sensitivity to laser treatments (or no response at all from laser treatments). Unlike Caucasian or African skin, Asian skin also is more responsive to changes in climate, producing what can seem like truckloads of oil. Acne is rarer in this population, but when it does occur, the lesions have been found to run deeper in the skin than other races (American Academy of Dermatology, 2010), making it difficult to treat.

My recommendation is to use a combined oil-and-water cleansing program twice-daily, followed by a potent antioxidant serum and zinc oxide-based sunscreen in the morning, and a potent retinoid treatment at night. If you experience acne, use salicyclic acid all over your face, and benzoyl peroxide followed by sulfur as an on-the-spot treatment. When you get excess oil, try blotting papers!

Hope you found this helpful! If you ever have any questions, please feel free to follow up with me in Comments, or on Twitter as @futurederm or @nickizevola.

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