Do Women with Skin of Color Think They Are Well Represented in Skin Aging Prevention Information?

Objective: There are clinical differences in healthy skin requirements and skin-aging features by race and ethnicity. However, individuals of color are underrepresented in dermatology-related medical information. We sought to gather information from women of color regarding their attitudes about the importance of the prevention of skin aging, available information, and perception of representation in skin-aging prevention information. Methods: This study involved an observational, cross-sectional, online survey of women aged 18 to 70 years residing in the United States. Participants were placed into one of seven cohorts based on self-reported race/ethnicity. Relative frequencies of responses were compared across cohorts; adjusted logistic regression was used to assess perception of representation in skin-aging prevention information. Results: The mean age of the 1,646 participants was 44.4 years. The mean (standard deviation) rating (from 0, "not at all important" to 10, "extremely important") of the importance of the prevention of skin aging ranged from 7.3 to 8.2 across the seven cohorts. All cohorts reported the most trusted source of information for skin-aging prevention products and treatments was a skin-care professional, but not all cohorts believed they are well represented in available sources of information. Older age, lower median household income, and a race/ethnicity of Black, Asian, "Other," and "More Than One Race" were less likely to report being well represented. Limitations: People without internet access could not participate, potentially excluding some older and lower-income groups. Conclusion: Women of color are less likely to feel represented in available information on the prevention of skin aging.

Cysteamine Isobionic-Amide Complex Versus Kligman's Formula for the Treatment of Melasma: Equal Efficacy and Rapid Onset of Action.

BACKGROUND: Modified Kligman's formula (mKF) is the gold standard treatment for melasma; however, its prolonged use is not recommended due to side effects. Cysteamine is a potent, safe, and effective depigmenting agent. Here, we conducted a double-blind, randomized, and placebo-controlled clinical trial to assess the efficacy of cysteamine isobionic-amide -- a complex with enhanced depigmenting efficacy -- and compared it to mKF for the treatment of melasma. METHODS: This study involved a total of 80 patients divided into 3 groups: cysteamine-isobionic amide, placebo, or mKF. The modified Melasma Area Severity Index (mMASI) score and spectrophotometric evaluation were conducted at baseline, week 4, week 8, and week 16. Dermatological assessment, patients’ feedback, and satisfaction including quality-of-life scores were also collected. RESULTS: At week 4, cysteamine isobionic-amide and mKF groups showed an equivalent onset of action in terms of mMASI and skin pigmentation contrast reduction. The 2 groups significantly reduced melasma severity and improved the overall skin condition with a comparable efficacy at week 16. Quality of life of melasma patients was significantly improved in the cysteamine isobionic-amide group at week 8 and further at week 16 (P<0.001) compared to the mKF group. Patients’ feedback and satisfaction were higher with the cysteamine isobionic-amide product compared to mKF. CONCLUSION: Cysteamine isobionic-amide provided a rapid onset of action and was as effective as the mKF for the treatment of melasma. The data suggest that cysteamine isobionic-amide could potentially be an acceptable alternative to mKF for the long-term treatment of melasma. J Drugs Dermatol. 2024;23(2):9-16.  doi:10.36849/JDD.7428.

A pilot study examining a double-conjugated, retinoid-based skincare regimen for darker, blemish-prone skin.

BACKGROUND: Retinoids and alpha- and beta hydroxy acids are common components utilized in regimens for blemish-prone skin. However, balancing efficacy and tolerability is often challenging. PATIENTS/METHODS: This pilot study evaluated a double-conjugated retinoid serum specifically formulated for blemish-prone skin (AHARet-SA) in combination with exfoliating peel pads (double-conjugated retinoid, glycolic, lactic, and salicylic acids), a cleanser, mineral-based sunscreen, and a lightweight moisturizer in female participants with mild-to-moderate blemish-prone skin. Fifty-five percent of participants were Fitzpatrick Skin Type (FST) IV and 27% were FST V. Participants used the exfoliating peel pads (3x/week for 8 weeks; 2x/week for 4 weeks) followed by nightly AHARet-SA and a moisturizer (as needed). Improvements in skin were assessed using the 5-point Investigator Global Assessment Scale, and participant satisfaction and tolerability were assessed over 12 weeks. RESULTS: Significant mean improvement from baseline in skin clarity occurred after 4 weeks (14%; p = 0.04) with progressive improvements through week 12 (52%; p = 0.004). Eighty-eight percent of participants reported improvements in the appearance and texture of their skin and fewer blemishes/breakouts. Mild, transient adverse events were reported. CONCLUSIONS: A regimen comprised of a double-conjugated serum and exfoliating peel pads formulated for blemish-prone skin led to significant improvements from baseline in skin clarity after 12 weeks in participants with predominately darker skin tones and mild-to-moderate blemish-prone skin.

Effectiveness and tolerance of multicorrective topical treatment for infraorbital dark circles and puffiness.

BACKGROUND: Treatment of infraorbital dark circles and under-eye puffiness is challenging due to its multifactorial nature and lack of broadly applicable, effective treatments. A daily skincare treatment option that is multimodal, effective, and tolerable across a broad patient population is an unmet need. AIM: A multicorrective topical eye cream (MTEC) formulated with Tetrahexyldecyl (THD) ascorbate (vitamin C), prebiotic Inula Helenium, bioavailable peptides, botanical extracts, chrysin, and caffeine is hypothesized to improve the appearance of infraorbital dark circles and under-eye puffiness by targeting microvasculature congestion and permeability, melanin accumulation and hemoglobin degradation-related pigmentation, and skin health. METHODS: An IRB approved, open-label, 12-week clinical study set out to evaluate the efficacy and tolerability of the MTEC across a broad patient population including varying ethnicities and Fitzpatrick Skin Types (FST). Female subjects (n = 40) ages 35-60 years old, with moderate-to-severe under-eye dark circles, moderate under-eye puffiness, and mild-to-moderate fine lines were enrolled into the study. Objective (Chromameter, VISIA® imaging, and Laser Doppler) and subjective assessments (clinical grading and self-assessment questionnaire) were conducted at baseline and post-baseline timepoints. RESULTS: Thirty-seven subjects completed the study, and the MTEC efficaciously demonstrated short-term and long-term improvements in objective and subjective assessments across a broad patient population. Specifically, the MTEC demonstrated significant improvement of infraorbital dark circles, mainly by the reduction in microvasculature congestion and permeability, melanin, and hemoglobin degradation-related pigmentation. CONCLUSION: Topical application of the MTEC may offer an effective and tolerable treatment option for infraorbital dark circles and puffiness.

A 1% colloidal oatmeal OTC cream is clinically effective for the management of mild to moderate atopic dermatitis in Black or African American children.

BACKGROUND: The efficacy and safety of an over-the-counter (OTC) 1% colloidal oatmeal cream versus a ceramide-based prescription barrier cream in children with mild-to-moderate atopic dermatitis (AD) were previously described. OBJECTIVES: Here, findings are reported for the Black/African American subgroup. METHODS: Patients were randomized to 1% oatmeal cream or prescription barrier cream twice daily or as needed for three weeks. Assessments included Eczema Area and Severity Index (EASI) scores, Investigator's Global Atopic Dermatitis Assessment (IGADA) scores, and patients'/caregivers' assessment of eczema signs and symptoms. RESULTS: Overall, 49 Black/African American children aged 2-15 years with mild/moderate AD were included. At week 3, mean (SD) changes from baseline in EASI scores were -2.4 (1.7) with 1% oatmeal cream and -2.1 (2.3) with barrier cream; improvements were observed from week 1. At week 3, mean (SD) changes from baseline in IGADA scores were -0.6 (0.7) and -0.7 (0.6), respectively. Improvements in subjective ratings of signs/symptoms of eczema were observed. Both study treatments were well tolerated. CONCLUSION: OTC 1% oatmeal cream was at least as effective and safe as prescription barrier cream in this population, providing a novel, fast-acting, and cost-effective option for the symptomatic treatment of mild-to-moderate AD in Black/African American children.

Exploration of Skin of Color Dermatology Content on YouTube.

BACKGROUND: There is a lack of diversity in dermatology regarding skin of color-related content. This has negative implications for patients of color and continues to be a hurdle to providing proper care to these patient populations. As patients increasingly look to the internet as a resource to gain insight on dermatologic conditions and potential treatment options, the information presented must be accurate and informational. The goals of this study included identifying and analyzing skin of color-related dermatology content found on YouTube, characterizing the content creators, and comparing board-certified dermatologists’ content to that created by other YouTubers. METHODS: A total of 23 dermatology terms associated with skin of color were searched on YouTube. The top 9 relevant videos for each search term were analyzed for views, comments, likes, and content creator classification. Each video was also labeled as being promotional or educational. The content creator and the content subject were also analyzed. Content created by board-certified dermatologists as well as physicians was then compared to content created by non-physicians. Statistical comparison was done using Mann-Whitney U tests and Pearson’s Chi-squared test where appropriate. RESULTS: The most popular search term was dandruff while the least popular search terms were dermatosis papulose nigra, eczema, and central centrifugal cicatricial alopecia. Of the total 207 videos analyzed (Figure 1), the majority of video profiles consisted of medical interest groups (77, 37.2%), whereas the majority of video subjects consisted of board-certified dermatologists (50, 24.2%). In contrast, the least common video profiles belonged to patients (2, 1%), and the least common video subjects were news media (2, 1%). When comparing board-certified dermatologists to all other classifications of content creators, there was a significant difference in views, comments, and likes (views P=0.0477, comments P=0.0324, likes P=0.0203). When comparing all physicians to all other content creators, there was a similar trend (views P=0.0009, comments P<0.0001, likes P<0.0001). Physicians were significantly less likely to include promotional content in their videos when compared to other content creators (P=0.0170). CONCLUSION: Although skin of color-related dermatology content on YouTube is primarily educational, board-certified dermatologists are underrepresented as content creators on YouTube. It is pertinent that physicians continue to make content on YouTube and other social media platforms so that patients can have access to accurate yet salient information about their conditions. Patel J, Braswell AC, Jiminez VS, et al. Exploration of skin of color dermatology content on YouTube. J Drugs Dermatol. 2023;22(7):678-684. doi:10.36849/JDD.6995.

Measuring children's perceptions of their mother's depression: the Children's Perceptions of Others' Depression Scale-Mother Version.

Several theoretical perspectives suggest that knowledge of children's perceptions of and beliefs about their parents' depression may be critical for understanding its impact on children. This paper describes the development and preliminary evidence for the psychometric properties of a new measure, the Children's Perceptions of Others' Depression - Mother Version (CPOD-MV), which assesses theoretically and empirically driven constructs related to children's understanding and beliefs about their mothers' depression. These constructs include children's perceptions of the severity, chronicity, and impairment of their mothers' depression; self-blame for their mother's depression; and beliefs about their abilities to deal with their mother's depression. The CPOD-MV underwent two stages of development: (1) a review of the literature to identify key constructs, focus groups to help generate items, and clinicians' ratings on the relevance and comprehensibility of the drafted items and (2) a study of the measure's psychometric properties. The literature review, focus groups, and item-reduction techniques yielded a 21-item measure. Reliability, factor structure, and discriminant, convergent, and concurrent validity were tested in a sample of 10- to 17-year-old children whose mothers had been treated for depression. The scale had good internal consistency; factor structure suggestive of a single construct; and discriminant, concurrent, convergent, and incremental validity, suggesting the importance of measuring children's perceptions of their mothers' depression beyond knowledge of mothers' depression symptom level when explaining which children have the greatest risk for emotional and behavioral problems among children of depressed mothers. These findings support continued development and beginning clinical applications of the scale.