Aging Differences in Ethnic Skin

Aging is an inevitable and complex process that can be described clinically as features of wrinkles, sunspots, uneven skin color, and sagging skin. These cutaneous effects are influenced by both intrinsic and extrinsic factors and often are varied based on ethnic origin given underlying structural and functional differences. The authors sought to provide updated information on facets of aging and how it relates to ethnic variation given innate differences in skin structure and function. Publications describing structural and functional principles of ethnic and aging skin were primarily found through a PubMed literature search and supplemented with a review of textbook chapters. The most common signs of skin aging despite skin type are dark spots, loss of elasticity, loss of volume, and rhytides. Skin of color has many characteristics that make its aging process unique. Those of Asian, Hispanic, and African American descent have distinct facial structures. Differences in the concentration of epidermal melanin makes darkly pigmented persons more vulnerable to dyspigmentation, while a thicker and more compact dermis makes facial lines less noticeable. Ethnic skin comprises a large portion of the world population. Therefore, it is important to understand the unique structural and functional differences among ethnicities to adequately treat the signs of aging.Aging is a complex process in all human societies reflecting biological, environmental, and genetic influences. It is multidimensional, comprising physical, psychological, and social change that is also influenced by cultural and societal standards. The cutaneous effects can be described clinically as features of wrinkles, sunspots, uneven skin color, and sagging skin that are often varied based on ethnic origin.1 In addition to inherited genetic traits, a multitude of other factors can modify the aging process, such as hormonal status and climatic, working, social, and cultural conditions.2The association of youth and beauty is well accepted in modern day society. The human desire for homogenous skin color and texture, absence of wrinkles and sagginess, and lustrous hair has fueled the cosmetic and surgical industries. Botulinum toxin, blepharoplasty, and soft-tissue fillers are among the many popular cosmetic treatments that enable the improvement in wrinkles, eyelid sagginess, and volume loss, respectively. Women who possess a youthful appearance are consistently rated as more attractive than older-appearing women.3-9 In a cross-cultural study, across five populations, women were perceived as more attractive to the extent that their predicted ages were less than their actual ages.3 Even when interviewers are explicitly instructed to adjust for age and sex of participants, looks of younger people are rated more favorably than those of older people.10 Studies on skin color and texture have demonstrated that humans have a preference for younger-appearing skin that is viewed as both healthier and more attractive.11-14 Skin texture studies have shown that the effects of skin color distribution can account for up to 20 years of perceived age.11 Understanding the fundamentals of mature skin is important to an aging population where individuals are living longer and expected to be productive into later years, while holding the strong desire to maintain a youthful appearance.Aging can be described clinically as features of wrinkles, sunspots, uneven skin color, and sagging skin. These cutaneous effects are influenced by both intrinsic and extrinsic factors and often are varied based on ethnic origin given underlying structural and functional differences. There are slight differences in the definitions of ethnicity and race; nonetheless, they are often used interchangeably in the medical literature. Ethnicity typically refers to broader groups of populations with a common culture and/or language, while race often represents a specific population in terms of genetic resemblance.15 In this article, the authors refer to ethnic skin as the broad range of skin phenotypes and complexions that characterize persons with darkly pigmented skin including those of African, African American, Asian, and Latino/Hispanic descent.