Working with Skin of Color

Skin Differences

“Black skin is 60 to 70 percent higher in lipid content than white skin and has larger sebaceous glands. A layer of cells in black skin, although thinner, has a higher concentration of cells than in white skin. Because the stratum corneum is therefore denser in black skin, and the oil glands are larger, black skin is much more prone to lesion formation through follicular impaction.” This quote appears in Christine Heathman’s article, ‘Acne and Skin of Color’ that was published in Dermascope magazine.

Black skin appears thicker than other skin because of its compact nature with more cells per layer.

When black skin is injured or diseased, as it is healing, the melanocytes do one of two things:

1. Hyper pigment—The skin will produce more melanin, creating darker pigmentation areas.
2. Hypo pigment—The skin will produce less pigment, creating white areas.

Black skin is prone to hypertrophic scars and keloids and has a UVB protection factor of 13.4% in the epidermis while white skin has just 3.4% in the epidermis.

When deciphering a person’s skin type, we are most concerned with people that have a 4, 5 or 6 skin type on the Fitzpatrick Phototype Scale and a 4 or 5 on the Lancer Ethnicity Scale (LES).

Fitzpatrick Skin Scale:

Developed by Professor Thomas Fitzpatrick MD of Harvard Medical School, is a classification system based on skin pigment to calculate sunlight burning.

Type	Skin Colour	Reaction to the Sun
I	Light, very white or freckled	Always burns, never tans
II	Light, white	Usually burns, tans with difficulty
III	Medium white to olive	Sometimes burns, tans average
IV	Moderate brown	Rarely burns, tans very easily
V	Dark brown	Very rarely burns, tans very easily
VI	Black	Never burns, tans very easily

 

The following chart is from Dr Harold Lancer, who is a world famous Cosmetic Dermatologist to the Stars. His practice is in Beverly Hills, California.

 

The Lancer Ethnicity Scale (LES)

 

Geography	Fitzpatrick	LES Type
Asian Background
Chinese, Korean, Japanese, Thai, Vietnamese, Filipino, Polynesian	Skin Type IVSkin Type IV	LES Type 4LES Type 4
African Background
Central, East, West African Enritean and Ethiopian, North African, Middle Eastern, Sephardic Jewish	Skin Type VSkin Type V Skin Type V Skin Type III	LES Type 5LES Type 5 LES Type 5 LES Type 4
European Background
Ashkenazy Jewish Celtic Central, Eastern European Nordic Norhtern European (general) Southern European, Mediterranean	Skin Type IISkin Type I Skin Type III Skin Type I-II Skin Type I Skin Type III	LES Type 3LES Type 1 LES Type 2 LES Type 1 LES Type 1-2 LES Type 3-4
North American Background
Native American (including Inuit)	Skin Type II	LES Type 3
Latin/Central/South American Background
Central American South American Indian	Skin Type IVSkin Type IV	LES Type 4LES Type 4

LES Type Risk Factor

LES Type 1 = Very low risk

LES Type 2 = Low risk

LES Type 3 = Moderate risk

LES Type 4 = Significant risk

LES Type 5 = Considerable risk

 

Hyperpigmentation

Depending on ethnicity, clients that have a propensity to hyperpigment and/or have darker skin complexions may be subject to hyperpigmentation after their permanent cosmetic makeup or corrective pigment camouflage application. Technicians need to be cognizant of post-inflammatory hyperpigmentation in regards to all permanent cosmetic applications, and plan their procedures accordingly.

We prefer that our clients use a Hydroquinone, Kojic Acid or Licorice product for at least 4 weeks prior to their initial lip, eyebrow, or Corrective Pigment Camouflage (CPC) procedure application, and also prior to any touchup application. Some professionals also use Lactic Acid, vitamin C, Mulberry and Bearberry to lighten the skin prior to any permanent cosmetic application. We have found that by using these products, our procedure results are far superior than if we did not use them. Preexisting hyperpigmentation in procedural areas will only be exacerbated with the insertion of the needle into the skin, so be very aware of the area you are working on.

Many times after a lip color application, the client will acquire specks of hyperpigmentation in their lips. This seems to be fairly common, and normal skin color may return slowly over a period of months. Hyperpigmentation occurs in Caucasian skin occasionally, although it will most likely occur on clients with heavy concentrations of melanin in their skin. Educating the clients on the proper use of lightening products to be used on their lips is imperative, as many products will remove the pigment colour as well as lighten up the hyperpigmentation.

Increased risk of keloid scarring

As technicians, we need to be cognizant of two particular problems that may arise from the actual procedures which are hypertrophic and keloidal scaring.

Keloids are abnormal scars that are made up of a tissue masses of interwoven broad bundles consisting of dense fibrotic tissue. They may be shiny, are hard, dense and often the tissue is darker in the effected area.

Hypertrophic scars appear raised but stay within the perimeter of the scar.

Scarring may result after the skin has repaired itself. Prior to working on a client it is imperative to ask if they, or anyone in their family history, has a propensity to keloid or scar. If they do, use extreme caution when considering their permanent makeup or CPC application. All skin types can keloid, however, it is more prevalent in darker skin types, but not all darker skin types will keloid either. We have worked successfully on many darker skin toned clients with good results. You must always implement prudence and use good judgment when choosing your clients.

If a client tells us that in fact they do keloid, we will not work on them. Any application of eyebrows, eyeliner or lip colour, utilizing either straight pointillism, lines or hair strokes, may still cause and create a keloid.

If a client were to keloid, or already has a keloid that we need to flatten, we use a product called Kelo-Cote that is applied 2-3 times a day. Kelo-cote can be applied years after a scaring with good results. The client may also ask their physician for Kenalog which is a steroid that is injected into the scar to flatten it. Kenalog manufactured by Squibb is made up of sterile Triamcinolone acetonide that reduces or inhibits the actions of chemicals in the body that cause inflammation, redness, and swelling. Kenalog also dispensed in a topical lotion.

Choosing colors for ethnic skin can be challenging. We always use a cool and a warm color for our client’s eyebrow hair simulation. Applying hair strokes using several different colors will create a three-dimensional eyebrow and look excellent on any client. If you choose to create a ‘solid fill’ in the eyebrow, make sure the color choice is accurate for the client’s skin undertone. Your best results will be in choosing a warm based pigment.

For eyeliner application, we usually choose a very dark brown and add a few drops of a medium warm brown to our pigment color. This will usually ensure us that the pigment will not appear to look ‘bluish’ in the future.

For lip color applications, using a warm based pigment is the best choice. If, however you choose to use a cool color, be sure to warm it up with a Pumpkin, Coral or Burnt Orange shade. The amount of warm color you will need to add to the cool color depends on how heavy the concentration of melanin (blue tone) the client has in their lip vermilion.

If you are not sure how your pigment color will heal, give the client a patch test of color directly into the design line and wait 4-6 weeks to see accurate color results. The client may not want to wait this long, but remember that you are the one in control must learn that not following proper protocol can result in a finished product that is less than acceptable. After you have worked on many, many clients, you should begin to see a pattern of ‘healed results’ of pigment color in certain skin tones, and using these same colors will give you beautiful results.

We have used the same pigment color choices for years, and basically still use the same formulas because they work so well for us. When we find techniques, pigment colors, needle groupings, or anesthesias that give us great results, we tend to continue using them. Why reinvent the wheel? This makes our life and job much easier. (For information on specific color formulas used by IIPC, please email info@iipcusa.com or chekck out our DVD on pigment .)

Corrections on Ethnic Skin can be challenging as well. When a technician uses an ash color for brows on a cool under-toned client, the result will be a very ash or ‘battleship gray’ looking brow. If a client’s eyebrows have healed too ash, you can warm them up with a ‘warm’ brown pigment color. The best results are accomplished if we try to lighten the incorrect color by giving the client several quick light peels, Microdermabrasion and a peel or laser removal treatment. Lightening up the undesired color first will give you a much more pleasing final result.

Depending on the perceived color of the eyebrow, we lighten the brows first. Then, depending on the client’s skin undertones, we will use a Golden Bisque, Baby Blonde or Camel pigment and make hair strokes into the brow area to create the semblance of a skin tone color. Last we apply a ‘warm’ brown to the eyebrows alternating between the lightened hair strokes.

Following this protocol, we give our clients a color refresher annually or every few years. This generates a happy client that will spread the word about how we have helped them to correct their permanent makeup mistakes.

Extreme designs in all applications should be avoided. Some ethnicities are known for a more dramatic makeup application.

 

 

If a client requests an eyebrow design that you are not comfortable with, you should refuse to work on them.

If you keep the lateral portion of the eyebrow going ‘outward’ instead of ‘down’ in 5 years the client’s brows should still look great.

If you place the brows too close to the corner of the eye in a ‘downward’ position from the initial application, as the skin looses its elasticity the brow will droop and will make the client look tired and sad.

Positioning the lateral eyebrow portion correctly from the initial application is one of the most important measurements of an eyebrow procedure.

 

 

If a client requests an eyeliner design that has wings on the corners, remember: when the skin looses its elasticity, the wings will appear to go downwards and make the client look much older.

 

 

 

While ‘WINGS’ may look great when the client is younger…

Gravity is not our friend! As we age, and our skin looses its elasticity, the eyeliner is ‘pulled’ down, making the eye look droopy.

 

 

 

 

Bright/intense red realistically cannot be achieved on ethnic skin. Everyone has blue in their lips, even if the person has warm skin undertones. This fact should be taken into consideration when choosing a lip color, whether it is for a lipline or full lip color application. We have found that many Afro-Americans seem to have gray and/or brown in their lip vermilion. In order to achieve a good color result, we suggest patch testing the color directly in the lip vermilion, waiting 6-8 weeks to see your final result. This is the only accurate way of discerning what color the client will end up with. Using blue-based colors for lips may not be a wise choice; since the lips have an abundance of melanin, using warm lip colors is a much better and safer choice.

 

 

This client had a ‘cool’ red-based lip color applied without consideration to her Indian heritage. When her lips healed they looked almost black.

After several applications of Burnt Orange and ‘Warm it up for Lips,’ we have achieved a softer looking lip color. Upon close examination, you can still see specks of hyper pigmentation in her lip vermilion.

 

Lips Half Dark and Half Orange

We have used a Coral on darker Hispanic and Afro-American lipliner clients and they look great. This color is light, bright and makes their faces look stunning. With all lip procedures you need to make the client aware that the pigment color will change throughout the day. As the client’s body temperature warms up, the lip color will appear to be warmer and brighter. As their body temperature cools down, their lips will appear to be bluer.

Clients requesting a ‘Chocolate Brown’ color, while some say that it is in fashion, will have (in our opinion) lips that look like they have been eating a Hershey’s chocolate candy bar. We have not seen Chocolate lips look attractive on anyone. Softer colors that just give the lips a bit of pigmentation seem to work out the best. Suggest the client receive a more subtle color and then apply their favorite lipstick over their permanent makeup lip color.

Do not let your clients talk to you into anything that you are uncomfortable with, as the client did in the previous photo. Your name is on your clients face. You should be proud of your work.

You have heard this for years, but bears repeating again and again……..

Remember with all permanent cosmetic makeup procedures.

Pigment color + Skin undertones = Your final color result

Natural lighting or daylight full spectrum bulbs should be your light source of choice. we use full spectrum bulbs in our overhead and medical lights. This allows us to see the perceived color from the beginning of the process. Example: you think a color will look good in the skin and using the day light bulbs will allow you to see the color you are using immediately. If it appears too ash, you can immediately warm up your color. If your pigment is too warm, you can cool it down. Using the correct type of lighting will make your procedure look more pleasing to the eye right from the start.