Skin and Hair Care for Women of Color (cont.)

Also, do not forget to wash your hair on a regular basis, even with the braids in. Condition the hair, as well.

Member question: I had acne when I was in high school. My skin got clear. Now that I've turned 40 I'm getting acne and/or blackheads again. What is the best way to treat this problem? Also, does water help with skin?

Taylor: Acne is not just a disease of teenagers; it commonly occurs in adult women in their 20s, 30s, and 40s. Usually by 55 the acne will resolve. Acne is not caused by dirt; it is caused by bacteria, excessive oil, and plugging of the pores. Our treatments are designed to kill the bacteria, decrease the oil, and unplug the pores. Washing vigorously and scrubbing can worsen acne, so cleanse and moisturize very gently. Antibiotics and retinoids are often used for the treatment of adult acne.

Member question: What causes one to have large deep pimples under the armpits, breast, and/or pubic area?

Taylor: The problem that you are describing is called hidradenititis suprativa. The cause of hidradentitis suprativa is unclear; however, we know there is a large inflammatory and infectious component. In this condition large cysts and abscesses develop under the arms, in the groin area, and on the buttocks. The condition can be very painful and uncomfortable. 

Often dermatologists will treat the condition with antibiotics, although other prescription medications may be used. I encourage you to see your doctor.

Member question: I seem to have a great deal of skin tags. How does one get them and what is the best treatment to have them removed (some of them snag on my clothing)?

Taylor: Skin tags are benign, noncanerous growths that commonly occur on the neck and under the arms and bra line as we mature. These growths are very annoying, but can be removed quite easily by your doctor. Often, the lesions are snipped or burned.

Member question: Are there any other drugs for women other than spirnolactone for hereditary hair loss? Can Propecia be given if postmenopausal?

Taylor: The most commonly recommended medication for the treatment of female pattern hair loss is Rogaine. Propecia, which is prescribed for men, has not been approved for use in women. Spirnolactone, which is a diuretic, or water pill, has been used by some dermatologists for the treatment of female pattern hair loss. Unfortunately, to date, additional therapies are needed for this troubling disorder.

Member question: I have your book on my bedside table and I often use it as a reference. The advice has helped me to improve my skin greatly after a recent bout with adult acne. I do, however, have three concerns. I have been experiencing what to me seems like a large amount of shedding hair. My hair is thick and there does not appear to be breakage, but how much shedding is normal? I am sweeping my bathroom floor on a daily basis. 

Second, I go to a professional hair care technician on a weekly basis. She takes time to oil my scalp during each service and I do so at home, however I still have a dry scalp. Do you have any recommendations for how often to use oil or a type that should be used in this case? 

Lastly, I was on a course of antibiotics for acne. The acne has almost completely cleared up but I do have four small areas of hyperpigmentation. Is there some product I can safely use on my sensitive skin? I do have a prescription (a mixed formula) from my dermatologist, but it was a little too harsh.

Taylor: It is normal to shed up to 100 hairs a day. Anything more than that is considered abnormal. If you are unsure if the amount of shedding that you have is abnormal, collect the hairs for a 24-hour period and count them. Less than 100 is normal, greater than 100 is abnormal and should send you off to the dermatologist for evaluation.

In general, I do not recommend that women of color oil their scalps. If you have a dry scalp that is flaky and itchy, that may be due to a problem called seborrheic dermatitis. Seborrheic dermatitis may be successfully treated with prescription shampoos. It is perfectly acceptable to apply oil to hair that is dry, but not to the scalp.

I would suggest that you call and discuss the reaction that your skin had from the prescription medication that your doctor gave you. Often, altering the amount that is applied or the frequency with which it is applied to the skin will result in improved tolerability of the product.

Member question: I'm 19 years old, and I've been suffering from acne for five years. I've used different products containing benzoyl peroxide, and now I'm using medication that contains clindamycin phosphate. What's your best advice to get rid of acne? What's the best home treatment (eating habits, sleeping, exercising, etc.)?

Taylor: Healthy living with adequate intake of water, exercise, and nutrition go a long way into improving the health of our skin. Drinking six to eight glasses of water and including fruits and vegetables and including a multivitamin in your diet will lead to healthy skin.

Unfortunately, there are some people who will, nonetheless, require prescription medications to treat their acne. Many women will try over-the-counter acne products containing the ingredients benzoyl peroxide or salicylic acid. These products will control mild acne in some women. If that is not the case with you, you should consider seeing your dermatologist.

Moderator: Do you have any final words for us, Dr. Taylor?

Taylor: In my book, Brown Skin, I discuss a wide range of skin, hair, and nail disorders that affect women of color. So if we were unable to answer your question today, you might utilize the book as a good resource. You may also visit my web site, which is

Moderator: Thanks to Susan Taylor, MD, for sharing her expertise with us today. For more information please read her book, Brown Skin: Dr. Susan Taylor's Prescription for Flawless Skin, Hair, and Nails!

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