The Real Color Wheel:
by A n n e t K ing
O ne of the most immediate impacts of
globalization is that our world is rapidly
becoming one populated by multi-racial,
multi-cultural citizens. Today, people
travel, live and work in places their
grandparents might not have even been
able to point out on a map. In the United
States alone, 6.8 million of us describe
ourselves as bi-racial or multi-racial.
And as the traditional delineations and
boundaries of ethnicity, nationality,
heritage and culture blur, we are faced
with many new challenges and oppor-
tunities as professional skin therapists.
IN OUR AGE OF “DON’T ASK/ DON’T
TELL”—DO ASK. IT’S UNPROFESSIONAL
NOT TO.
What advice does the skin therapist
give to a client of say, Irish/ Cherokee
background? Or Pakistani / Anglo-
English? None of the old rules apply. In
fact, just saying aloud the names of the
three old racial categories—Caucasian,
70 D E R M A S C O P E February 2005
Negroid, Mongoloid—sends shivers
down any politically correct spine. The
fact is, there never was a time when these
three incredibly broad labels were spe-
cific enough to sum up the diversity of
human ethnic identity—and today they
sound hopelessly Victorian. The noun
“race” itself, in fact, is of dubious value
as our world rapidly expands.
In the skin care industry, the term
“Caucasian” is still used as shorthand
to describe Northern European, Celtic
and Nordic skins, but in reality the
indigenous people of India, whose com-
plexions range from milky to mahogany,
are among the original “Caucasians”.
In Webster’s Encyclopedic Unabridged
Dictionary of the English Language,
2001 edition, one of the definitions of
“Caucasian” reads, “…of, pertaining to,
or characteristic of one of the traditional
racial divisions of humankind, marked
by fair to dark skin, straight to tightly
curled hair, light to very dark eyes, origi-
nally inhabiting Europe, parts of North
Africa, western Asia and India.” People
with backgrounds including Spanish,
Italian, Russian, Turkish and Moroccan
may all be considered “Caucasians”
under this less-than-precise definition.
And, more and more people who
are not of 100 % Nordic or Celtic ances-
try are now choosing to define their
ethnicity in other ways. This means that
manufacturers and service providers,
including skin therapists, who continue
to view their clientele as homogenously
Caucasian, are missing out on oppor-
tunities which will only continue to
expand. For example, according to recent
research at the University of Georgia,
the growth of the self-described “eth-
nic” market will eclipse the Caucasian
market by 2009. Other sources, such as
the MarketResearch.com U.S. Market
for Ethnic HBC: Hair Care, Skin Care,
 Redefining “Ethnic Skin”
Color Cosmetics report, forecast that
ethnic skin care sales will reach $1.9 bil-
lion by 2006.
Inquiring about someone’s ethnic
background, once considered rude, may
be uncomfortable in some contexts,
because historically such inquiry has
generally had a racist underpinning.
All of this underscores the point
that sensitivity is paramount in opening
up the subject of ethnicity with any cli-
ent. The questions must be asked, and
asked with tact; we are asking not to dis-
criminate, but to better serve. We must
approach our practice as skin therapists
with the understanding that this infor-
mation is vital to understanding the
needs of the skin and provide the client
with the most professional treatment
possible.
ASSUME NOTHING. AND EXPLORE
EVERYTHING
Pre-treatment consultation is the
first and most crucial step toward offer-
ing clients truly informed service. For
instance, the skin analysis can be a unique
vehicle for collecting information about
the individual’s skin, including a written
consultation card and close visual and
tactile examination of the face, throat
and ears based upon dividing these
areas into sections. Communication and
questioning with the client is key to
developing a safe, customized treatment,
not based upon assumption, but upon
accurate information and observation.
Face your “global-skinned” cli-
ent with fresh eyes. While touching the
freshly cleansed skin of the face and
neck, begin with these three questions:
1. How easily do you burn, and
what SPF value sunscreen do you tend
to use? (This establishes the client’s tol-
erance to sun and where the individual
falls on the Fitzpatrick Scale.)
2. Have you ever experienced
brown marks on your skin resulting
from a pimple, bite or scratch? (This
establishes the client’s tendency toward
hyperpigmentation.)
3. What about sensitivity? Do
your cheeks ever feel hot? Does your
skin ever sting? Have you ever had a
reaction to a product on your skin?
(Darker skin is hard to read as “sensi-
tive,” since there may be no visible signs
of inflammation or irritation. In the case
of more deeply pigmented clients, ques-
tion precisely, and feel the skin for hot
spots. Asian skin in particular will often
be very sensitive, while not showing vis-
ible “red flags” of distress!)
The most essential part of this
inquiry process begins with the drop-
ping of assumptions. For instance, what’s
in a name? Not much. Surnames, once a
February 2005 D E R M A S C O P E 71
telling indicator of ethnicity, mean less
and less in our “multi-culti” world. A
woman’s name may of course be her
husband’s familial name, so don’t let
an “ethnic” name, or lack thereof, lead
you to unfounded conclusions about
the nature and tendencies of a person’s
skin.
Not only can we never make safe
assumptions about anyone’s true ethnic
identity, based upon their appearance or
surname—we must also rid our-
selves of antiquated notions of
what ethnicity itself truly means.
One of these notions can most
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easily be called primitivism, or
exoticism. It is the belief that
non-Northern Europeans —
people who are visibly “ethnic”
— are somehow hardier, heartier,
tougher and more resilient than
their fair-skinned counterparts
in the British Isles, Germany,
Austria and Scandinavia. This is
a falsehood based upon deeply
racist notions.
For example, African and
African American hair, with
its pronounced wave pattern, is gener-
ally speaking the most fragile hair on
earth, and the most prone to break-
age. Every bend in the S-shaped or Z-
shaped wave pattern is a point of vul-
nerability. Likewise, deeply pigmented
skin including African-derived skin is
the most prone to hyperpigmentation
as the result of cutaneous injury, and is
especially prone to pronounced keloid-
ing. It is no coincidence that decorative
and ceremonial scarring is a tradition in
Africa, and not in Norway. Non-Nordic
skin is actually more fragile, in the sense
that every scratch, blemish and burn will
leave its mark upon the skin for months,
or possibly longer. This fact makes treat-
ing acne, for instance, a challenge to
72 D E R M A S C O P E February 2005
the therapist when dealing with ethnic
clientele.
By contrast, Celtic and Nordic skins
are actually more resilient when faced
with wounding, piercing and other
cutaneous damage. A 100% Northern
European skin, one with no non-Celtic
or non-Nordic genetic content, is much
more likely than an ethnic skin to heal
from a wound with little or minimal
scarring. By contrast, even very light-
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complected individuals of Asian, Latino
and Middle Eastern descent experience
hyperpigmentation in many forms,
including a response to unprotected sun
exposure—which leads us to ANOTHER
assumption of which we must rid our-
selves and our clients! This is the dan-
gerous assumption that anyone with
visibly ethnic skin does not need sun
protection!
THE SUN IS THE ENEMY OF ALL SKINS.
We now know that UV rays actually
enter the dermis, far deeper than once
believed, and this affects Nordic and
Celtic skins most immediately. A fair
Northern European skin will be quick
to show the short-term effects of sun
damage, since this type of skin reflects
(rather than absorbs) approximately
60% of available light. By contrast, a
dark skin may shield itself 30 times more
natural protection from UV damage by
virtue of its structure. This is not to be
confused, however, with dark skin being
“tougher” or “thicker”. While undeniably
more sun-tolerant, ethnic skin has noth-
ing to gain by testing this tolerance with
unprotected sun exposure. Although
evolution and heredity give dark skin
a genetic advantage, deliberately
sunning is equivalent to gambling
with the health of the skin.
Here are the facts: in very
dark skin, such as the classic
Australian Aboriginal complex-
ion which is the most richly pig-
mented on earth, as little as 5%
of the UV rays ever enter the
dermis, keeping cellular damage
to a minimum. Dark skin does
possess higher melanin content,
and is able to absorb up to 70 %
of UV radiation. Many dark skins
also contain a high concentration
of sudoriferous glands which pro-
duce a protective mantle of dense
lipids and fats which further protect the
epidermis from free radical activity—
perhaps even more so than dark skin’s
specific formations of the pigmentation
molecules themselves.
Dark skin does indeed resist vis-
ible signs of aging better than Northern
European skin. For example, instead of
the fine lines and “crow’s feet” which may
define the eye area of very fair Northern
European skin by the age of 30, ethnic or
more deeply pigmented skin will often
remain unlined for decades, although
perhaps showing lentigines or freckles as
the result of photo damage.
With the emerging new world of
multiracialism, however, most of us and
our clients are going to fall somewhere
in the middle—somewhere between
pure vanilla and bittersweet espresso.
And this means that sun protection
must be a part of everyone’s skin care
consciousness.
The fastest-growing ethnic popu-
lation in the United States is Latino.
So what exactly is “Latin” skin? Queen
Isabel of Spain was a fair-skinned, blue-
eyed redhead according to the history
books. Contrast this with Celia Cruz, the
legendary Cuban singer who brought
Caribbean music into the mainstream
worldwide in the 1940s, 50s and 60s, who
evidenced her Afro-Caribbean heritage
in her rich caramel complexion. Actress
Salma Hayek, who immortalized the
artist Frida Kahlo (who was Hungarian
and Mexican) in a recent film, evidences
both her own Lebanese and Mexican
background in her dark hair, dark eyes
and medium-olive skin.
Here’s the challenge: “Latina” heri-
tage often embraces African (Arabic,
Semitic and North African in the case
of individuals from Spain, West African
in the case of clients from Puerto Rico,
Cuba and the Dominican Republic, for
example) heritage as well as European
“Hispanic,” meaning Iberian. Likewise,
throughout the Americas, “Latin” heri-
tage generally includes Native American
ancestry, which, from an anthropologi-
cal point of view, is considered Asiatic
in origin. All of this is relevant in light
of the fact that for Latin, Asian and
African-descended skin, hyperpigmen-
tation is the most pressing concern.
Because most Latin skin is not
purely Northern European, even a light-
complected Latina will probably have
more pigmentation issues than her
Swedish or Irish counterparts; this is
an essential understanding when exam-
ining a client’s skin and prescribing
treatment. For example, if a client has
West African, including Afro-Caribbean
74 D E R M A S C O P E February 2005
heritage, she may be prone to keloid-
scarring. This applies even if the West
African heritage is remote or combined
with Northern European heritage, and
her complexion appears more “cream”
than “coffee” to the eye! Likewise, when
any skin “of color,” including the skin of
many Latinas, is subjected to trauma,
dark scarring may result. For this rea-
son, heat-oriented or invasive medical
skin treatments such as lasers and deep
chemical peels may be contraindicated
for most non-Northern European skins.
Clients of Asian descent may have
many of the same issues. Once again,
there is no single Asian monoculture.
There are infinite variations and nuanc-
es, including skin tones. In general, tra-
dition dictates that Asian women work
to preserve as fair a complexion as pos-
sible. Like all non-Nordic skin, Asian
skin often will show irregular patches of
hyperpigmentation — call them freck-
les, age spots or what have you, they are
most commonly triggered by hormone
fluctuations and sun damage. However,
hyperpigmentation does indeed have
other causes.
OUT, OUT, DAMNED SPOT!
Different types of hyperpigmenta-
tion may be triggered by specific condi-
tions, and by a combination of these
conditions:
HORMONES – Melasma or chloas-
ma, identified by brown, sharply defined
patches on the forehead, especially on the
NOT ONLY CAN WE NEVER MAKE SAFE
ASSUMPTIONS ABOUT ANYONE’S TRUE ETH-
NIC IDENTITY, BASED UPON THEIR APPEAR-
ANCE OR SURNAME—WE MUST ALSO RID OUR-
SELVES OF ANTIQUATED NOTIONS OF WHAT
ETHNICITY ITSELF TRULY MEANS.
forehead, temples and cheeks, forming a
“mask-like” appearance, result from the
activity of estrogen and progesterone.
This condition is often called the “mask
of pregnancy” (Melasma Gravidarum),
but also may result from use of the birth
control pill. Other common hormon-
ally caused types of hyperpigmentation
are darkening of the nipples, as well as
the “Linea Negra” which runs vertically
down the abdomen during pregnancy.
Some ovarian disorders also may trigger
these pigmentation formations. Often,
hormonally induced hyperpigmenta-
tion will diminish or disappear when
hormonal levels are normalized once
again. However, diligent application of
sunscreen is the best prevention.
STRESS – Stress acts like a car-
alarm upon the brain and body, kicking
all of the body’s interrelated systems into
overdrive. When the pituitary gland is
stimulated by stress, it in turn kick-starts
the adrenal glands to produce adrena-
line, along with other steroids and hor-
mones. This cascade of stress-chemicals
may produce discoloration (as well as
acne-like disturbances), especially along
the jaw line and neck.
TRAUMA/INJURY-Cutaneous
trauma, ranging from a surgeon’s inci-
sion to an accidental cut, to the effects
of laser and chemical treatments— can
all leave permanent marks upon ethnic
skins. Recent studies now show that
some types of wounds and inflamma-
tions actually result in hyperpigmenta-
tion deep in the dermis, not merely in
the more superficial epidermal layers of
the skin as originally thought. This infor-
mation is good
cause to treat
any skin
trauma with-
out delay, in
order to opti-
mize poten-
tial reversal of
the discoloration. Anti-inflammatory
and brightening products, combined
with thorough UV protection, should

INQUIRING ABOUT SOMEONE’S ETHNIC BACKGROUND, ONCE CONSIDERED RUDE, that generates heat,
MAY BE UNCOMFORTABLE IN SOME CONTEXTS, BECAUSE HISTORICALLY SUCH can trigger hyper-
INQUIRY HAS GENERALLY HAD A RACIST UNDERPINNING.
be employed immediately following any
cutaneous trauma, especially to Latina
skin.
PASS THE SUNSCREEN, POR FAVOR
Ethnicity and culture do play a role
in the care and health of the skin. To
generalize, much of the world’s Latin,
Spanish-speaking population lives in
areas of intense solar exposure, with
a dense concentration in the desert
regions of the Americas and the tropi-
cal heat of Florida and the Caribbean
islands. Education about sun protec-
tion has not historically been a health
concern in many Latin communities,
although historically fairness has often
been an aesthetic value and social prefer-
ence—equally true in many traditional
Asian cultures. In any case, it is essential
that UV-protection become acculturated
early on to prevent or at least minimize
hyperpigmentation issues in the future,
not to mention the possibility of skin
cancer.
Another cultural area to address
with clients is the long history of home-
remedies and home-treatments (called
“conchas” in Spanish) which are part
of many traditional Latin upbringings
(other ethnicities have their own spec-
trum of such home-cures as well!). These
herbal folkways are a deeply integral part
of a rich heritage, and deserve respect
as cultural traditions. Some of these
practices may still offer value, certainly
in terms of affirming and celebrating
ethnic identity. However, many of these
“curandera” practices are potentially irri-
tating to the skin, and should be dis-
cussed and closely evaluated.
Home-remedies aside, many pre-
scription drugs cause photosensitiv-
76 D E R M A S C O P E February 2005
pigmentation if used
ity, which may result in hyperpigmenta-
tion, including commonly prescribed
anti-depressants, diabetes medications,
antibiotics, many anti-inflammatories,
and numerous others. Even a perfume
or cologne may interact with UV rays,
causing discoloration of the skin, which
may be difficult to reverse. Sun protec-
tion, regardless of one’s habits, heredity
or geography, is essential in preventing
hyperpigmentation.
BEYOND THE REACH OF BLEACH…
Because ethnic skin is often high-
ly reactive, hydroquinone is never a
recommended option. Many people
of color have relied upon hydroqui-
none as the active ingredient for “fade”
creams for decades. However, it must
be said that hydroquinone is banned
in many countries, and is now classi-
fied as an over-the-counter drug by the
Food and Drug Administration (FDA),
and the Occupational Safety and Health
Administration (OSHA). In the United
States, the substance is described as
“mutagenic, with cancer-causing poten-
tial.” With prolonged use, many people
may develop allergenic responses to
hydroquinone, including extreme sen-
sitization to other products, as well as
contact dermatitis. Botanicals including
Kiwi, Rice and Bearberry extracts also
can reverse hyperpigmentation. They
take longer to work, but this new genera-
tion of brightening products based upon
these ingredients poses far fewer risks to
your clients.
MORE OPTIONS
Another popular practice, which is
generally off-limits to ethnic skin, is…you
guessed it…MICRODERMABRASION.
But this, like any resurfacing treatment,
especially a service
incorrectly.
Professional exfoliation holds great
potential for addressing hyperpigmenta-
tion without heat. The newest ingredient
to hunt down is an enzyme called Bacillus
ferment, which actually is a helpful strain
of bacteria! Sounds strange, but look
for the new concentrates which allow
you to use this ingredient in varying
strengths during professional treatment.
This range of intensity is now called the
“bioactivity scale,” and using it offers the
best way to customize exfoliation treat-
ments for your clients.
Finally, skin is skin. We experi-
ence our world through it, and through
these experiences we define ourselves
as the human family. Through educa-
tion as well as understanding the subtle
and particular needs of various skins,
acknowledges and honors the growing
diversity of this family—and keeps us all
feeling and looking our best.
Annet King is the Director of Training and
Development for the International Dermal
Institute (IDI). Her responsibilities include
overseeing the IDI teaching staff around the
globe, as well as developing their global cur-
riculum. Prior to joining IDI she was Director
of Training for a skin care distribution company
in Singapore, supervised the regional training
for several major skin care lines, and served as
Vice Principal to two CIDESCO certified schools.
In addition Ms. King has consulted and assisted
in the development of skin care centers and spas
throughout Southeast Asia. Ms. King is a licensed
skin care therapist, certified by both CIDESCO
and CIBTAC, an instructor and industry author.
Her expertise in skin and spa operations com-
bined with her dynamic personality has put her
in high demand as a guest speaker representing
the International Dermal Institute at educational
events around the world.