122 INCLUSIVITY
Skin type assessments For the personal care industry, progress is still required. A key element that requires improvement is the inaccurate use of the Fitzpatrick Skin Type (FST), which is being used within the industry to illustrate if a product or ingredient has been tested on ‘multiple ethnicities’. However, there are various racial limitations
of FST, with many studies advocating for clinical studies to be mindful of conflating race and ethnicity with FST, and that more culturally appropriate and clinically relevant methods for describing different ethnicities need to be developed. This argument becomes clear when you consider the original intention behind the development of the FST scale, which was to assess the propensity of the skin to burn during phototherapy, and has little to do with depth of skin tone or colour. To this end, other classification systems
for the assessment of skin types are in development. With regards to consumers’ buying choices, the Naz-Westland Index, developed by Farah Naz and Professor Stephen Westland, aims to present a much more diverse and accurate scale of skin colour. Originally developed to help consumers decide on a makeup shade for Naz’s EX1 Cosmetics Brand, the duo intend to work with brands and research groups to combat under- representation and replace biased approaches. For those working in the healthcare sector,
members of the Lexicon Group, part of the British Association of Dermatologists, have also developed a new five-point Eumelanin Human Skin Colour Scale (EHSCS), after they realised that there was no standard nomenclature for describing the diversity of human constitutive skin colour.10 The resulting development of the EHSCS
can be used to describe constitutive skin colour in an objective, equitable and understandable manner, and allow the development of other scales that address specific functional aspects of human skin, such as the response to the ultraviolet radiation.11 The British Association of Dermatologists are
acting as pioneers in the minority ethnic group inclusivity space. As well as developing the EHSCS, they also work to combat discrimination in the workplace, support patients and the wider public by addressing the lack of diversity in dermatology patient information materials, and increase minority ethnic group representation across training materials for medical students and dermatology journals. Their current work includes developing
images, nomenclature and terminologies and education, to ensure that clinical practice in dermatology is inclusive, encompassing the diverse range of human phenotypes and genotypes, and that minority ethnic group skin types are fully integrated into how they describe skin symptoms and diseases. Though clinical measurements and inclusion
are improving, for the consumer, diversity and inclusion are particularly important when it comes to choosing brands. 93% of consumers believe that brands have a responsibility to approach diversity and inclusion, and for 60%
PERSONAL CARE April 2023
“93% of consumers believe that brands have a responsibility to approach diversity and inclusion, and for 60% of them, this is also important during a luxury purchase”
of them, this is also important during a luxury purchase.12,13 This creates an opportunity for brands, as
multi-ethnic consumers are an underserved market, with 40% stating that it is not easy to find cosmetics and skin care.12
Brands would
also benefit from acknowledging that multi- ethnic consumers spend more on health and beauty, and are also more likely to tell their friends about an impressive brand or product. If this group can be provided with the
products they require, the brands would not only benefit from being chosen more, but also purchased more often, and receive more organic peer-to-peer recommendations.
Catering for different ethnicities To be able to fully cater for different ethnicities, brands need to be aware of the differences that may be present in skin of differing ethnicities. However, this has not proved easy to define. As well as a lack of studies in general, those that have been conducted have generated varying results, including controversies in findings related to transepidermal water loss (TEWL), lipid levels in the stratum corneum and ceramide/cholesterol ratio, to name a few. More surprisingly, there have been studies
conducted by the same brands which have different results. For example, a 2013 study by Johnson & Johnson shows that TEWL is lower in African-American skin compared to Caucasian skin.14 However, in a further study they conducted in 2016, there was seen to be no significant differences in TEWL between Caucasian and African-American groups. Furthermore, the 2016 paper did not even reference the 2013 study.15 This led to their initiation of a large-scale
prospective study in dermatology, designed to generate key insights among black, Hispanic, Asian, indigenous and other people of colour in the United States, admitting that there was
‘still a pressing need for more data in people of colour’. Most studies that have been undertaken
reference a key paper by AV Rawlings, on differences in skin structure and function in ethnic skin types, published in the International Journal of Cosmetic Science. Though published in 2006, this paper is still the best review of differences to be found.16 Some key findings are that black skin has
the least TEWL, highest water content and increased cell cohesion which leads to a stronger barrier and reduced irritation. Black skin has the least amount of lipids, a 2.5 times greater spontaneous desquamation rate, and reduced epidermal cathepsin L2 levels, which contributes to ashy skin, a key complaint within the black population. For Asian skin, there may be a thinner and
less resilient stratum corneum, fewer and less cohesive corneocytes, and higher eccrine gland density, which means less resistance to mechanical stress, and increased sensitivity to environmental aggressions. However, it is more likely to possess higher levels of ceramides, which combined with more collagen type I, means that it is less affected from skin wrinkling from photo-ageing. For those with white skin, they are more
prone to ageing more quickly, with wrinkling and sagging from tissue degradation. They can also be most prone to sensitivity from mechanical aggressions, pollution and other exogenous agents. However, though it would be beneficial to
explore the ethnic differences in more detail and draw more complete conclusions, it is not necessary to do so in order to best serve the booming inclusivity market. We must also take note that there are other aspects which would have an even greater impact on the skin condition of the consumer; the climate they live in, the seasonal changes experienced, their diet
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