AestheticsWire Exclusive: Embracing Diversity in Aesthetics

There’s no such thing as a one-size-fits-all approach to rejuvenation as people across genders, ethnicities, and age groups often have different concerns and aesthetic goals.

This is the main takeaway from a new study that sought to better understand facial and body aesthetic concerns among Asian, Hispanic, and Latino Women. The Allergan Aesthetics-sponsored research was presented at the 2023 meeting American Society for Dermatologic Surgery (ASDS) in Chicago.

Study author Annie Chiu, MD, a dermatologist in Manhattan Beach, CA, sat down with Modern AestheticsÒmagazine to discuss the findings and share how respecting these nuances and cultural considerations can translate into improved outcomes and greater patient satisfaction.

What were some of the biggest takeaways from the study? 

Annie Chiu, MD: “It’s always interesting to identify the top aesthetic concerns across various ethnic and racial groups as they tend to be different than what our current paradigms may suggest as most studies are done in Caucasian or Eurocentric populations.”

What were some of the top concerns expressed by Asian, Hispanic, and Latino women, and how do they differ from Caucasian women?

Dr. Chiu: “Skin quality, dark circles under the eyes, and submental fat are the more dominant aesthetic concerns in the Hispanic populations, with skin quality and dark circles also being rated high concerns in Asians.  This differs from Caucasian women, where issues like glabellar lines and other wrinkles rate higher among their aesthetic concerns.  Hyperpigmentation and hair loss were the other top two concerns among people with darker skin tones, and these can be more challenging and require counseling because there are often different underlying medical reasons for these cosmetic concerns.”

How so?

Dr. Chiu: “Uneven pigmentation is a major concern for most patients with darker skin tones, including Asian and Hispanic women. In aesthetic consults, there is often an emphasis on lines and wrinkles that we can address with injectables, and this is a reminder that we need to be aware and also be focusing on issues like dyspigmentation and skin quality as part of routine cosmetic consults, as that is clearly important to patients.  Sometimes, these issues are more challenging, as there are a breadth of reasons for hyperpigmentation, and conditions like melasma require long-term multimodal treatment modalities.  We are doing a disservice to patients of diverse skin tones if we do not prioritize addressing these dermatologic issues and why they are more difficult to treat.” 

What is driving these differences?

Dr. Chiu:  “Underlying anatomical and cutaneous differences in different cultural backgrounds explain why some ethnic groups cite certain issues more often as an aesthetic concern.  For example, those with Hispanic backgrounds have been shown to more often have underlying bone structure with less prominent mandibular structure.  This is often a reason they see submental fat as a problem, as there can be a lack of lower face structure that holds up the skin in the upper neck.   In Asians, medial flattening or concavity of the maxillary bone gives less support to the undereye and can cause the appearance of elongation of the lower eyelid, which may be why they notice more prominent undereye circles.   It’s important for dermatologists to not only understand our aesthetic patients' concerns in all cultural backgrounds but to relate these issues to the underlying facial anatomy, structure, and physiology so we can most effectively customize and map treatments.”

How can dermatologists incorporate this knowledge into culturally competent treatment plans?

Dr. Chiu:  “It’s very important to ask and address the patient’s main concerns and be aware of different ethnic backgrounds and highlight and honor diversity.   Don’t let your biases dictate aesthetic consults and assume the primary concerns are the same across different populations, and we should be doing our best not to “westernize” or make homogenous faces.  The key is to bring balance and harmony while respecting diversity”

Are we getting better at recognizing and embracing differences?

Dr. Chiu: “I think so, and awareness and acceptance of different ethnic looks is improving among industry, marketing, and dermatologists.  Diversity now includes so much more than color. It also includes gender and culture, and the more aware and respectful we are of that the better.”