Treating Skin of Color With KnowHow

ERICKA DUNLAP, Miss America 2004, retired her crown last year, but she has not moved out of the spotlight. Her new career as a country singer still requires her to maintain a flawless complexion. So when acne flares up, she flies from her home in Nashville to Washington for treatment at the Cultura Cosmetic Medical Spa.

The spa attracts other celebrities, including Venus Williams, the basketball star Alonzo Mourning and Alfred C. Liggins III, the president of Radio One. Patients may appreciate Cultura's luxury amenities, the muted lighting, hush-hush atmosphere and minimalist décor. But the medical spa's main attractions are its founders - Dr. Eliot F. Battle Jr., a dermatologist, and Dr. Monte O. Harris, a facial surgeon - experts in cosmetic treatments for blacks, Asians and Latinos.

"Before I found Cultura I drifted around from spa to spa for a while," said Ms. Dunlap, who is African-American. "But so many times the advice I got wasn't given from a cultural perspective. Dr. Battle didn't just clear up my acne. Every time I go there I learn something new about taking care of my ethnic skin."

Dr. Battle and Dr. Harris are among a small number of prominent physicians who specialize in treatments for patients of color, along with dermatologists like Dr. Susan C. Taylor of Philadelphia; Dr. Jeanine B. Downie of Montclair, N.J.; Dr. Fran E. Cook-Bolden of New York City; and a few others. All are known as authorities on how acid peels, lasers and other cosmetic treatments, whose results vary depending on skin pigmentation, can be best performed on people with non-Caucasian skin. These doctors also have become masters at fixing the blemishes, discoloration and scarring that occur when the procedures are done by dermatologists with little experience with those patients.

Like many other dermatologists before them, they also write self-help beauty books and appear in medical segments on television programs like "Good Morning America" and the "Today" show. And they are attracting a growing clientele of actors, newscasters, politicians, members of Middle Eastern nobility and Southeast Asian entrepreneurs. Their increasing prominence reflects a rising interest among black, Asian and Hispanic consumers in cosmetic treatments and calls attention to the fact that these consumers need expert care.

"The growing focus on skin of color is partly tied to consumers who seek out dermatologists who look like them, thinking that the doctors must know about their skin, hair and nails," Dr. Taylor said. In 1998 she opened the Skin of Color Center at St. Luke's-Roosevelt Hospital Center in Manhattan, a clinic that specializes in medical and cosmetic treatment. "But it's also tied to dermatologists who are open to the idea of gaining expertise in skin of color and creating centers around the country to treat these consumers."

Dr. Amy S. Paller, the chairwoman of the dermatology department at the Feinberg School of Medicine at Northwestern University in Chicago, which has just opened the Center for Ethnic Skin, said the new focus may be overdue. "There has recently been a greater recognition of the need for more research and expertise in this area," she said, "particularly in new treatments that can have a tremendous cosmetic significance for skin of color."

Similar clinics have recently started up at the Henry Ford Health System in Detroit and at the University of Miami.

Changing demographics have pushed dermatologists to shift their attention. Hispanics, Asians, African-Americans and American Indians will represent almost half of the American population by the year 2050, according to projections from the Census Bureau, a large increase from 2000, when those groups accounted for about one-third. But perhaps more important, consumers in those groups are getting more cosmetic treatments like laser hair removal and Botox injections than ever before. Hispanic, Asian and African-American patients had 19 percent of all cosmetic procedures in 2004, an increase from 14 percent in 2000, according to the American Society for Aesthetic Plastic Surgery.