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Peer-reviewedCC BY-NC 4.0American Journal of Clinical Dermatology

Cutaneous Aging in Skin of Color: A Narrative Review

  • Nisal Vipulaguna1,2
  • Ferdos Abdulkader3,4
  • Eryn Patin5,6
  • Saroja Rao6,7,8
  • Nada Elbuluk9
  • Arianne Shadi Kourosh8,10
  • Tasneem F. Mohammad4
  • Michelle Rodrigues11,12
12 affiliations
  1. 1The University of Queensland Faculty of Medicine, Brisbane, QLD Australia
  2. 2The Princess Alexandra Hospital, Brisbane, QLD Australia
  3. 3Department of Dermatology, University of Colorado School of Medicine, Aurora, CO USA
  4. 4Department of Dermatology, Henry Ford Health, Detroit, MI USA
  5. 5University of Texas Southwestern Medical School, Dallas, TX USA
  6. 6Department of Dermatology, Massachusetts General Hospital, Boston, MA USA
  7. 7Wake Forest University School of Medicine, Winston-Salem, NC USA
  8. 8Department of Dermatology, Beth Israel, Deaconess Medical Center, Boston, MA USA
  9. 9Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
  10. 10Harvard Medical School, Boston, MA USA
  11. 11The University of Melbourne, Melbourne, VIC Australia
  12. 12Chroma Dermatology, Pigment and Skin of Colour Centre, Melbourne, VIC Australia
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Abstract

Cutaneous aging is a complex biological process that follows a distinct trajectory in skin of color (Fitzpatrick skin types III–VI) compared with lighter skin types. While increased epidermal melanin provides partial photoprotection and often delays the development of rhytides, skin of color is disproportionately affected by pigmentary sequelae of aging, including mottled hyperpigmentation, solar lentigines, melasma, and post-inflammatory hyperpigmentation. These differences are further complicated by gaps in skin of color-specific clinical training, as well as heterogeneity across ethnic subtypes, cultural practices, and social determinants, making management of aging in skin of color uniquely challenging. In this narrative review, we summarize contemporary evidence on the clinical and histologic features of skin of color, key mechanisms underlying intrinsic aging and photoaging, and practical strategies to address common aging concerns in this population. We highlight that long-wavelength UVA (UVA1) and visible light can induce oxidative stress and persistent pigmentation, and that conventional sunscreens may inadequately protect against these wavelengths. Accordingly, broad-spectrum photoprotection, particularly formulations that provide visible-light coverage (e.g., tinted sunscreens with iron oxides), should be emphasized as a cornerstone intervention. We also review topical agents (including retinoids and pigment modulators), oral antioxidants, and procedural therapies, underscoring the need for cautious selection and technique given the higher propensity for post-inflammatory hyperpigmentation and scarring. These strategies are underpinned by the need for individualized counseling, culturally responsive education, and improved skin of color-specific training for dermatologists globally.

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Cite

BibTeXRIS
BibTeX
@article{vipulaguna2026cutaneous,
  title = {{Cutaneous Aging in Skin of Color: A Narrative Review}},
  author = {Nisal Vipulaguna and Ferdos Abdulkader and Eryn Patin and Saroja Rao and Nada Elbuluk and Arianne Shadi Kourosh and Tasneem F. Mohammad and Michelle Rodrigues},
  journal = {American Journal of Clinical Dermatology},
  year = {2026},
  month = aug,
  doi = {10.1007/s40257-026-01064-9},
  url = {https://doi.org/10.1007/s40257-026-01064-9},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Cutaneous Aging in Skin of Color: A Narrative Review
AU  - Nisal Vipulaguna
AU  - Ferdos Abdulkader
AU  - Eryn Patin
AU  - Saroja Rao
AU  - Nada Elbuluk
AU  - Arianne Shadi Kourosh
AU  - Tasneem F. Mohammad
AU  - Michelle Rodrigues
PY  - 2026
DA  - 2026/08/21
JO  - American Journal of Clinical Dermatology
DO  - 10.1007/s40257-026-01064-9
UR  - https://doi.org/10.1007/s40257-026-01064-9
AB  - Cutaneous aging is a complex biological process that follows a distinct trajectory in skin of color (Fitzpatrick skin types III–VI) compared with lighter skin types. While increased epidermal melanin provides partial photoprotection and often delays the development of rhytides, skin of color is disproportionately affected by pigmentary sequelae of aging, including mottled hyperpigmentation, solar lentigines, melasma, and post-inflammatory hyperpigmentation. These differences are further complicated by gaps in skin of color-specific clinical training, as well as heterogeneity across ethnic subtypes, cultural practices, and social determinants, making management of aging in skin of color uniquely challenging. In this narrative review, we summarize contemporary evidence on the clinical and histologic features of skin of color, key mechanisms underlying intrinsic aging and photoaging, and practical strategies to address common aging concerns in this population. We highlight that long-wavelength UVA (UVA1) and visible light can induce oxidative stress and persistent pigmentation, and that conventional sunscreens may inadequately protect against these wavelengths. Accordingly, broad-spectrum photoprotection, particularly formulations that provide visible-light coverage (e.g., tinted sunscreens with iron oxides), should be emphasized as a cornerstone intervention. We also review topical agents (including retinoids and pigment modulators), oral antioxidants, and procedural therapies, underscoring the need for cautious selection and technique given the higher propensity for post-inflammatory hyperpigmentation and scarring. These strategies are underpinned by the need for individualized counseling, culturally responsive education, and improved skin of color-specific training for dermatologists globally.
SN  - 1175-0561
SN  - 1179-1888
ER  -