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Common skin problems for people with darker skin tones
People of color can have unique skin conditions. Here’s what you need to know to help keep your skin healthy and safe.
Your skin is your body’s largest organ, and it’s important to keep it healthy. Skin problems can affect anyone. But some conditions are more likely to affect people with darker skin. If you have a darker skin tone, there are certain problems you might want to watch for. For example, seborrheic dermatitis (a type of flaky rash) is most common in Black people.
Skin cancer is more common in people with fair skin tones. But it’s often diagnosed later in people of color, says the Skin Cancer Foundation.1 That can be deadly when it’s melanoma, the most serious form of skin cancer.
Another serious issue for people with darker skin tones? Skin conditions may look different for them than they do in lighter-skinned people. That’s a problem because dermatologists (doctors who treat skin conditions) may not always know what to look for. In fact, a recent study found that nearly half of all dermatologists didn’t feel they had the necessary training to diagnose skin diseases in people of color.2
Sometimes, these skin problems are cosmetic. They keep you from looking your best, and that can lower your confidence. But some skin issues may be a sign of something more serious. Here’s what to know.
1. Post-inflammatory hyperpigmentation (PIH)
This is the most common skin issue for people with darker skin tones, says Laurie Levine, MD. She’s an Optum dermatologist in Rhinebeck and Lake Success, New York. PIH happens when a part of your skin gets irritated. That makes the area turn tan, brown or purple.
“Any damage to the skin can make it darken,” says Dr. Levine. “It could be a pimple or a bug bite. It’s really hard to get rid of.” In fact, as many as 6 in 10 people with dark skin who have acne also have PIH.3
How it’s managed: First, your doctor will ask you to use sunscreen daily because sunlight can cause PIH to darken. Then, they may prescribe creams to lighten the dark spots. If that’s not helping, you may need laser therapy. That’s a procedure where intense beams of light repair your skin. Or your doctor may use a chemical peel. That’s a solution that removes any damaged layers of skin.4
2. Acanthosis nigricans
This causes velvety, dark patches of skin. They can appear on the back of your neck, elbows, armpits and knees. It can happen on other areas of the body too. It’s more common in people with darker skin tones and often takes months or years to form.
If it appears suddenly though, pay attention. It may be a warning sign of skin cancer, says the American Academy of Dermatology (AAD). Acanthosis nigricans can also be an early warning sign of diabetes. Be sure to get in touch with your doctor.5
How it’s managed: Your doctor may prescribe creams or gels to lighten the skin color. Laser treatments can help, too. You may also take antibiotic creams to make your skin feel more comfortable. And retinol pills or creams can help clear up your skin’s appearance.5
3. Acne keloidalis nuchae
This looks a lot like acne or razor bumps on the back of your neck and scalp. It’s a pretty common skin issue that makes your skin bumpy.
How it’s managed: The right treatment can get rid of bumps and reduce the risk of scarring. Medicated cleansers and shampoos can help prevent infection. And your doctor may prescribe creams or an antibiotic to treat an infection around your irritated skin. They can also treat your skin with laser therapy.6
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4. Hidradenitis suppurativa
Have you noticed painful lumps deep in your armpits, inner thighs or groin? If so, you may have hidradenitis suppurativa (HS). Experts aren’t sure about the exact cause. But it typically begins to develop when hair follicles become blocked.
HS often appears as a tender spot that looks like a deep pimple. It can also look like a boil (a bump that’s infected and filled with liquid).
How it’s managed: Your doctor may prescribe creams that you apply to the area of your skin that has HS. If your HS is more advanced, you may take a pill that works through your entire body. Sometimes painful or infected lumps can be treated with surgery. Your doctor can drain a painful lump, cut off the skin on top of a lump, or treat it with lasers.7
Melanoma is the most serious kind of skin cancer. It often shows up as a new spot on your skin. Or it could be an old spot that changes in size, shape or color. It can even look like a sore that won’t heal or a patch of skin that’s rough and dry.8 If you notice any of these skin changes, see a dermatologist ASAP.
It can also show up in places you might not expect, such as your hands and feet. In fact, the hands and feet are the most common places melanoma is found in people of color.9 It can also show up underneath your nails, on the soles of your feet or your palms, or between your fingers and toes.
People of color have more melanin in their skin. That can keep them from getting skin cancer as often as fair skinned people. But when people with darker skin tones do get it, it’s often found much later.10 That makes it more deadly because it can’t be cared for as early.
How it’s managed: Your treatment depends on how deeply the melanoma has grown into your skin and if it’s spread to another part of your body. Your doctor may perform surgery to remove the cancer. Other treatments may include T-cell therapy, which uses your immune system to fight the cancer.10
Rosacea can be easy to miss in people with darker skin tones.11 It causes redness in lighter skin tones and a rash on the nose and cheeks. If you have a darker skin tone, you might feel warm. The affected skin might have a darker brown color, says the AAD. Your skin might sting and burn when you apply skincare products. It might even get puffy or break out in a rash that looks like acne but doesn’t clear up. Rosacea can also affect your eyes. You may notice symptoms like redness, crusty eyelids, and tearing.
How it’s managed: Your doctor will talk to you about skin care tips that ease symptoms. You can use mild cleansers and skip harsh deodorants or soaps. And some prescription medications can help.12
7. Seborrheic dermatitis
This causes flaky skin on oily areas of your body. The scalp or face are common places. If you have a darker skin tone, your rash may be pink, slightly purple or lighter than the skin around it. Or you may have dark spots or patches on your skin. In the United States, Black people are most likely to have this problem.13
How it’s managed: Your doctor may suggest an over-the-counter or prescription dandruff shampoo. Or they may prescribe medications you apply to your scalp to soften thick crusts. You may also get a short-term prescription to stop any swelling or discoloration.14 Do any of the above symptoms sound familiar? See your dermatologist for care.
Try these care tips for darker skin tones
Take your skin care into your own hands. Use these tips to help keep your skin from the sun and keep it clear and healthy.
Protect your skin from the sun. Yes, darker skin tones need sunscreen to protect against skin cancer. Use a broad-spectrum sunscreen with an SPF of at least 30 on any exposed skin every day. Dr. Levine suggests finding a sunscreen with iron oxide. That keeps visible rays from entering your skin, she says. (You can stock up on important health products, like sunscreen, at Optum Store. It has the items you love at everyday low prices. Shop now.) Other smart moves: Wear a wide-brimmed hat, wear sun protective clothing, and seek shade during the hottest part of the day.
Do a regular full body check. Melanoma often appears on skin that gets too much sun. Do a head-to-toe scan of your skin on a regular basis (including your scalp). Pay special attention to your hands and feet. Keep your eye out for a new spot or growth, a sore that doesn’t heal or a pinkish-red spot. Find something? See a dermatologist.
Ask about seeing a dermatologist. Maybe you never find a suspicious skin growth or spot. A dermatologist can help find and care for any skin problems you may have. They will also do a full-body skin cancer check. Ask your doctor if they think you should see a dermatologist, and how often you should go.
The big takeaway: Take the lead in caring for your skin. Be aware of any changes and let your doctor know if you notice anything you’re concerned about. And most of all, protect your skin from the sun. A bottle of sunscreen and a wide-brimmed hat are your best friends for healthy skin. Don’t leave home without them. Learn more ways to keep your skin healthy here.
- Skin Cancer Foundation. Skin cancer in people of color. Published July 5, 2020. Accessed February 28, 2023.
- British Journal of Dermatology. Under-representation of skin colour in dermatology images: not just an educational issue. Published June 2019. Accessed February 28, 2023.
- National Center for Biotechnology Information. Postinflammatory hyperpigmentation. Last reviewed October 2022. Accessed March 15, 2023.
- National Library of Medicine. Postinflammatory hyperpigmentation. Published October 3, 2022. Accessed March 30, 2023. 5. American Academy of Dermatology. Acanthosis nigricans: signs and symptoms. N.d. Accessed March 5, 2023.
- American Academy of Dermatology. Acanthosis nigricans: diagnosis and treatment. N.d. Accessed March 30, 2023.
- American Academy of Dermatology. Acne keloidalis nuchae: diagnosis and treatment. Last reviewed July 28, 2022. Accessed March 30, 2023.
- American Academy of Dermatology. Hidradenitis Suppurativa: diagnosis and treatment. Last reviewed May 3, 2022. Accessed March 30, 2023.
- Cleveland Clinic. Skin cancer. Last reviewed November 19, 2021. Accessed February 28, 2023.
- American Academy of Dermatology. Skin cancer in people of color. Accessed February 28, 2023.
- Skin Cancer Foundation. Skin cancer in people of color. Last reviewed September 2022. Accessed March 30, 2023.
- American Academy of Dermatology. Skin cancer types. Melanoma diagnosis and treatment. N.d. Accessed March 30, 2023.
- American Academy of Dermatology. People with darker skin tones can get rosacea. N.d. Accessed March 30, 2023.
- American Academy of Dermatology. Rosacea Treatment. N.d. Accessed March 30, 2023.
- 5. American Academy of Dermatology. Seborrhiec dermatitis. Accessed February 28, 2023.
- American Academy of Dermatology. Sebhorrheic dermatitis: diagnosis and treatment. Last reviewed December 6, 2022. Accessed March 30, 2023.
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