How These 4 Skin Conditions Impact People of Color

When it comes to ethnic skin, there are unique issues to consider.

As anyone with combination skin can tell you, not all skin is the same. For people with ethnic skin — which typically includes people of African, African American, Asian, Caribbean, Hispanic/Latino, Native American, Mediterranean, Middle Eastern and multiracial descent — there are certain considerations when it comes to skin conditions.

“Some skin conditions can occur exclusively in people with ethnic skin,” says Nada Elbuluk, MD, a dermatologist at Keck Medicine of USC and clinical associate professor of dermatology at the Keck School of Medicine of USC. “There are also skin conditions that can occur in anyone but are more common in darker skin populations. And then, there are some conditions that can occur in everybody, but they look different in darker skin and may need to be treated differently.”

Despite these differences, only a small number of dermatologists specialize in skin of color, but that’s beginning to change. Dr. Elbuluk credits an increase in research on ethnic skin and global organizations dedicated to skin of color with helping dermatologists become better equipped to treat ethnic skin.

“By seeing a dermatologist who specializes in ethnic skin, you can get to the root of your condition and start getting answers,” she says. And that can make all the difference.

Here’s how four skin conditions may affect skin of color.

1. Discolorations from acne and eczema

While acne and eczema are common skin conditions, a secondary issue that may arise for people of color is pigmentation changes, which may be more troubling than the original condition.

According to Dr. Elbuluk, one of the most common reasons people of color go to a dermatologist is for skin discoloration, which can be either a darkening or lightening.

“Skin discoloration can occur after a dermatologic condition clears up,” she explains. “You could have acne, and the acne goes away, but it leaves you with dark spots. Or you could have eczema that goes away and, again, leaves you with light or dark spots.”

There are many different types of treatment, depending on the condition and your skin type, but prevention goes a long way. Because dark spots last longer when exposed to sunlight, affected individuals should be vigilant about wearing sunscreen.

2. Melasma

Individuals of color, particularly women, are at increased risk for developing melasma, which results in dark patches, usually on the face. “It’s often related to pregnancy and hormone exposure,” Dr. Elbuluk says.

Sometimes called the “mask of pregnancy,” melasma may be caused by a hormonal change, but exposure to ultraviolet and visible light from the sun is also a cause. The light stimulates pigment-producing cells.

Melasma may resolve in a few weeks or it may be persistent and take years to go away, which is why it’s especially important to consult a dermatologist.

3. Keloid scarring

Keloid scars are known for their dense, raised appearance. They can vary significantly in size and always grow beyond the size of the original wound. They tend to occur more commonly in skin of color, particularly in people of African descent.

The first step in treatment is to limit the future development of keloid scars by attending to any underlying skin condition, such as acne. “Treatment of keloids can be challenging, but there are several options that can help reduce their size and symptoms,” Dr. Elbuluk says. Consulting a board-certified dermatologist is essential.

4. Skin cancer

Some people may think that skin of color is less susceptible to skin cancer, since melanin provides natural protection against damaging ultraviolet rays from the sun. That’s somewhat true — people with darker skin do have a lower risk of developing melanoma than people with lighter skin — but ultraviolet radiation isn’t typically the issue. According to the Skin of Color Society, almost three-quarters of the melanomas in people of color are on parts of the body that are not exposed to the sun, like the soles of their feet, palms of their hands or under their nails. Risk factors can include radiation therapy, albinism and preexisting pigmented lesions, among others.

If caught early, the cure rate for melanoma is quite high. Examine your skin surfaces regularly, and bring any concerns to your dermatologist.

When to see a doctor

“If you’re an individual of color dealing with a skin, hair or nail issue that is not improving, it’s important that you see a board-certified dermatologist, and if possible, one who specializes in ethnic skin,” Dr. Elbuluk says. “The dermatologist can properly evaluate, diagnose and treat the condition.”

Dr. Elbuluk notes that more and more board-certified dermatologists are specializing in skin of color. They have expert training and understand your skin type, skin conditions, how to evaluate them properly and the treatment options that exist.

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