Recognizing Common Skin Conditions on Diverse Skin Tones

February 28, 2024

Photo of African American Family - Understanding skin conditions for skin of color

People of color don’t always receive an accurate skin health diagnosis, or they may receive the right diagnosis without a treatment plan that fits their needs. According to Dr. Kassahun Bilcha of U.S. Dermatology Partners in Frederick, Maryland, “From differences in the appearance of certain skin health concerns in people of color to doctors who don’t have the necessary knowledge to advocate for appropriate treatments, those with darker skin tones may not get the same dermatologic care as those with lighter skin tones. I’ve worked hard to ensure I provide culturally sensitive care and develop a greater understanding of the unique needs of those with diverse skin tones.” In this blog, Dr. Bilcha reviews common skin conditions for people of color as well as challenges to diagnosis and treatment related to these conditions.

Common Skin Conditions on Skin of Color

When it comes to common skin conditions in people of color, Dr. Bilcha says, “People with darker skin struggle with all of the same skin health concerns that people with lighter skin have, but they may experience some skin conditions more often or differently compared with those who have lighter skin tones. By understanding these conditions and their common symptoms, people of color can become better advocates for themselves to receive the dermatologic support they need.” Below, you can learn more about common skin conditions often experienced by people of color:

  • Melasma – This condition is caused by the overproduction of melanin, skin pigment produced by pigment-forming cells called melanocytes, in certain parts of the body. Darker skin has higher concentrations of melanocyte cells naturally, which makes people of color more susceptible to developing melasma. In people of color, melasma creates dark brown, black, gray, or even blue patches or spots on the sun-exposed parts of the face, arms, or torso.
  • Hyperpigmentation – Melasma is one common form of hyperpigmentation, a condition that causes darker spots to develop. Hyperpigmentation can occur as a response to an injury, chronic skin conditions like acne, eczema, psoriasis, etc., or a variety of other issues, including medications.
  • Keloids – This is an irregular form of scar tissue that can develop after an injury or, sometimes, without an injury. When the healing process would normally be completed, keloid scar tissue continues to develop. What starts as the common raised areas of newly formed skin develop into large lumps or bumps protruding from the skin beyond the area of the initial injury.
  • Eczema – Also known as atopic dermatitis, this skin condition leads to itchy, dry skin that may appear red and inflamed. For people of color, this condition may be undiagnosed or misdiagnosed because darker skin tones hide skin’s redness. People of color should look for itchy patches of skin that are darker than their natural skin tone. These patches may also appear purple or gray in color.
  • Acne – While acne itself isn’t necessarily more common in people of color, the adverse effects related to acne can be. Specifically, scarring and post-inflammatory hyperpigmentation are common for people of color. It’s always important to manage acne symptoms, but for people of color, managing acne symptoms can mean the difference between clearer skin and life-long acne scarring and dark spots.

Challenges in Recognition

There are many challenges related to the diagnosis and treatment of skin conditions in people of color, beginning with recognizing skin issues in earlier stages. Common challenges to recognizing skin conditions in people of color include:

  • Poor training – Unfortunately, there are fewer case studies in textbooks showcasing skin health concerns in people of color. This means that dermatologists have less access to resources and knowledge about the proper diagnosis of skin conditions in people of color. This makes it more challenging for them to provide accurate diagnoses.
  • Difference in appearance – Skin health issues often present differently for people of color. This can lead to misdiagnosis or failure to diagnose even common skin conditions.
  • Hidden concerns – Diverse skin conditions may be more difficult to spot. They can hide in the hairline, nail beds, and other areas where they are more difficult to see.
  • Differences in treatment outcomes – People of color often have unique cultural, socioeconomic, and therapeutic needs that should be addressed more cautiously.

Preventive Measures and Treatment Options

According to Dr. Bilcha, “While skin of color is different in many ways, there are some basics that everyone should keep in mind. Skin health actually starts from the inside out. Ensuring you eat a nutrient-rich diet, drink plenty of water, exercise regularly, and get enough sleep provides significant benefits to improving the health and appearance of your skin. From there, a dermatologist can work with you to develop the best skincare routine to achieve and maintain healthy skin.” Dr. Bilcha provides the following skin care tips for keeping skin healthy:

  • Keep skin clean using gentle cleanser and toner. Do not overwash as this can dry skin. Follow up with dermatologist-recommended treatments and serums. Then, use a moisturizer to keep your skin hydrated. Even if you’re struggling with oily skin, it’s important to apply moisturizer in the morning and evening as the skin will produce greater amounts of sebum, your skin’s natural oil, without adequate hydration.
  • Wear sunscreen! While darker skin tones are less prone to burning and immediate forms of sun-related skin damage, the long-term adverse effects of sun exposure, like skin cancer and accelerated skin aging, still impact people with darker skin tones. Protect your skin with sunscreen daily to prevent serious health concerns in the future. Physical sunscreens are preferred.
  • Take steps to prevent symptoms of skin conditions or treat them right away to avoid more serious effects. Irregular scar tissue formation and hyperpigmentation are common for people of color, so the sooner damage to skin or health concerns are addressed, the less likely they are to leave a lasting mark.
  • Consistently use medications and receive treatment for chronic skin health concerns. By working to maintain healthy skin with regular dermatologic interventions and at-home care, the most serious symptoms can be avoided.

When to Consult a Professional

Discussing when to talk to a professional about skin health concerns, Dr. Bilcha says, “If you notice any changes in the appearance or texture of skin, you should have a dermatologist take a look. It will put your mind at ease and ensure you don’t need more advanced intervention to keep your skin healthy. It never hurts to have another set of eyes on an area of concern. Many people are worried that they’ll sound silly for reaching out if there’s nothing seriously wrong, but with skin health concerns, it’s always best to diagnose and begin treating issues in the earliest stages. Even if it’s nothing, we would rather know for sure.” Situations where you should see a dermatologist include:

  • New or changing moles, freckles, or skin lesions. This can be indicative of skin cancer.
  • Your skin health issue isn’t responding to consistent at-home skincare.
  • You frequently experience rashes, itching, or general skin irritation.
  • Worrying about changes in skin health or appearance is increasing.
  • Cosmetic side effects of skin conditions negatively impact confidence.

Trust Your Instincts and Talk to a Professional

At the end of the day, Dr. Bilcha says, “The choice to consult a professional is always up to you, but you don’t have to worry about skin changes. By taking a few minutes once a month to perform a self-exam and alert your dermatologist to any changes in skin health, you can receive an accurate diagnosis and appropriate treatment from a trusted professional.”

Schedule a Dermatologic Consultation

We understand that it can be challenging or even frightening to discover irregularities on your skin, but the U.S. Dermatology Partners team can help you understand changes in skin health and develop a plan to treat or manage skin conditions. If you have questions about an irregularity found on your skin, please don’t hesitate to reach out to the U.S. Dermatology Partners team to schedule a visit. You can take a few moments to fill out our online scheduling request. Once we hear from you, a local team member will be in touch to answer any questions you have and finalize the details of your appointment.

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