Read Full Article HereHave you ever noticed an unusual bump, spot, or scar on your skin and run it by a search engine, only to be met with a bunch of pictures that don’t match your skin tone? Many Black and brown folks know this experience all too well. Often, the lack of representation of skin conditions on our complexions can leave us feeling even more confused as we try to figure out what’s going on.
There’s an array of conditions that affect every skin tone, but many of these look different on melanated skin than on white skin. A handful of these issues also affect Black and brown skin disproportionately. A 2025 medical article from the Journal of the European Academy of Dermatology and Venereology states that “conditions like post-inflammatory hyperpigmentation and melasma are more prevalent and often more severe in individuals with skin of color.”
To further increase awareness and resources around caring for skin of color, we’ve created a guide to the most common conditions for those with darker skin, breaking down exactly what you need to know to identify and treat them.
What is melanin and how does it affect skin health?
Before we talk about how to properly treat melanin-rich skin, it’s important to know exactly what melanin is. Melanin is the pigment that causes your skin color. There are two types of melanin: eumelanin (brown pigment) and pheomelanin (yellow pigment).
A quick search of the hashtags #melanin and #melaninqueen on Instagram validates that the term “melanin-rich skin” has become mostly associated with darker skin tones. But Jenna Lester, MD, a board-certified dermatologist in San Francisco, says most people have some sort of balance of the two types of melanin.
Depending on a person’s skin color, they may have more of one type than the other. In general, eumelanin is more prevalent in people with darker skin. “So it’s not that people with dark skin have more melanin; they just have more of a different type of melanin,” says Dr. Lester.
Why skin conditions can look different on dark skin
Since Black and brown skin has more eumelanin, certain skin conditions may present differently on darker skin tones than on lighter complexions. Take post-acne marks, for example. They might appear as post-inflammatory erythema [redness] on fairer skin, while they “look more brown [on dark skin] or even more purplish,” explains Esther Henebeng, MD, a board-certified dermatologist with U.S. Dermatology Partners Fairfax. “So if the photo that you’re seeing online is a stock photo on white skin, but when you look in the mirror, and you see Black skin, you might not identify the issue.”
Common skin conditions on dark skin (at a glance)
Condition How it appears on dark skin When to see a dermatologist Post-inflammatory hyperpigmentation Dark spots of varying sizes and on different areas of the skin where injury has occurred. If spots persist for months without progress or cause distress. Melasma Darker patches of skin, commonly seen on the upper lips and cheeks. If patches worsen or cause distress. Vitiligo Patches of skin that are lighter than the pigment all over the body. If patches spread or cause distress. Keloids A thick, dense, hard lump on the skin that can range in size. When scars are painful, itchy, or increase in size. Dermatosis papulosa nigra Small, flat, brown to black lesions that slowly become larger in size with time. If lesions change, bleed, become inflamed, or affect confidence. Traction alopecia Hair loss and thinning, accompanied by scalp tenderness, pain, and pimple-like bumps in the areas of highest tension—typically the hairline. If you experience scalp sensitivity or see hair loss or thinning. Central centrifugal cicatricial alopecia, (CCCA) Hair loss at the crown of the head that spreads outward. At the first signs of hair loss, early diagnosis helps prevent further loss. Pseudofolliculitis barbae Small pimples that can also be paired with ingrown hairs. Depending on the severity, they can occur in rash-like clusters and can cause irritation and itching. If bumps are recurrent, painful, or irritated. Acral lentiginous melanoma Dark brown or black spots or streaks on the palms, soles, or under the nail bed. If the spots or streaks change in color or size, or if you notice a new or irregular mark. Acanthosis nigricans Dark, velvety, or thickened skin often on the neck, armpits, groin, or knuckles. Immediately, to rule out underlying conditions like insulin resistance. Seborrheic Dermatitis Dark or hypo-pigmented patches with flaky scales, often on the scalp, eyebrows, nose, and ears. If the condition is severe, persistent, itchy, or causes hair loss.
