Everyone’s skin is unique and has its own set of problems, but African American skin conditions can be more common due to sensitivity, lack of available treatments geared toward issues seen in darker skin types, and the use of generic hygiene products that aren’t ideal for African American skin care. If you’re struggling with maintaining healthy, flawless skin, you’re not alone. In this blog, we’ll review some of the many common skin conditions that people of color struggle with.
1 – Melasma
This is a skin condition commonly seen in African American women between the ages of 20 and 40. It typically presents with symmetrical, brown blotches seen as an irregularity within the facial pigmentation. While it’s most common in adult women, men, children, and older adults can also develop this condition.
Melasma can cause embarrassment, but according to Dr. Calvin Williams from U.S. Dermatology Partners Keller, “Melasma isn’t painful, and best of all, it can be easily treated. Often, patients achieve improvement with over the counter hydroquinone creams like Esoterica and Porcelana. There are also numerous prescription products and professional treatments available for more severe cases.” Some of the more advanced professional treatments may include advanced topical hydroquinone combination treatments, oral medications, and microneedling. But as always, sunscreen is the backbone of treatment for this condition.
2 – Vitiligo
This skin depigmenting disorder occurs due to the loss of melanocytes (pigment cells that produce melanin that create different skin tones). The main symptom is large patches of milky-white skin that can appear anywhere on the skin. While this condition can affect men and women and those of any race, it is most noticeable and stigmatized for those with darker skin tones.
While research is ever-changing, treatment for vitiligo will be customized to address your unique situation. Most treatment options are geared toward restoring lost pigmentation and creating even skin tones. Some patients choose to use at-home products like concealers to restore natural color, but this is usually not a good long-term solution. A dermatologist can provide a number of treatment options, including topical medications, light treatments, and surgical skin grafts.
3 – Confluent and Reticulated Papillomatosis (Gougerot-Carteaud Syndrome)
Confluent and reticulated papillomatosis (CARP) is a very rare skin condition that typically affects adolescents, teens, and young adults. This condition may also be referred to as Gougerot-Carteaud Syndrome named after the discoverers of this skin problem who attempted to develop treatment for the first treatment. CARP occurs when keratin levels are disordered. In most cases, people will see blueish-gray to skin-colored papules on the abdomen, back, and neck. These skin patches or papules don’t usually contain any mucus or pus, and they are completely painless. Though, some people do experience mild itchiness.
There is no known cause of this skin condition. Many studies have looked into potentially underlying hormonal shifts and bacterial infections. In most cases, patients receive topical and/or oral antibiotic treatments that are very effective in reducing the appearance of CARP.
4 – Post-Inflammatory Hyperpigmentation
Post-Inflammatory Hyperpigmentation (PIH) is a condition that occurs after a skin injury or inflammation. This condition causes the skin surrounding and at the site of injury or inflammation to produce larger amounts of melanin, which can lead to darker skin color. While PIH can affect almost anyone, those with darker skin colors tend to be more commonly affected, have more severe and persistent cases, and also have the most concerns about the pigment irregularities.
In most cases, treatments for PIH will be the same as those available for Melasma, including over the counter or prescription topical medications, hydroquinone therapy, and sun protection.
5 – Folliculitis & Pseudo-Folliculitis Barbae (Razor Bumps)
Folliculitis and Pseudo-Folliculitis Barbae is the medical terminology used to describe the razor bumps that can affect anyone in all areas of the body where the hair is shaved, plucked, or waxed. This condition occurs when the body has an adverse, inflammatory response to shaving usually due to folliculitis (ingrown hairs). It is very common among African American males.
Most cases of folliculitis and pseudo-folliculitis barbae are due to damaging hair removal products or techniques. Making changes to your grooming practices, such as switching for shaving with razors to trimming the hair with clippers will typically help to ensure you avoid this condition or improve it. For severe cases or those that don’t clear up on their own, a dermatologist may prescribe antibiotic gel and/or oral antibiotics, a topical steroid or retinoid, and/or laser treatments.
6 – Acne Keloidalis Nuchae
Acne Keloidalis Nuchae (AKN) usually affects the hair growing around the nape of the neck, and it can last for years. It occurs when hairs on the back of the head and neck grow into the skin. This causes inflammation and can lead to scar tissue. This skin condition most often impacts people of African descent, and it is 20 times more common in males.
Treatment for AKN may include topical antibiotics and steroidal gels to suppress inflammation. A dermatologist may also recommend steroidal injections. Serious cases may require surgical removal. In early cases, laser hair removal has proven to be an effective preventive measure.
7 – Traction Alopecia
Traction alopecia is a form of hair loss that occurs due to tension on the scalp. African Americans often develop traction alopecia secondary to the tension due to normal hair styling practices. The repeated tension leads to hair loss, inflammation, and presents a risk of permanent hair loss.
The easiest way to avoid traction alopecia is to wear styles that have low tension forces. If you’ve already experienced traction alopecia we may recommend changing your hair styling practices, adding in supplements to repair damage and strengthen your hair, and also topical medications that can aid with symptoms patients may have from inflammation.
8 – Acanthosis Nigricans
Most common in people with diabetes, those with dark skin are also at significant risk for developing acanthosis nigricans. This skin condition causes hyperpigmentation (darkening) and hyperkeratosis (thickening) of the skin. Most people notice these effects in skin folds like armpits (axilla), the groin, and the back of the neck. They look like thick, brown patches, and they have a velvety texture.
Treatment for acanthosis nigricans is typically targeted to address the four main symptoms of this condition – skin color, thickness, odor, and pain. The color and clarity of skin may be improved with prescriptions topical treatments as well as oral and/or topical retinoids. Laser therapy has proven effective in addressing skin thickness. If the skin affected by acanthosis nigricans has a strange odor, this is likely due to bacteria. We will recommend the use of topical antibiotics and regular cleaning with antibacterial hand soaps.
9 – Dermatosis Papulosa Nigra
Dermatosis papulosa nigra, often simply referred to as DPN, is a skin condition that causes small black or brown spots to develop. These spots usually appear on the face. Some also develop these spots on the neck, back, and chest. Most of the spots are relatively flat, but others hang off of the skin like a skin tag.
This is a benign condition that does not typically cause any discomfort and isn’t associated with any serious health conditions. Most people choose to forego treatment for this condition, but there are surgical removal methods available in severe cases.
10 – Keloids
A keloid is an atypical scar formation that results from injury. They can impact any part of the body, but keloids are most common on the chest and shoulders. A keloid scar can appear right after an injury, or it may take months to develop. In addition to this unpredictable development, there’s no specific indicator of what types of wounds will lead to keloid scars.
Treatment for keloids may include steroid injections, moisturizing oils, using silicon pads, cryotherapy, and surgical removal in severe cases with a well-designed aftercare to aid with preventing recurrences.
11 – Psoriasis
The symptoms of psoriasis are most noticeable on the skin and nails, but it’s actually an autoimmune condition. Psoriasis causes an overgrowth of skin cells leading to thick, scaly plaques. This condition is more common in people of European descent, but some researchers believe this may be due to a lack of accurate diagnosis in the skin of color. The National Psoriasis Foundation has dedicated research and training to help dermatologists make more accurate psoriasis diagnosis for African Americans and other people of color.
Psoriasis cannot be cured, but with proper care and maintenance, most people are able to control the symptoms of this autoimmune condition. Some of the treatments that may be used included phototherapy (light) with narrowband UVB, injections, oral and topical medications, moisturizers, and behavioral changes to reduce stress and other contributing factors.