During Black History Month, we take the time to honor people of color who have made a difference and continue to work toward positive change in our world. It’s also an opportunity to increase awareness of and shed light on areas where people of color are underrepresented or misrepresented. According to Certified Family Nurse Practitioner Tashara Lester of U.S. Dermatology Partners in Carrollton, Texas,  “People of color are much less likely to seek treatment from a dermatologist, and there is a deficit of research into how skin conditions impact skin of color. Black History Month is an opportunity to reach out to patients of color as well as educate dermatologists and other skin care professionals about common skin conditions seen in this population.” 

1 – Post-Inflammatory Hyperpigmentation
Following an injury to the skin, people of color are at risk for post-inflammatory hyperpigmentation (PIH). This condition occurs when inflammation causes the production of elevated levels of melanin in the skin around a wound. Melanin is what gives our skin its pigment, so higher levels of melanin production in one area can lead to darkening of skin called hyperpigmentation. PIH can affect anyone, but it’s much more common in people of color. Additionally, hyperpigmentation cases tend to be more chronic and conspicuous in people with darker skin tones. The good news is that treatment for hyperpigmentation can be as simple as applying a topical treatment like hydroquinone or cysteamine or having a chemical peel and most importantly enhancing your sun protection plan.

2 – Melasma
Melasma causes patches of discolored skin to develop on the face, usually on the forehead, upper lip, and cheeks. While melasma can impact anyone, Ms. Lester says, “Women of color between the ages of 20 and 40, especially those who are pregnant, who have recently given birth or are using an oral contraceptive are much more likely to develop this condition. The good news is that melasma is treatable.” Like post-inflammatory hyperpigmentation, melasma is most often treated using topical hydroquinone creams and taking care to protect skin from sun exposure. For more advanced cases of melasma, dermatologists may also recommend oral medications, micro-needling, or other treatments.

3 – Vitiligo
Unlike hyperpigmentation and melasma which cause darker areas of skin, vitiligo is a condition that causes depigmented (light) patches of skin to form on various parts of the body. While anyone of any skin tone can develop vitiligo, it is much more noticeable in people of color who are more likely to seek treatment for vitiligo. Depending on the severity of vitiligo and how the individual’s skin responds, treatment plans may include topical medications, light therapy, or even skin grafts. For mild cases of vitiligo that affect areas of the skin that aren’t frequently exposed, patients may opt to forego treatment.

4 – Ingrown Hair & Razor Burn
Folliculitis or ingrown hairs are much more common for men of color. When hairs regrow or grow in beneath the skin rather than through the skin, they’re considered ingrown. When this happens, patients see a red bump and irritated area on the skin. Prevention is the best treatment for folliculitis. By making some changes to shaving habits, most people can avoid ingrown hairs. For more severe cases of folliculitis, your dermatologist may prescribe oral and/or topical antibiotics, steroid creams, topical retinoid, or laser treatments.

5 – Abnormal Scarring
According to Ms. Lester, “Scarring can be a problem for anyone of any skin tone, but people of color are much more likely to experience abnormal scarring. Keloid scars, which are large lumps of skin that develop after an injury, are a common type of abnormal scars that are more frequently developed by people with darker skin tones. Additionally, people of color are more likely to develop acne scars. When dermatologists and other medical professionals are aware of an increased risk for abnormal scar tissue development, they can take steps to prevent these concerns.” In addition to preventive measures taken during the treatment of injuries or during surgical procedures, your dermatologist can also provide at-home care tips to prevent scarring as you heal. This may include using moisturizing oils, silicon pads, and compression garments as the skin heals. After scars have formed, the dermatologist may use steroid injections or surgical removal.

6 – Eczema
Eczema is a chronic skin condition that can affect anyone. On darker skin, eczema appears as dryness with pink, purple, brown, or gray inflamed skin tissue below the affected areas. Eczema is typically treated by switching to gentler cleansers, avoiding products with perfumes and dyes, and applying moisturizer frequently. Like acne, eczema is much more likely to cause scarring and skin discoloration in people of color, so it’s important to work with your dermatologist to develop an appropriate treatment plan.

7 – Skin Cancer
Ms. Lester says, “The good news is that skin cancer is much less common in people of color, but the bad news is that it’s often diagnosed in significantly more advanced stages. Again, prevention is the ideal method for avoiding skin cancer. You should apply sunscreen daily. To avoid an unpleasant cloudy appearance on the skin, you may want to use a tinted physical sunscreen or a chemical sunscreen. You should also check your skin at home regularly to look for changes and schedule an annual professional exam with your dermatologist.”

8 – Psoriasis
Psoriasis is a common cutaneous disorder that causes the overgrowth of skin cells, leading to thick, scaly areas of skin called plaques. While psoriasis seems to be more common in people with lighter skin tones, research indicates this may be due in part to misdiagnosis of the condition in people of color. Those who are diagnosed with psoriasis need to work with a dermatologist to develop a plan to address the symptoms of psoriasis as well as the underlying autoimmune dysfunction.

9 – Traction Alopecia
Traction alopecia is hair loss that happens when too much stress is placed on the hair. Common hair care products and styles can overtax the scalp, leading to hair loss. According to Ms. Lester, “Routinely styling your hair in tight braids or ponytails for too long can lead to traction alopecia in any patient. Changing your hairstyle regularly is a great way to prevent this condition. If you’re already experiencing traction alopecia, we can sometimes stimulate follicles using a variety of injections or topical medications.”

Daily Care Routine for Skin of Color
Ms. Lester says, “Everyone’s skin care needs are different, so it’s always best to work directly with a dermatologist to develop a unique routine. In general, I always recommend that my patients keep things simple. Use gentle cleansers for your face and body, and apply moisturizer after washing your face or bathing. It’s also important to take care when shaving, waxing, or using other methods of hair removal.”