Skin of Colour
While the term “skin types” can mean, for example, how dry or oily your skin is, dermatologists often have to differentiate between different skin types based on the effect of ultraviolet radiation (UVR) from the sun on their skin, and that is what we are referring to in this section. Doctors often use the Fitzpatrick scale to establish a person’s skin type, which assesses the appearance of the skin, eyes and hair and also how skin reacts to UVR. The section on the skin’s appearance is illustrated below, but as there are variables within each skin type and the final skin type is based on a total score from a range of questions, these are just examples. Your skin type cannot be changed and does not vary according to how tanned you are –it is determined by your genes. When talking about skin of colour or darker skin types there is no concrete definition, however, in this context we will be referring to Fitzpatrick types V (5) and VI (6). Broadly speaking, this group encompasses people of diverse geographic ancestral origin, including some people of African, Caribbean and Asian origin, as well as people of mixed ancestry. Skin diseases can affect anyone, but some conditions are more common, or appear differently, in people with skin of colour, and you can find outmore about some of these towards the bottom of this page.
Skin burns very easily in the sun and never tans. This is the palest skin type. For example, people with skin type 1 usually have very fair or red hair and freckles and light blue/green eyes.
Skin usually burns in the sun and tans minimally. For example, type 2s may have either light or dark hair but the skin is naturally pale. They usually have blue or green eyes and may have freckles.
Skin can burn after long or intense sun exposure, but generally tans quite easily. For example, someone with type 3 skin may have dark blonde or chestnut hair and blue, green, hazel or light brown eyes. They may have a few freckles.
Tans easily, but could possible burn with lengthy exposures to intense sunshine. Sometimes this skin type is referred to as olive skin. For example, people with skin type 4 usually have dark hair and brown eyes and rarely have freckles.
Skin can darken easily with sun exposure and doesn’t generally burn unless exposure to the sun is very intense. For example, skin type 5 is naturally brown skin with dark hair and brown eyes and no freckles.
Skin is the most deeply pigmented skin type, with dark brown eyes and black hair. Skin type 6 does not sunburn and will not have any freckles.
Skin diseases can affect anyone, but some conditions are more common, or appear differently, in people with skin of colour. These include the following:
Acne and scarring: Acne affects all skin colours, but its appearance and scarring can vary in different skin tones. In darker skin types, dark patches can appear on the skin when an acne cyst (spot) has cleared. Skin of colour is also more prone to keloid scars, which are covered in this section. The earlier acne is treated, the less likely it is that you will experience dark spots and scarring. If you’re looking for products to treat mild acne, ingredients to try are a retinoid, salicylic acid and benzoyl peroxide. There is a concern that benzoyl peroxide can bleach the skin but the American Academy of Dermatology has debunked this myth. Hair oil, cocoa butter and shea butter can clog pores and cause spots. Look for skincare products that are labelled “non-comedogenic” or “won’t clog pores.” For more information, visit www.acnesupport.org.uk
Keloids: When a wound heals, it leaves a scar. A keloid is a scar that overgrows and becomes larger than the original wound. It is not uncommon for a scar to become slightly thick and raised, but keloids are a bit different. For example, they can develop after very minor skin damage, such as an acne spot, or sometimes without any obvious trauma to the skin (spontaneous keloids); they spread beyond the original area of skin damage, and they may be permanent. Keloids can affect anyone, but they are more common in skin of colour. For more information visit our page on keloids.
Melasma: Melasma, also called ‘chloasma’, is a common skin condition in which brown or greyish patches of pigmentation (colour) develop, usually on the face. The exact cause is not known, but it is thought to be because of pigment-producing cells in the skin (melanocytes) producing too much pigment (melanin). Several factors can contribute to developing melasma, including pregnancy and using hormonal drugs such as birth control pills and hormone replacement. For more information visit our page on melasma.
Post-inflammatory hyperpigmentation (PIH): Postinflammatory hyperpigmentation causes skin to darken following an injury or skin condition, such as a burn, eczema or infection. It is more common in darker skin types. This darkening is usually temporary, but more severe injury can lead to postinflammatory hypopigmentation, which is usually permanent, and causes lightening rather than darkening of the skin.
Pseudofolliculitis (razor bumps): Pseudofolliculitis, also known as ‘shaving bumps’, or ‘razor bumps’, is inflammation of hair follicles and surrounding skin, caused by hairs trapped beneath the skin surface. It is similar to folliculitis, which is inflammation of hair follicles due to infection, but the inflammation in pseudofolliculitis is not primarily due to infection. Pseudofolliculitis is typically seen on the face and neck of men who shave, when it may be called pseudofolliculitis barbae, (“barba” being the Latin word for a beard). It is more common in men of sub-Saharan African lineage, however it can affect men and women of all ethnicities inany body area where hairs are coarse, abundant and subject to shaving, waxing and tweezing. For more information visit our page on pseudofolliculitis.
Sun Protection: Sun protection advice for skin of colour is different for those with lighter skin types. Naturally occurring biological agents in the skin absorb a proportion of UV radiation (UVR), with melanin being one of these. People with the darkest skin, for example those of African descent, have the most melanin and so are usually best protected from the sun. Just because your skin may have some natural protection from the sun’s UV rays, it doesn’t mean you are completely resistant to sun damage. In the UK, sun protection to avoid sunburn is probably unnecessary in people with darker skins, especially very dark brown skin. Our page on Sun Advice for Skin of Colour covers this in detail.
Vitiligo: Vitiligo is a condition in which areas of skin lose their normal pigment (colour) and become very pale or pink. It is often symmetrical, affecting both sides of the body, although sometimes it can be localized to one part of the body. The skin otherwise feels entirely normal. The most common sites for vitiligo are the hands and face, around body openings (the eyes, nostrils, mouth, navel and genital regions), and within body folds such as the underarms and groin. When hair-bearing skin is involved, the hair may lose its pigment and appear white. Vitiligo affects men and women of all ethnicities equally, but it tends to be more noticeable in people with skin of colour. For more information visit our page on vitiligo.