Common skin conditions

Acne

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. 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 this is a myth, which has been debunked. For self-care, dermatologists will recommend using skincare products that are labelled ‘non-comedogenic’, which means they won’t clog pores. For example, hair oil, cocoa butter, and shea butter are all ingredients that can clog pores and cause spots. For more information on acne, treatments and self-care, visit www.acnesupport.org.uk 

Keloid scars 

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)

 Post-inflammatory 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 post-inflammatory 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, in any 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. In the UK, sun protection to avoid sunburn is probably unnecessary in darker skin tones, especially very dark brown skin. However, 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. 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 can have a greater impact on people of colour as it tends to be more noticeable. For more information visit our page on vitiligo. 

Erythema

Erythema, often referred to as redness, is one of the most common symptoms in dermatology. However, simply referring to it as redness is misleading, as it can look different from person to person, particularly those with darker skin tones.  

How to spot erythema 

Erythema (from the Greek erythros, meaning red) is a change in colour of an area of skin, caused by increased blood flow in certain capillaries. It is a symptom common to many diseases, particularly inflammatory skin diseases. 

While redness can be an obvious symptom in people with white skin tones, where the contrast is clear, this is not necessarily the case in those with black, brown and olive skin tones. An example of this is sunburn, it is a common misconception that people with dark skin tones do not burn in the sun. Although it is uncommon, it can happen, but may not be easily visible. If it does occur, it may not appear as the ‘redness’ that people generally associate with sunburn. 

The term redness itself can be misleading, as the colour change can run the spectrum of pink, red, and purple – in some cases it may be limited to a subtle darkening of the existing skin colour. 

While the signs of erythema in black or brown skin tones can be easy to miss, there are ways of spotting it. Changes in skin colouration, are often the main sign – this can be easier to spot when affected areas are compared with unaffected skin. 

There is no straightforward way to predict exactly what colour erythema will look like in an individual’s skin. It is dictated by a person’s skin tone, of which there are many more variations than most people realise, and the nature of the disease in question. 

Other signs, which even if not clearly visible may become more obvious upon touching the area in question, include: 

• Swelling, when subtle this may be appreciated with closer inspection of the skin pores, which may become more prominent and widely spaced 

• Heat, localised to the area in question 

• Surface discomfort or pain, localised to the area in question 

• Changes to the texture and contours of your skin 

In addition to this, if you suspect that inflammation is not easy to spot on your skin then it is sensible to take into consideration other potential symptoms of your condition. For example, if you have psoriasis another common symptom to be aware of would be the appearance of scaly patches of skin.