Common Conditions in Dark Skin
There is a common misconception that people with darker skin do not have to be as vigilant about sun protection as their fair-skinned counterparts. But all skin types, no matter what shade or color, are at risk for skin cancer and other dermatologic conditions.
Melanoma is the most dangerous type of skin cancer. While it is not as prevalent in darker skin, it is often diagnosed at an advanced stage because of where it tends to appear, like in and around the nails, or on the palms, soles, mouth or genitals. “While these locations are relatively uncommon for melanoma, they account for a higher percentage of melanomas in people with darker skin because these patients develop fewer sun-related melanomas,” said Beth Israel Deaconess Medical Center dermatologist Dr. Shalini Vemula. She encourages people to be aware, perform self-check-ups monthly, and have any new or changing spots examined by a dermatologist.
Acne is one of the most common skin problems affecting young adults of all races and both genders. It often starts in teenagers and can continue into adulthood, particularly in women. After it heals, acne can often leave behind dark spots in darker-skinned people. “More often than not, the dark spots are more frustrating than the acne itself, and can linger for several months to years,” said Dr. Vemula. She urges people to not pick or scratch their acne in any way, as it can make the dark spots more prominent. In addition, she recommends that people limit sun exposure and use daily oil-free sunscreen to help the dark spots clear faster.
Known as the “itch that rashes,” eczema is an intensely itchy rash that primarily affects children but can persist into adulthood. It usually appears as dry, red, flaky skin on the face, neck, inside of the elbows, and back of the knees. In darker skin, it can have a darker undertone such as a deep pink, brown or gray hue. Similar to acne, eczema often heals with dark spots on darker skin. Dr. Vemula suggests those battling eczema use gentle skin care techniques, including avoiding hot showers, wearing loose-fitting clothing, using gentle fragrance-free soaps and creams and avoiding any products with fragrances.
Scarring is normal after a skin injury, but in some cases, scar tissue grows excessively, forming harmless, but sometimes itchy or painful, smooth, hard growths called keloids. They are more prevalent in African American and South Asian people. According to Dr. Vemula, people that are prone to developing keloids should weigh the pros and cons of any procedure that will affect their skin, such as ear piercings, tattoos and cosmetic procedures. “Surgery can also cause keloids to develop but people should not decline necessary surgical procedures for fear of developing a keloid since it’s a benign scar that can be treated,” said Dr. Vemula. Though treatment can be difficult, steroid shots injected directly into the keloid can help with itching, pain and size reduction.
Melasma is one of the most common pigment disorders in women of Hispanic, Asian or African decent. It appears as brown patches on the face, most commonly on the cheeks, upper lip and forehead. Although the exact cause is unknown, studies have shown an association with sun exposure, hormones from pregnancy and birth control pills. For treatment, Dr. Vemula recommends using a broad-spectrum sunscreen with SPF 30 or higher that contains zinc, titanium or iron oxide, and seeing a dermatologist to discuss other cosmetic treatment options.
Vitiligo is a condition that results in loss of skin color (white patches) that can affect any part of the body, including the skin around the eyes and mouth, chest, hands, and groin. All races are equally affected but the skin depigmentation is much more prominent in people with darker skin. “We see more dark-skinned patients present to our office because of the great impact it can have on the quality of their life,” said Dr. Vemula. She recommends regular use of sunscreen because it can protect vitiligo patches that are at greater risk for sunburn and also can limit tanning of normal skin. Treatment options include prescription creams and ointments, laser therapy and phototherapy (light therapy), but success is variable.
“Skin is the body’s largest organ – it performs many vital functions for the body so it’s crucial to take good care of it,” said Dr. Vemula. Please speak to your doctor or a dermatologist if you notice any skin changes.
The Department of Dermatology at BIDMC offers a variety of care and treatment services for all types of skin conditions.