Treating Acne in Dark-Skinned People: A Few Pointers

Acne in dark-skinned people has its special challenges, especially among African-Americans

While acne is never a fun experience, acne in dark-skinned people often presents differently than it does in their lighter-skinned brethren. For one thing, while it's still just as common, in many cases it's less obvious, so it gets less attention. But that doesn't mean it's a walk in the park.

Dark-skinned individuals, especially those of African descent, do face significant dermatological challenges. So let's take a closer look.

Positive and Negatives

The good news is that people with dark skin are more likely to have inflammatory acne than any other type, with fewer cysts and nodules than the lighter-skinned. But post-inflammatory scarring is more common with dark skin, especially on the chest and back.

African-Americans may also suffer from a condition called hyperpigmentation. As an acne lesion heals, the pigment melanin may concentrate in that location, leaving dark spots that many people find more distressing than the pimples themselves.

Given such responses to acne, preventative treatment becomes more important than ever.
Treating the Acne

Benzoyl peroxide works very well for dark-skinned individuals. Although it may dry out and peel the skin, it typically causes less flakiness and scaling than in people with lighter skin tones.

However, some commentators claim that benzoyl peroxide may "decolorize" the skin in some cases, while prolonging hyperpigmentation in others. Accutane and prescription retinoids (like adapalene and tretinoin) may be better choices.

Treating the Hyperpigmentation

Post-inflammatory hyperpigmentation gradually fades over time -- but not nearly fast enough for those who experience it. Cosmetics can help hide the spots, though those who use it run the risk of causing more clogged pores if they're not very careful.

Other people turn to skin-lighting products, which can help if used as directed. Some are available over-the-counter; others require prescriptions. If you suffer from hyperpigmentation, check with your dermatologist before using these products, so you can learn how to apply them most effectively.

A Special Case

A while back, I wrote about the problem of pomade acne, which results when oily hair treatments clog pores on the scalp, forehead, and temples, causing acne breakouts as a result. This phenomenon is especially common among African-Americans who use pomades to style their hair.

Also called "acne cosmetica," pomade acne is distinct from everyday "acne vulgaris" and more easily treated. Basically, all you have to do is stop using the oily pomade or switch to a water-based version, and your skin will soon clear up.

The Bottom Line

People of color are less likely to suffer from obvious acne, and don't get non-inflammatory acne as often as light-skinned people. However, acne in dark-skinned people does have its complications, particularly hyperpigmentation, and pomade acne may occur with the use of oily hair products.

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