While most skin problems occur in all ethnic groups, there are some skin conditions that occur more often in dark or black skin -- or when they do occur, are more difficult to treat. In other instances they may simply be more visible, causing them to seem more severe.
Fortunately, in nearly all instances, an early diagnosis -- and early treatment -- level the playing field, increasing the recovery odds and reducing severity.
Here are the most important dark skin conditions and their solutions.
Postinflammatory Hyperpigmentation in Dark Skin
The major symptom of postinflammatory hyperpigmentation is a darkening of the skin that occurs after it has been injured. A cut, scrape, burn, or even lesions that occur from acne or eczema can set the stage for hyperpigmentation to occur.
While the dark spots can fade over time, this is not a hard and fast rule. What can help, however, is seeking treatment early. Procedures that can help to some degree include chemical peels and skin bleaching -- all designed to lighten the darkened areas.
Dark spots can be prevented from deepening in color via diligent use of sunscreen.
Vitiligo (Loss of Skin Pigment) in Dark Skin
Skin gets its color from pigment cells known as "melanocytes." When those cells are damaged or destroyed, they can no longer produce pigment, causing white or "colorless" spots to appear. The spots can grow larger over time and eventually blend together so that large portions of the skin have no color.
While no one knows why this occurs, many experts suspect it is related to problems within the immune system. There is also some evidence of links to heredity.
People of any skin color can develop vitiligo, but it's most obvious on dark skin. It commonly occurs on the hands, face, upper chest, around body openings (like eyes and nose), in body folds (like armpits and groin), or at the site of an injury.
When vitiligo impacts the hair, premature gray color is the result.
One common treatment is controlled exposure to UV light, called phototherapy. This can help increase the amount of melanocyte cells at the skin's surface.
Other treatments include prescription-strength corticosteroid cream, light/laser treatments, and, in rare instances, skin grafting.
Pityriasis Alba in Dark Skin
Commonly affecting black children, this skin disorder causes round, light patches with a fine, scaly texture. It can occur anywhere, though the most common sites are the face and arms. It is considered a mild form of eczema, and usually responds well to topical therapy, such as corticosteroid cream. Unlike vitiligo, the color change is temporary and disappears after treatment.
Dark Skin That's Dry and Ashy
Any skin type or color can become dry and flaky. But when it occurs in black skin, the complexion takes on a gray, ashy appearance. This can be particularly frustrating for black women since makeup used to conceal the problem may further dry the skin and increase ashiness.
The solution is relatively simple: Frequent use of moisturizers. An over-the-counter product may be all that's needed.
Eczema and Dark Skin
This itchy, irritating rash can occur in skin of any type or color. However, according to the National Eczema Society, it occurs twice as frequently in black skin. And when it does occur, differences in the structure of black skin can cause related problems. This includes pigmentation and a thickening of the skin (a problem known as lichenification) that can also cause changes in skin color. While skin usually returns to normal once the inflammation is under control, getting the right diagnosis and treatment can be difficult. One reason is that the eczema rash itself can be harder to identify in black skin, and is often confused with psoriasis, or fungal infections.
Once the correct diagnosis is made, traditional topical eczema medications are helpful. If the source of the rash is an environmental influence, such as certain types of clothing, eliminating it can usually help control the eczema.
Flesh Moles and Black Skin
These brown or black raised spots -- called flesh moles or dermatosis papulosa nigra -- occur almost exclusively in African-Americans and most often in women. While they resemble moles or sometimes flattened warts, they are, in fact, a variant of a condition known as seborrheic keratosis. They are always benign, never lead to skin cancer, and are not harmful. However, some people do have them removed for cosmetic reasons.
Keloids (Scar Tissue) and Dark Skin
Any time black skin becomes injured, this dramatically increases the risk of keloids -- a scar that spreads beyond the boundary of the original injury and develops into a growth on its own. Most commonly occurring on the earlobes, chest, back, and arms, keloids can develop immediately following an injury or take a long time to grow. Sometimes keloids can itch, cause pain and burning, or be tender to the touch.
No one knows for certain why keloids develop, but one popular theory links them to defects in collagen production that occurs when skin is injured. Treatments for keloids include cortisone injections, radiation therapy, pressure dressings, and silicone gel applications. Keloids can also be removed via traditional or laser surgery, though they can recur.
Pseudofolliculitis Barbae (Ingrown Hairs of the Beard) and Black Skin
The shape of the hair shaft in people of African heritage is curved, not straight. This is true of not only hair on the head, but also on the face and anywhere on the body, and there lies the source of several black skin conditions.
One such common issue is ingrown hairs, a particular problem for men who shave too close. Doing so can lead to the pointed, sharp ends of the beard growing back into the skin, resulting in acne-like bumps, which in turn can become infected and/or lead to hyperpigmentation.
For some men, chemical hair removers can help, but they should never be used on a daily basis. Electrolysis, which permanently removes the hair at the root, can be helpful as well. The latest and most effective solution involves laser hair removal, combined with or without creams that slow hair growth.
nother solution is to simply shave less often (or grow a bear), and when you do shave, soften the beard with soapy lather and never shave against the direction of the stubble. Sometimes, exfoliating skin scrubs used before shaving can help.
Additionally, dark-skinned men who use a razor for trimming hair on the back of their necks can develop a similar problem known as acne keloidalis nuchae or folliculitis keloidalis. In this instance, the bumps may itch and occasionally become infected. When this happens, oral antibiotics and topical acne products, or sometimes topical or injected cortisone treatments, can help. If lesions persist and/or become severe, surgery may be necessary.
