Though all of us are covered with skin, the skin that covers us comes in a wide variety of colors and textures depending on our ethnicities, our ages, the climates we live in, and the portion of our lives spent in the sun. Since the majority of the world’s population, and one-third of the population of the United States, consists of people of color, including African Americans, Asians, Indians, Hispanics and native Americans, dermatologists have to have a comprehensive understanding of all skin types and their potential skin conditions and concerns.

Even within people of the same ethnicities, the skin on every person varies from one part of the body to another. The palms of the hands and the soles of the feet, for example, are paler because they are less exposed to sunlight — even in warm climates. Beyond this, some people have freckles or age spots and certain illnesses or disorders can produce flushing, pallor, discolorations or jaundice (a yellowish cast). Injuries and surgeries, too, can result in bruising, skin irregularities, and scars that are temporary or permanent.

At Unique Dermatology & Wellness Center, we are well-trained in treating every type and shade of skin. Dr. Dyan Harvey knows that an individualized approach is needed for each patient, an approach that takes into account the particulars of his or her skin, and whether such particulars are attributable to genetics, environment or medical conditions.

What makes dark skin dark?

Skin color is determined by the amount of melanin in the skin. While everyone has the same number of cells that make melanin, some people make more melanin than others. The more melanin your skin makes, the darker your skin. People with naturally dark skin are more protected from the sun’s harmful rays and also have the advantage of developing fewer wrinkles as they get older.

The amount of melanin your body produces is basically determined by genetics, but the more you are exposed to sunlight, the more melanin your skin will produce. This is your body’s way of trying to protect you from the sun’s rays. Individuals who have darker skin to begin with are more protected than those who are fair-skinned, but the sun’s rays are damaging to everyone. While skin cancer is more prevalent in people with light skin, everyone is susceptible to the disease and everyone should use sunscreen regularly.

Skin Conditions that Affect Ethnic Skin

A number of skin conditions affect people of color more frequently, or more problematically, than they affect people with fair complexions. Skin conditions Dr. Harvey routinely treats successfully include:

Folliculitis Keloidalis Nuchae

A form of folliculitis (inflammation of hair follicle) and cicatrical alopecia (scarring hair loss) that affects the occipital scalp and nape of the neck. This condition develops almost exclusively in men and can persist for years.

Pseudofolliculitis Barbae

Commonly known as razor bumps, this condition results from shaving, and is not a result of an infection. As many as 60 percent of men (as well as others with curly hair) develop bumps and inflammation on skin they have shaved. The difficulty arises when very curved hairs grow back into the skin, causing the skin to react to it’s own hair as an invasive foreign body. Unfortunately, each time the patient shaves, the ends of the facial hairs are sharpened so they can penetrate the skin surface more easily.

A simple solution for this problem is to let the beard grow, since once the hairs have grown to a certain length they will not grow back into the skin. Even just growing a beard temporarily while applying a prescription cortisone cream can resolve the issue. For some men, shaving on alternate days and/or using a lubricating shaving gel or an electric shaver can be helpful. Laser Hair removal is also a great cure for this troublesome problem.

Pigmentation Disorders

Several skin disorders affect the pigmentation (coloring) of the skin by damaging the melanocytes (melanin-producing) cells. Sometimes these conditions affect only patches of the skin; other times they may involve the whole body. There are two categories of pigmentation disorders: hyperpigmentation and hypopigmentation. Both can affect people with dark skin. Hyperpigmentation disorders are more frequently found in people of color and hypopigmentation disorders are more noticeable on darker skin.

Hyperpigmentation means that your skin gets darker. This can result from sun exposure, pregnancy, and some diseases, like Addison’s disease or lupus. In dark-skinned individuals, hyperpigmentation is often the result of injuries like cuts or burns, or as a post-inflammatory reaction to eczema or acne.

Hypopigmentation can occur as a rare genetic condition known as albinism, characterized by skin and hair without color, or as vitiligo, a disorder that causes patches of white skin to appear on the face or body, often in symmetrical patterns. Vitiligo occurs in up to 2 percent of the population, but is most noticeable in people with dark skin. The condition happens when melanocytes (pigment-producing cells) die or stop functioning. The disease is hereditary, but may also be triggered by severe sunburn, stress or exposure to toxic chemicals. In addition to albinism or vitiligo, hypopigmentation can occur as a result of infections or injuries.

Keloids

Keloids result from the overgrowth of scar tissue. Typically they occur at the site of a previous skin injury where collagen, a protein the body uses to repair wounds, overgrows, producing a pink or red bumpy, ridged area, normally larger than the original scar. Though keloids can be surgically removed, this is not usually a good idea. Because patients with a tendency to produce keloids will continue to have a tendency to abnormal scarring and are likely to develop keloids again. It should be noted that those who are prone to develop keloids are at greater than average risk of developing keloids when their skin is traumatized, such as if they get a tattoo or skin piercing.

Dermatosis Papulosa Nigrans

Facial and neck moles (known scientifically as dermatosis papulosa nigrans, or DPN) are not actually moles. They usually appear as little brown or black spots on the skin around the cheekbones and eyes. In some cases, they are also found on other areas of the face, neck, chest, and back. These moles, which may be flat or hang off the skin like skin tags, may show up as a few, isolated spots, or may appear as hundreds of small lesions.

While dermatosis papulosa nigrans are benign and no cause for concern, in addition to being aesthetically unappealing, they can be itchy or otherwise irritating. Individuals of dark skin tone are more plagued by this problem than those with lighter skin tones, and women are more at risk than men. These spots usually appear after puberty and tend to proliferate and grow in size as you age. Treatment is typically focused on minimizing the appearance of the spots because other treatments may result in scarring.

Acne

Going along with the benefits of having dark skin — its resistance to sun damage and skin cancer development — is the disadvantage of vulnerability to discoloration. Similar problems arise when treating dark skin for acne as in treating dark skin for other problems, such as hair removal. Some of the skin products and procedures that treat acne on lighter caucasian skin are not appropriate for dark skin; and as a matter of fact, can make the cosmetic situation considerably worse.

Those with dark skin are at much greater risk of experiencing pigmentation changes than their light-skinned counterparts. As an example, people of certain ethnicities are up to 15 times more likely to develop acne-related scars. It is extremely important that people of color consult with a dermatologist well-skilled in treating all types of skin.

Hair Thinning

Hair loss, known as alopecia, can occur in various locations on the scalp or body and may or may not be reversible. There are several possible causes of alopecia:

• Male pattern baldness, related to your genes and male sex hormones
• Alopecia areata, an autoimmune disorder
• Traumatic hair breakage due to relaxers, dyes, dryers, curling or flat irons
• Frictional force due to rubber bands, excessive brushing or combing
• Anemia, thyroid disease
• Diet changes including protein and vitamin deficiencies
• Hormonal fluctuations in women after pregnancy or menopause
• Extreme stress
• Chemotherapy

Learn more about how Platelet Rich Plasma (PRP) can help you with hair loss.

Scalp Disorders

There are many scalp disorders that can affect individuals with any color skin. These include:

• Dandruff
• Seborrheic Dermatitis
• Head Lice
• Ringworm (tinea capitis, a fungal infection)
• Folliculitis
• Psoriasis
• Lichen planus (inflammatory condition of skin and mucous membranes)

While some scalp disorders, especially in mild cases, can be treated with home remedies, most have to be diagnosed and treated by a trained professional.

If you are looking for an experienced, highly skilled dermatologist in Florida, make sure to contact Dr. Harvey of Unique Dermatology & Wellness Center in Valrico, Florida. She is comfortable and successful working with patients of all races and ethnicities and is empathetic to the psychological, as well as physical, aspects of your skin issues.