Skin conditions can fall under various categories. Inflammatory, autoimmune, infectious, bacterial—to name a few. Inflammatory conditions, such as psoriasis, acne, and eczema, are all too common for a lot of people. These occur when the skin becomes inflamed due to an overreactive immune system. Depending on your skin tone, these conditions can look very different. This is especially true for patients with darker skin, which makes diagnosis and treatment more difficult.
So, in this article, we’re gonna break down why psoriasis looks different on darker skin and why it’s super important to understand those differences.
First of all: What is psoriasis?
Psoriasis is an autoimmune and inflammatory disorder. This basically means that the immune system is too active, causing skin cells to grow at an exaggerated rate and pile up on the skin surface. These patches that are thick and scaly are the ones that patients associate with psoriasis. Here is a handy diagram showing the process:
Skin cell buildup from psoriasis
Why does psoriasis look so different across skin tones?
The main reason that the symptoms of psoriasis vary according to skin tone is someone’s level of melanin, the pigment responsible for the color of our skin. Melanin not only helps the skin protect itself from UV damage but also has a role to play in the way the skin recovers after being injured or inflamed. A person with dark skin who has a psoriasis flare-up will have more melanin produced in their skin during the healing process. This not only causes the patches of psoriasis to become darker but also makes them less visible.
Whereas for people with light skin, signs and symptoms of psoriasis that are typical will be more pronounced, thus making it easier both to detect and cure. Specifically, these symptoms show up as red, inflamed areas that are covered with a silvery-white scaly layer.
Not only melanin, but blood flow below the skin is another factor that influences the manifestation of psoriasis. In light-skinned individuals, the blood vessels are quite visible, and this is what causes the redness usually accompanying inflamed skin. However, in dark skin, the blood flow is less visible because the increased melanin masks it, making the inflammation harder to see. Hence, psoriasis can be less visible in terms of redness than it actually is.
The challenges of diagnosis and treatment
Diagnosing psoriasis in patients with dark skin can be really frustrating because the lack of both redness and visible scales might lead a dermatologist to overlook some of the early signs of the disease and thus mistakenly delay treatment and diagnosis.
A different approach to psoriasis care
To improve psoriasis care for people with darker skin, better education is key for both patients and healthcare providers. Dermatologists need to be trained to recognize how conditions like psoriasis show up on different skin tones and learn how to adjust treatments to avoid causing pigmentation changes.
Communication is key. Not only for patients to openly discuss their skin condition and the effectiveness of their medications, but also to determine whether they have noticed changes in their pigmentation. Do not hesitate to instruct your dermatologist about what psoriasis looks like on your skin tone and whether the treatment you are using is appropriate.
Takeaway
Psoriasis is a disease that anyone can get. Nevertheless, the appearance of the disease largely depends on your skin color. Classic symptoms of redness and scaling in people with darker skin may be less visible, which could delay diagnosis and treatment. By understanding these differences and improving care for all skin tones, we can make treatments more effective for everyone. A better understanding of how skin conditions show up on different skin tones will help us get faster diagnoses, fewer complications, and ultimately, better skin health for everyone!