Tag: dark skin

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How to Deal with Those Stubborn Marks Left by Acne on Darker Skin

We can face it; acne is already enough of a pain. But for those with darker skin, that struggle begins once the blemishes leave. In most cases, they don’t vanish entirely; they sometimes leave behind dark marks that can take months or even years to fully fade. The formal medical name for these markings is post-inflammatory hyperpigmentation (PIH), and it’s seen more frequently in those with darker skin tones.

What is PIH, and why does it occur?

Then why do these marks take longer to fade away, even for individuals blessed with melanin-rich skin? Well, it all boils down to how sensitive your skin is. In other words, when you get a pimple, it means that your skin is inflamed. In response, it prevents similar damage from happening (for a little while at least) by increasing the production of melanin, which is essentially the pigment that gives your skin its color.  People with darker skin have melanin-producing cells that are more active, meaning that they tend to have darker patches that last longer when inflammation occurs.

How PIH looks different on darker skin

PIH generally appears red or pink on lighter skin and usually fades sooner. On darker skin, though, those same marks will show up brown or purple to gray and turn into more internalized as well. These can last for much longer, especially if not treated well or are irritated further.

The problem with dermatology representation

The representation of skin color in dermatology has a big gap currently. This is because most medical resources — especially textbooks and training materials, and also skincare advertisements — show acne and pigmentation concerns on predominantly fair skin types, which is one of the reasons it remains an unmet need. And because of this, patients and doctors have less experience with how these disease processes look in brown skin. You may have never seen how it appears on deeper skin tones if you only experience red acne on pale skin. That could lead to real issues like not receiving the required care or attention.

What you can do about it

If you have dark skin, the good news is that PIH can be treated. 

By following a regular skin care routine, you can see dark spots fade back, and it helps minimize their appearance. Azelaic acid, niacinamide, or kojic acid are some of the key ingredients to look out for. And don’t forget sunscreen! While darker skin does not burn as easily, it can still be damaged by the sun, which only serves to exacerbate PIH. Also, be sure not to use harsh scrubs or over-exfoliate since it may aggravate the skin and make things worse. If possible, go to a dermatologist who knows how to treat PIH in the same skin color. They will tell you what is best for your skin type and will guide you to the best treatment to have.

Final thoughts

After all, acne marks on darker skin are completely normal and easily treatable. Where it is not okay, however, is when the absence of representation in skincare and dermatology gives way to feeling ignored if you have darker skin. Everyone deserves to be seen, acknowledged, and cared for. Your skin experiences count. This is your chance to have your say!

References

“Hyperpigmentation.” Cleveland Clinic, Cleveland Clinic, 7 Oct. 2021, my.clevelandclinic.org/health/diseases/21885-hyperpigmentation.

Fisher, Jennifer. “Demystifying Hyperpigmentation: Causes, Types, and Effective Treatments.” Harvard Health Publishing, 11 Mar. 2024, www.health.harvard.edu/diseases-and-conditions/demystifying-hyperpigmentation-causes-types-and-effective-treatments.

Ludmann, Paula. “How to Fade Dark Spots in Darker Skin Tones.” American Academy of Dermatology, 10 Mar. 2025, www.aad.org/public/everyday-care/skin-care-secrets/routine/fade-dark-spots.

Markiewicz, Ewa, et al. “Post-Inflammatory Hyperpigmentation in Dark Skin: Molecular Mechanism and Skincare Implications.” Clinical, Cosmetic and Investigational Dermatology, vol. 15, 25 Nov. 2022, pp. 2555–2565, Dove Medical Press, doi:10.2147/CCID.S385162. PubMed Central, PMC9709857.

Veazey, Karen. “What to Know about Hyperpigmentation on Dark Skin.” Medical News Today, 21 Sept. 2023, www.medicalnewstoday.com/articles/hyperpigmentation-black-skin.

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Thinking About a Cosmetic Procedure? Read This First if You Have Darker Skin

What is a keloid?

Say you have a tiny scar on your skin, hoping it would eventually fade away over time—only to realize it’s expanding instead. What starts as a tiny bump becomes hard, raised, and sometimes sore or itchy skin. It even becomes bigger than the initial wound, as if your skin doesn’t know when to stop healing. This is what it feels like to have a keloid scar, one of several scars that occur to millions of individuals and seem to attack at random or without a clear reason! This article explores the science behind keloids and the risks of cosmetic procedures if you have a darker skin tone.

Simplified diagram of keloid formation
Keloid formation

What causes a keloid?

When the body’s healing mechanism just goes a bit too far, a keloid occurs. Your skin would otherwise start healing by producing collagen, which helps to mend injured tissue, after a cut, piercing, acne infection, or even a bug bite. The body normally gets the message to stop after the cut has healed. That “stop” signal isn’t answered with keloids, though. Fibroblasts just keep on producing collagen, and what comes out is a thick, raised scar that goes beyond the original wound. These tend to be tender or itchy, and they’re typically rubbery and shiny in texture. In addition, they barely ever seem to go away by themselves.

Some individuals are more likely to develop keloids than others, but no one is immune. You are much more likely to have keloids if you have darker skin, particularly if you are Middle Eastern, African, Hispanic, or Asian. Caucasians are significantly less likely to develop keloids, whereas 16% of highly darkly melanated people might develop them.

Why is this?

Well, genetics come into play. Some genes involved in inflammation and collagen synthesis have been demonstrated to increase keloid predisposition, possibly familial in nature. Skin biology is involved as well. Melanin itself does not directly contribute to keloids, but darker skin types have a thicker dermis, increased fibroblast activity, and heightened inflammatory response after injury. These differences may be the reason that keloids are most frequently found, especially in the skin around the earlobes, jaw, shoulders, and chest. Tugging tight over a wound, age, and hormones also play a role.

But biology is just half of it. Medical education and studies have long ignored keloids, especially when they appear on skin of color. It may be harder for some doctors to diagnose keloids in darker-skinned individuals since most reference images and textbooks contain mostly lighter skin. This disparity leads to treatments not being specific to other colors, a lower chance of their prevention, and delayed diagnosis.

That keloids are generally preventable—if the risk is caught early enough—is especially disquieting. The danger of keloid can be reduced by taking simple steps such as using silicone gel sheets, receiving steroid injections, or using pressure earrings following piercing. Choosing non-surgical cosmetic treatments is also advantageous. But if your practitioner does not know about your risk factor, he or she will not alert you. And that might make you surprised when a little scar becomes larger.

Takeaway

In all, learning about keloids isn’t just about scars—it’s about recognizing and respecting all skin types. Everyone and their unique skin tone deserves to be seen, supported, and given care that reflects their skin’s unique needs. So if you have darker skin and are thinking about a piercing, surgery, or cosmetic treatment, don’t hesitate to ask about keloid risk.

References

  1. Marneros, Alexander G., and John J. Uitto. Keloids and Hypertrophic Scars. StatPearls Publishing, 2024. NCBI Bookshelf, https://www.ncbi.nlm.nih.gov/books/NBK507899/.
  2. American Academy of Dermatology Association. “Keloids: Causes.” AAD, https://www.aad.org/public/diseases/a-z/keloids-causes.
  3. Draelos, Zoe Diana. “Dermatological Conditions in Skin of Color: Managing Keloids.” Journal of Clinical and Aesthetic Dermatology, 2021, https://jcadonline.com/dermatological-conditions-in-skin-of-color-managing-keloids/.
  4. Ogawa, Rei. “The Pathogenesis of Keloids.” Plastic Surgery Key, 2015, https://plasticsurgerykey.com/the-pathogenesis-of-keloids/.
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Why Vitiligo Looks So Different on Dark Skin—And Why Doctors Keep Missing It

Vitiligo is a chronic skin condition that causes the formation of white patches of skin that may appear anywhere on the body. This condition can show up in all races more or less equally, but can be especially more conspicuous—and sometimes more difficult to treat—in darker skin due to the strong color contrast with normal skin. Unfortunately, medical cosmetics and dermatological literature have most often dealt with lighter skin types, leaving both patients and practitioners poorly informed. This article discusses the biology of vitiligo, the way color functions in the skin, and why vitiligo differs in people with darker skin.

What is vitiligo?

Vitiligo is a chronic, autoimmune disease. In other words, the body’s immune system incorrectly attacks the body’s own cells, in this instance called melanocytes. Located in the skin’s outer layer (epidermis), these are cells that have the special function to produce melanin!

Simplified diagram of a melanocyte

Melanin colors the skin, hair, and eyes. Where melanocytes are lost or are not functioning, the areas involved lose their pigment and turn milky white.

Vitiligo is one of two types: non-segmental (more common and occurs on both sides of the body symmetrically) or segmental (less common and is typically on one side of the body). The disease is neither painful nor contagious, but can be devastating to one’s self-esteem.

How Skin Pigmentation Is Formed

In order to find out why vitiligo appears more on darker skin, we have to examine how skin color is created. Melanocytes produce melanin and package it into small organelles known as melanosomes, which are transported to the surrounding skin cells. We all have roughly the same number of melanocytes, but in darker-skinned individuals, the cells are more active and produce more melanin.

When people with darker skin lose pigment, the contrast between the light spots and the rest of the skin is so much more pronounced. In light skin, the spots may be quite light or pink.

Why Vitiligo Appears So Different on Dark Skin

Dark-skin vitiligo patches tend to be very noticeable and snow white, attracting more attention than they would if they were located on light skin. In fact, most dermatology textbooks and instructional photos of skin diseases show vitiligo in light skin. This contributes to the delayed or erroneous diagnosis of the disease in darker patients.

Inequalities in Skin of Color Diagnosis and Treatment

Vitiligo may be misdiagnosed in dark-skinned patients as another skin condition, such as tinea versicolor, post-inflammatory hypopigmentation, or chemical leukoderma. This is particularly so for physicians who are not used to dealing with dark skin. After proper diagnosis, treatment may involve creams with corticosteroids, calcineurin inhibitors (such as tacrolimus), and narrowband UVB phototherapy. Depigmentation therapy may be considered for severe cases. But not everyone chooses to get treated. Most individuals would prefer to accept the way they appear and search for makeup products that will enable them to hide their imperfections. Even then, very few makeup or concealer products are suitable for dark skin.

Closing Comments 

Vitiligo is not riskier on darker skin, but can be readily noticeable, less understood, more frequently, and under-treated or mistreated. Diversity role models, more medical training, and education are the solutions to all of these problems. If you or your relative has vitiligo on darker skin, you need to know that help is growing—and your skin’s narrative needs to be told accurately, sensitively, and with pride.

References

Pietrangelo, Ann. “Vitiligo on Black Skin: What You Should Know.” Medical News Today, Healthline Media, 28 Oct. 2022, https://www.medicalnewstoday.com/articles/vitiligo-black-skin.

Cleveland Clinic. “Vitiligo.” Cleveland Clinic, 13 Oct. 2023, https://my.clevelandclinic.org/health/diseases/12419-vitiligo.

Hitti, Miranda. “What People of Color Should Know about Vitiligo.” WebMD, 6 June 2023, https://www.webmd.com/skin-problems-and-treatments/features/vitiligo-darker-skin-tones.

NHS. “Vitiligo.” NHS, National Health Service UK, 13 Feb. 2024, https://www.nhs.uk/conditions/vitiligo/.

Goldman, Lisa Zamosky. “Vitiligo and People of Color: The Nuances of a Visible Condition.” WebMD, 6 June 2023, https://www.webmd.com/skin-problems-and-treatments/features/vitiligo-poc-nuance.