Tag: skin science

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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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Do Hormones Actually Cause Acne? A Look at the Biochemistry

Acne is one of the most common skin conditions in the world—yet also one of the most misunderstood. You’ve probably heard people casually blame it on “hormones” or reassure you that it’ll just go away with time. But what does that actually mean? What role do hormones really play in acne—and why doesn’t it always disappear on its own? In this post, we’ll break down the biochemistry behind hormonal acne and explore how your skin responds to shifts inside your body.

Hormones are chemical messengers that help regulate everything from growth to mood to skin health. During puberty or hormonal shifts, the body produces more androgens—a group of hormones that includes testosterone. Androgens are central during puberty, driving physical changes like hair growth and voice development.

In the skin, androgens stimulate sebaceous (oil) glands, telling them to produce more sebum—the oily substance that moisturizes skin. But too much sebum can clog pores, especially when mixed with dead skin cells and bacteria.

Once a pore becomes clogged, it creates the perfect environment for a normally harmless skin bacterium called Cutibacterium acnes to multiply. As the bacteria break down the trapped sebum, they release byproducts that irritate the surrounding skin. This triggers an immune response—your body sends white blood cells to the area, leading to inflammation, redness, and the formation of pimples.

In short, androgens kickstart a chain reaction: more androgens → more sebum → clogged pores → bacterial overgrowth → inflammation.

This explains why acne often appears during puberty and flares up during hormonal changes like menstrual cycles and pregnancy.

But it also explains why acne doesn’t always “just go away.” If your hormone levels remain imbalanced or your skin is particularly sensitive to even normal levels of androgens, breakouts can persist well into adulthood.

Why Everyone’s Acne Looks Different

Not everyone’s skin reacts to hormones the same way—and that’s where genetics, skin type, and even lifestyle come into play. Some people have sebaceous glands that are more sensitive to androgens, while others may produce stickier sebum or shed dead skin cells irregularly, making it easier for pores to get clogged.

Additionally, stress can worsen hormonal acne by increasing cortisol levels, which may indirectly boost androgen activity. Diet, while not a root cause, can also influence acne for some people—high glycemic foods and dairy have been shown in some studies to aggravate breakouts, potentially by affecting insulin and IGF-1 (insulin-like growth factor) levels, which can increase sebum production.

Treating Acne Isn’t One-Size-Fits-All

Because hormonal acne stems from a complex interaction of internal and external factors, what works for one person may not work for another. Dermatologists often take a layered approach—combining hormone-regulating medications with topical treatments and lifestyle changes tailored to each individual’s skin biology.

Takeaway:

Acne isn’t just a cosmetic issue—it’s a visible signal of underlying biochemical activity. Understanding the hormonal science of acne can empower you to seek targeted, science-backed treatments rather than relying on myths or quick fixes. Whether you’re a teen navigating puberty or an adult dealing with stubborn breakouts, knowing the “why” behind your acne is the first step toward long-term, effective solutions.

Sources:

“Androgens.” Cleveland Clinic, 28 Feb. 2023, https://my.clevelandclinic.org/health/articles/22002-androgens. Accessed 4 June 2025.

“Hormonal Acne.” Cleveland Clinic, 9 May 2022, https://my.clevelandclinic.org/health/diseases/21792-hormonal-acne. Accessed 4 June 2025.

Progesterone. ScienceDirect, https://www.sciencedirect.com/topics/psychology/progesterone. Accessed 4 June 2025.

“What Is Hormonal Acne and Why Does It Happen?” Columbia Skin Clinic, 18 July 2022, https://columbiaskinclinic.com/medical-dermatology/hormonal-acne-what-it-is-and-why-it-happens/. Accessed 4 June 2025.