Black skin and acne
Treating acne in black skin
- Acne very common in both adolescents and adults of African decent
- Tendency for hyperpigmentation
- Very few studies
Acne is the most common skin disorder in black adolescents and black adults and is often the primary reason for a visit to a doctor or dermatologist.1-3 According to the Journal of the European Academy of Dermatology and Venereology, "Acne vulgaris is an extremely common dermatological problem in Africans and people of African descent worldwide."4 Despite this prevalence, relatively few studies have been conducted on people with black skin.
What is different about black skin
People with black skin tend to have inflammatory acne, the most common type of acne. This is actually good news because inflammatory acne is easier to treat than non-inflammatory acne. Black people also tend to have fewer nodules and cysts, the more severe types of acne lesions. Despite the fact that black people tend to have less severe lesions, there is a higher chance of keloid scarring, especially on the chest and back, making effective acne prevention paramount.
Next, all non-Caucasian skin types tend to have a higher incidence of post-inflammatory hyperpigmentation, a fancy term for marks left after acne goes away. This is such a big issue that dermatologists often remark on how their black patients consider these marks worse than the acne itself.2,5-8 See the hyperpigmentation section below to learn more about how to contend with these dark spots that acne leaves behind.
People of African heritage do not tend to suffer with rosacea.9
Pomade acne - a special case
Sometimes the greasy emollients which make up black hair care products can come into contact with the skin and aggravate acne. If you use these products and tend to break out along your hairline or in places where your particular hair style comes into contact with your skin, this may be the culprit.2
How to treat acne in black skin
Luckily, inflammatory acne develops and is treated the same way regardless of skin color, and with the right regimen is easy to clear. There are several options including topical treatment as well as Accutane (isotretinoin). According to the International Journal of Dermatology, "benzoyl peroxide is particularly effective for the inflammatory component." Benzoyl peroxide is a mild drying and peeling agent, but people with black skin tend to have less flakiness and scaling of the skin and tolerate it well.10-11 There is a highly effective topical regimen here on acne.org which works extremely well on darker skin types.
The bottom line
The foremost concern should be prevention. Preventing acne will prevent the dark spots that are often left behind and will also prevent scarring. Concentrate your efforts on clearing up your acne and getting it under complete control. Then, if you choose, you can try on one of the many methods of hastening healing of the dark spots that are left behind.
People of African descent should not take the antibiotic minocycline to treat acne symptoms. "Fatal cases of hypersensitivity" have been reported with this drug in people of African descent.11
- Dunwell P and Rose A. "Study of the skin disease spectrum occurring in an Afro-Carribean population." International Journal of Dermatology. 2003; 42(4): 287-9.
- Alexis AF and Lamb A. "Concomitant therapy for acne in patients with skin of color: A case-based approach." Dermatology Nursing. 2009; 21(1): 33-36.
- Yahya H. "Acne vulgaris in Nigerian adolescents - prevalence, severity, beliefs, perceptions, and practices." International Journal of Dermatology. 2009; 48(5): 498-505.
- Jacyk WK. "Adapalene in the treatment of African patients." Journal of the European Academy of Dermatology and Venereology. 2001; 15(Suppl 3): 37-42.
- Taylor SC, et al. "Acne Vulgaris in Skin of Color." Journal of American Academy of Dermatology. 2002; 46: S98-S106.
- Halder RM and Nootheti PK. "Ethnic Skin Disorders Overview." Journal of American Academy of Dermatology. 2003; 48: 143-148
- Shah SK and Alexis AF. "Acne in skin of color: Practical approaches to treatment." Journal of Dermatological Treatment. 2010; 21(3): 206-211.
- Davis EC and Callender VD. "A review of acne in ethnic skin: Pathogenesis, clinical manifestations, and management strategies." The Journal of Clinical and Aesthetic Dermatology. 2010; 3(4): 24-38.
- Poli F. "Differential diagnosis of facial acne on black skin." International Journal of Dermatology. 2012; 51(1): 24-6.
- Kane A, et al. "Epidemiologic, clinical, and therapeutic features of acne in Dakar, Senegal." International Journal of Dermatology. 2007; 46(Suppl 1): 36-8.
- Poli F. "Acne on pigmented skin." International Journal of Dermatology. 2007; 46(Suppl 1): 39-41.
- Alexis AF, Sergay AB and Taylor SC. "Common dermatologic disorders in skin of color: a comparative practice survey." Cutis. 2007; 80(5): 387-94.
- Arfan-ul-Bari and Khan MB. "Dermatological disorders related to cultural practices in black Africans of Sierra Leone." Journal of College of Physicians and Surgeons Pakistan. 2007; 17(5): 249-52.
- Arsouze A, et al. "[Presenting skin disorders in black Afro-Carribean patients: a multicentre study conducted in the Paris region]." Annales de Dermatologie et de Venereology. 2008; 135(3): 177-82.
- Czernielewski J, Poncet M and Mizzi F. "Efficacy and cutaneous safety of adapalene in black patients versus white patients with acne vulgaris. Cutis. 2002; 70(4): 243-8.
- Mosam A, et al. "Quality of life issues for South Africans with acne vulgaris." Clinical and Experimental Dermatology. 2005; 30(1): 6-9.