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.
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.
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
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. 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.9-10 There is a highly effective topical regimen here on acne.org which works extremely well on darker skin types.
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.
Note 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.10