How People of Color Can Diagnose Common Skin Conditions

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There is a common misconception that people of color do not have to be as vigilant about skin protection as others. But all skin types, no matter what shade or color, are at risk for skin cancer and other dermatologic conditions.

Skin cancer

Melanoma is the most dangerous type of skin cancer. While it’s not as prevalent among people of color, it is often diagnosed at an advanced state because of where it tends to appear, like in and around the nails, on the palms, soles of feet, mouth, or genitals.

“While these locations are relatively uncommon for melanoma, they account for a higher percentage of melanomas in people of color because these patients develop fewer sun-related melanomas,” says Beth Israel Deaconess Medical Center dermatologist Dr. Shalini Vemula.

She encourages everyone to be aware and perform self-checkups monthly, and have any new or changing spots examined by a dermatologist.

Acne

Acne is one of the most common skin problems, affecting young adults of all races and genders. It often starts in teenagers and can continue into adulthood, particularly in women. After it heals, acne can often leave behind dark spots in people of color.

“More often than not, the dark spots are more frustrating than the acne itself, and can linger for several months to a year,” says Dr. Vemula.

She urges people not to pick or scratch their acne in any way, as it can make the dark spots more prominent. In addition, she recommends that people limit sun exposure and use daily oil-free sunscreen to help the dark spots clear faster.

Eczema

Known as the “itch that rashes,” eczema is an intensely itchy rash that primarily affects children but can persist into adulthood. It usually appears as dry, red, flaky skin on the face, neck, inside of the elbows, and back of the knees. In people of color, it can have a darker undertone such as a deep pink, brown, or gray hue. Similar to acne, eczema often heals with dark spots on darker skin. Dr. Vemula suggests those battling eczema use gentle skin care techniques by avoiding hot showers, wearing loose-fitting clothing, using gentle fragrance-free soaps and creams, and opting for fragrance-free products.

Keloids

Scarring is normal after a skin injury, but in some cases, scar tissue grows excessively. It can form harmless, but sometimes uncomfortable, smooth, hard growths called keloids. They are more prevalent in the African-American and South Asian communities.

According to Dr. Vemula, people that are prone to developing keloids should weigh the pros and cons of any procedure that will affect their skin, such as ear piercings, tattoos, and cosmetic procedures. “Surgery can also cause keloids to develop, but people should not decline necessary surgical procedures for fear of developing a keloid since it’s a benign scar that can be treated,” says Dr. Vemula. Though treatment can be difficult, steroid shots injected directly into the keloid can help with itching, pain, and size reduction.

Melasma

Melasma is one of the most common pigment disorders in women of Hispanic, Asian, or African descent. It appears as brown patches on the face, most commonly on the cheeks, upper lip, and forehead. Although the exact cause is unknown, studies have shown an association with sun exposure, hormones from pregnancy, and birth control pills. For treatment, Dr. Vemula recommends using a broad-spectrum sunscreen with SPF 30 or higher that contains zinc, titanium, or iron oxide, and seeing a dermatologist to discuss other cosmetic treatment options.

Vitiligo

Vitiligo is a condition that results in loss of skin color (white patches) that can affect any part of the body, including the skin around the eyes and mouth, chest, hands, and groin. All races are equally affected, but the skin depigmentation is much more prominent in people of color.

“We see more dark-skinned patients present to our office because of the great impact it can have on the quality of their life,” says Dr. Vemula. She recommends regular use of sunscreen because it can protect vitiligo patches that are at greater risk for sunburn and also can limit tanning of normal skin. Success is variable, but treatment options include prescription creams and ointments, laser therapy, and phototherapy (light therapy).

“Skin is the body’s largest organ,” says Dr. Vemula. “It performs many vital functions for the body, so it’s crucial to take good care of it.”

Please speak to your doctor or a dermatologist if you notice any skin changes.

The Department of Dermatology at BIDMC offers a variety of care and treatment services for all types of skin conditions. For more information, visit bidmc.org.