Introduction
Skin care and treatment of skin conditions vary according to skin color. Dark skin or pigmented skin is prone to certain skin conditions that should be monitored and treated carefully. It is necessary to implement the proper treatment according to skin color.
Pigmented or dark skin is usually considered ethnic skin. Melanocytes are the cells that produce melanin. This melanin, in turn, gives color to the skin. Melanocytes in dark skin people make more melanin than light skin people. As a result, lighter skin people are more prone to sun damage, and darker skin people are more prone to skin aging.
What Is Cosmetic Dermatology in Ethnic Skin?
Cosmetic dermatology in ethnic skin or ethnic dermatology focuses on the appearance, diagnosis, and treatment of skin conditions in patients with pigmented skin. It is often known as dermatology for people with darker skin.
How May Skin Tone Affect the Appearance of the Skin?
The color of the skin affects the skin's presentation in the following ways:
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Skin color affects the skin structure. For example, darker skin usually has thicker dermis (the inner layer of skin) and small collagen fibers.
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Skin color also affects the aging of the skin. The melanosomes where melanin is synthesized degrade more slowly in dark skin than in fair skin.
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Dark skin tends to protect against ultraviolet (UV) exposure more than fair skin.
How Can Dermatological Appearance Vary Based on Skin Tone?
Several diseases present themselves differently in different skin tones. For example:
1. Eczema: A skin disease called eczema is an inflammatory skin condition that appears reddened, dry, and itchy in people with fair skin because of the dilation of blood capillaries and tiny vessels connecting the arterial and venous systems. However, in pigmented skin, the redness of the skin (erythema) is less noticeable because this erythema is replaced by dark patches.
2. Skin Cancer: Those with dark skin indeed have natural protection against skin cancer. However, still, skin cancer can appear in dark skin people. Melanoma and other skin cancers in people with darker skin are frequently present on palms, soles of the feet, and nail bed areas as the skin is lighter in these areas. The melanoma death rate is highest among dark skin people because they do not take treatment at the early stages, and it is often mistaken as plantar warts.
3. Acne: Acne occurs in both dark and light skin tones. However, as it is related to hyperpigmentation, it is a topic of concern for people with dark skin tones. Acne production is linked to the excessive formation of oil in the skin. This excessive oil combines with bacteria within the skin pores and blocks them. Because of the blockage of skin pores, inflammation occurs under the skin, which results in acne. Acne can lead to hyperpigmentation of the skin.
In addition, benzoyl peroxide is frequently used to treat acne in people with fair skin. However, darker skin appears more sensitive to its irritating, drying effect. Recent research has shown that topical retinoids, benzoyl peroxide, and clindamycin can be effective.
4. Pseudofolliculitis Barbae (PFB) in Dark Skin: This skin condition is predominant in dark skin people and can be identified by the formation of bumps under the skin surface. It is often mistaken for acne. It is mainly caused by stems from ingrown hair and most commonly occurs in dark skin people because of the distinct hair follicle shape.
5. Keloids in Dark Skin: A keloid is a scar that extends beyond the original injury and develops into growth. Keloids are most commonly caused by cuts or burns and form in the earlobes, chest, back, and arms. They can form immediately after an injury or after months or years to grow. Sometimes, they cause pain by touching or even giving a burning sensation. In dark skin, there is a greater risk of keloid formation. Therefore, keloids are best treated with laser treatment. However, other options, such as radiation therapy, cortisone injection, and silicon gel application, are also available.
6. Vitiligo In Dark Skin: Vitiligo is a skin condition characterized by depigmentation of the skin. The depigmented skin appears as light or white skin patches on the skin. Vitiligo is observed more in people with dark skin. It is caused by damaged melanocytes, which produce melanin. Though the cause of vitiligo is unknown, it is thought to be linked with genetic susceptibility triggered by an environmental factor that leads to an autoimmune disorder.
Vitiligo causes hair to turn white and sometimes causes premature gray hair. The treatment approach is to re-pigment the skin, including phototherapy (controlled exposure to ultraviolet light) and topical ointment tacrolimus. Research has shown that using this ointment twice a day can restore normal pigmentation. Another treatment option is the use of steroid creams.
How to Take Care of Dark Skin Tone?
Darker skins appear more prone to strong irritations, reactions, and poor scarring. Therefore, a proper skincare regime should be used. For example:
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Hydrating Lotions: Darker skin tones are more prone to drying and cracking. An increased tendency toward acne frequently accompanies this effect. While oil-free, moisturizing lotions will minimize local irritation, avoiding over-striping the skin and harming its necessary barrier function is essential. Using abrasive or strong mixes may cause skin irritation and aggravate postinflammatory hyperpigmentation in dark skin tone.
However, many astringents contain alcohol, which removes essential oils from the skin, making it more prone to inflammation, hyperpigmentation, and irritation. Therefore, the popular belief of using cocoa butter to treat every ethnic skin condition is also inaccurate. Instead, a logical assessment involving identifying the specific problem and selecting focused therapy is recommended.
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Sunscreens: Sunscreen has been closely associated with lower rates of skin cancer and photoaging in people with lighter skin. However, sunscreen uses are less common in people with dark skin. Sunscreens, however, help prevent and treat pigmentary skin diseases such as melasma. In contrast, sunscreen use is unpopular among people with dark skin because of its typical chalkiness appearance on the skin. Sometimes, patients may be allergic to some of the ingredients of sunscreens, especially para-aminobenzoic acid, and its derivatives.
Conclusion
Dark skin manifests skin conditions differently than light skin. Dark skin people are more susceptible to skin cancer of the palm, sole, and nail bed. Hyperpigmentation is the main issue for acne in dark-skinned people. Pigmentation appears as dark patches, and skin diseases like vitiligo are more visible in these skin tones. Therefore, skin care products and treatments should be carefully chosen for people with dark skin.
