Over the past decade, there have been many advances in understanding the biology of brown skin. Although much more work to do in this area, the beauty industry has begun to appreciate and act on the fact that there is a diverse range of complexions in the world, each with nuanced skin care needs that deserve to be recognized.
Below are some of the skin care concerns specific to those of us with darker complexions, as well as some tips for handling them.
Uneven Tone
Hyperpigmentation as a result of acne, skin inflammation, or melasma is one of the most common reasons that those with dark, melanin-rich skin seek dermatological care. A reliable way to combat uneven skin tone is the daily use of a broad-spectrum sunscreen with an SPF of 30 or higher. Sun care products help to prevent and reduce this condition called post-inflammatory hyperpigmentation. There are roles for other products such as topical antioxidants, retinoids, and fading creams; however, none of these can get the job done alone.
To achieve their full effect, these products all benefit from the diligent application of sunscreen—every day and in all weather. Ultraviolet (UV) light can damage the skin as long as there is daylight, although strong overhead sun makes it more likely.
Skin Cancer in Brown Skin
Although the plentiful melanin of dark skin protects individuals against UV light, anyone, regardless of skin tone, can get skin cancer. In fact, when those with darker skin get skin cancer, especially the squamous cell and melanoma variants, the disease can be more advanced and, thus, deadlier at the time of diagnosis. In fact, the Skin Cancer Foundation reports that the estimated five-year melanoma survival rate for Black patients is just 70 percent, while white patients are expected to survive the five years following diagnosis 94 percent of the time.
In addition to sun protection, everyone should get a yearly examination by a board-certified Dermatologist and perform monthly self-skin examinations to detect skin cancers as early as possible. These practices would surely bring down the mortality rate of skin cancer in people of color. It is also important to remember that brown skin can sunburn, as well. No skin tone is immune to the harmful effects of UV light.
Dry Skin
Dry skin can be more obvious on darker tones, as it may have a gray or whitish cast. This increased visibility can be distressing to some. In general, using non-soap cleansers in the shower, and moisturizing with products that contain mineral oil, ceramides, and hyaluronic acid can help to avoid or prevent this problem altogether.
What's more, dry skin can be worse in the winter. If there is inflammation as well, this may be a sign of eczema, psoriasis, or some other skin condition. If gentle cleansers and consistent moisturization don't seem to improve the dryness, seek the care of a Dermatologist to rule out other causes.
Moles in Skin of Color
Moles are genetic and can occur anywhere on anyone. Those with brown skin should be diligent about checking moles located on the palms of the hands, soles of the feet, and oral and genital skin. These locations are where melanoma is most likely to develop in Black and brown skin. Monthly self skin checks, looking out for new or changing lesions in these areas are highly encouraged.
Dermatosis papulosa nigra (DPN) are benign mole mimickers that commonly occur on the face and neck of those with melanin-rich skin. They are small, brown, and can be slightly raised. DPN are not a cause for medical concern, although some do not like their appearance. If this is the case, there are quick in-office procedures that can help.
A Dermatologist can offer individual guidance on whether any questionable skin feature should be investigated or whether it can be removed.
Melasma
Melasma is characterized by blotchy hyperpigmentation on the face—most often, on the cheeks, forehead, or chin. It is more common in women and those with skin of color. The cause of melasma is thought to be a combination of hormones (usually from pregnancy or birth control) and light exposure. Harmful light can come from the sun or screens—yes, computer and cell phone screens, and even lighting in the office or home, can cause melasma. This makes wearing sunscreen daily, indoors and out, imperative. Melasma will not improve without appropriate protection against light.
Generally, tinted mineral-based sunscreens with iron oxides are the best choice, as they protect against all types of light. Your Dermatologist can help to provide additional treatment options for melasma.
Acne
Acne is common in all skin tones. Still, discoloration on brown skin can last well after the lesion has resolved. As previously mentioned, this condition is called post-inflammatory hyperpigmentation. Using a broad-spectrum sunscreen with an SPF of 30 or higher to protect against this hyperpigmentation (or fade it, if it has already occurred) is very important.
A Note from the Author
As of just a few years ago, only 5.8% of Dermatologists identified themselves as black, and only 3.3% identified as Hispanic or Latinx, despite these groups representing about 12% and 18% respectively of the nationwide population at the time. This underrepresentation in a key medical field must change if all patients are to receive the best possible experience.
As a woman of color myself, I can appreciate how frustrating it is to see a dearth of health care providers that mirror one's ethnic identity. Having a cultural resonance with your doctor is paramount, as it often improves understanding, communication, and outcomes.
When looking for a Dermatologist—or any medical practitioner, for that matter—don't hesitate to seek out someone who has expertise in your own type of melanin-rich skin.
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