Individuals with darker skin tones often face a unique set of skin challenges. These include hyperpigmentation, keloid scars and higher sensitivity to certain treatments like peels and lasers. Sadly, most medical schools and training programmes do not cover skin of colour seriously. According to a 2013 study, just 22% of dermatology trainees reported any formal training in skin of colour. Fewer than half felt properly able to treat people of colour, who make up about 18% of England and Wales. There is a wealth of misconceptions around skin of colour, so we are here to dispel them. In this article, we explore the unique needs and best skincare for skin of colour.
Skin Problems Unique to Skin of Colour
Skin of colour is a term that covers a wide range of skin tones. Crudely speaking, it refers to non-white skin. People of African, Asian, Latin, Mediterranean and Middle Eastern descent tend to have higher melanin levels. Most have skin types 4 to 6 on the Fitzpatrick scale. Melanin-rich skin offers some natural protection against sun damage. This means it is less prone to photo-ageing. In fact, people with skin of colour often show signs of skin ageing 10 to 20 years later than lighter-skinned counterparts. That said, there are also concerns that skin of colour is at greater risk of. These include hyperpigmentation, post-inflammatory hyperpigmentation (PIH), melasma and keloid scars.
Hyperpigmentation in Skin of Colour
Hyperpigmentation is one of the most common issues affecting skin of colour. It is where the skin makes excess melanin in isolated areas. This leads to dark spots and uneven tone that can linger for months or even years. Darker skin tones have larger melanocytes, which produce and hold more melanin. This is why skin of colour is more prone to hyperpigmentation.
A variety of triggers can increase melanin production. These often include excessive sun exposure, inflammation or injury, and hormonal fluctuations. Skin of colour has better protection, but it is still susceptible to sun damage. Excess sun pushes the skin to produce more melanin to protect against UV rays, which shows up as hyperpigmentation. Skin of colour is less prone to this than lighter skin tones, though it is not immune. It can also develop hyperpigmentation from hormonal changes, known as melasma. Hereditary hyperpigmentation is more common too. This normally appears as patches of darker skin around the eyes, neck, chin and lips.
Skin of colour is also far more prone to post-inflammatory hyperpigmentation than lighter skin. This is where dark patches develop after trauma, including acne, burns or even eczema. The trauma causes inflammation that damages the melanocytes (the pigment-producing cells). Melanin then leaks out and deposits into the skin where the melanocyte sits. This is why you get isolated patches of dark skin at the site of the injury.
It is difficult to completely avoid hyperpigmentation in skin of colour. You can, however, reduce the risk. Easy wins include using sun protection, treating skin conditions like acne and eczema, and avoiding injury to your skin. There are also a number of treatments that can help fade hyperpigmentation, which we discuss below.
Keloids & Hypertrophic Scars
People with skin of colour are also more prone to keloids and hypertrophic scars. Keloids are tough, raised scars that expand beyond the original wound’s borders. Hypertrophic scars are also raised, but they stay within the wound’s initial boundary. Both result from an overactive healing response. The body makes too much collagen to repair a wound or inflammation site, which leads to raised, thickened skin.
The risk of these scars is significantly higher in skin of colour. Raised melanin content does not only influence the skin’s colour. It also plays a role in the skin’s inflammatory and healing responses. This hyperactivity can tip the scales of healing, leading to an overproduction of collagen and these abnormal scars.
Keloids and hypertrophic scars can follow any skin injury, including surgical cuts, piercings, burns, acne or even minor abrasions. Keloids can also continue to grow for years and often recur even after surgical removal. They can be itchy, tender or even painful. They can also carry a real emotional and psychological burden, affecting quality of life and self-esteem. As such, it is important to be mindful of these risks and seek help early if you notice any unusual scars. It also helps to reduce skin trauma and manage inflammation, so these scars are less likely to form in the first place.
Flesh Moles
Also known as dermal melanocytic naevi, flesh moles can occur in all skin types. However, they tend to be more common and noticeable in skin of colour. This is largely down to the contrast between the colour of the mole and the surrounding skin. Flesh moles are usually benign and pose no health risk. That said, any change in the size, shape or colour of a mole should be checked by a dermatologist. Ideally they should be experienced in skin of colour, as these changes can be signs of skin cancer.
Early Skin Cancer is Often Missed
Skin of colour has more melanin, the pigment that gives skin, hair and eyes their colour. This provides some natural protection against harmful UV radiation, but not complete protection. So although skin cancer is less common in darker skin, it can be more deadly. This is because it is often detected at a later stage. Part of the problem is a lack of education, for the public and for doctors, on how skin cancer looks in skin of colour.
Therefore, if you have skin of colour and notice a new mole or skin changes, it is vital to see a dermatologist experienced in treating people of colour. This matters even more if mole removal is needed, so they can reduce the risk of keloid scars.
Vitiligo
Vitiligo is an autoimmune condition that leads to the loss of skin pigment in patches. It can affect all skin tones. However, it is often more noticeable in skin of colour, due to the contrast between pigmented and depigmented skin.
In skin of colour, vitiligo can also be more emotionally distressing. The contrast is more pronounced, and there can be cultural stigma around changes in skin colour. Many people experience significant psychosocial fallout, including anxiety and depression.
In terms of treatment, the goal is to stop or slow the loss of pigment. Options include immune suppressants, topical corticosteroids, calcineurin inhibitors and light therapy. In some cases, tattooing (micropigmentation) or cosmetic camouflage may be an option. It is also crucial to protect the skin from the sun, as depigmented areas burn easily. Crucially, people with skin of colour and vitiligo should seek a dermatologist experienced in treating this condition in diverse skin types.
Ashiness
Dry skin, or xerosis, is usually more noticeable in skin of colour. This is because dry, flaky skin shows up more against a darker tone. Ashiness occurs when the skin’s surface becomes dehydrated and loses water. The result is a dull, rough and often greyish or “ashy” appearance. It is caused by various external factors. These include harsh soaps, too much sun, cold and dry weather, and certain medical conditions or medications. Research also suggests that some skin of colour may be more prone to transepidermal water loss, which causes dryness.
The best way to combat ashiness is twofold. Avoid the factors that dry out the skin, and use a hydrating routine. This includes gentle, non-irritating cleansers, regular exfoliation to remove dead skin cells, and hydrating occlusive moisturisers.
Pseudofolliculitis Barbae
Pseudofolliculitis barbae, also known as “razor bumps”, disproportionately affects people with skin of colour. It is especially common in those with thick, curly hair. It happens when shaved, plucked or waxed hair grows back into the skin. This causes inflammation and painful bumps. Over time, the inflammation can also lead to hyperpigmentation.
The structure of the hair is the reason it is more common in skin of colour. Curly or coiled hair, when cut close to the surface, can curl back and pierce the skin. The body sees this as a foreign object and mounts an inflammatory response. This gives rise to clogged pores and bumps. It also promotes melanin production, which causes dark spots or patches.
Managing pseudofolliculitis barbae centres on reducing irritation and inflammation. Helpful measures include avoiding close shaves, using single-blade razors or electric clippers, shaving in the direction of hair growth, and using a soothing aftershave. Ingredients like salicylic and lactic acid can help exfoliate the skin and free up ingrown hairs. Skin-lightening agents may then help fade any associated hyperpigmentation.
Problematic Skin Products & Treatments for Skin of Colour
When it comes to skincare, not all treatments are equally safe or beneficial for skin of colour. What works well on lighter skin can wreak havoc on darker skin. Certain active ingredients can be irritating and cause problems. One key culprit is high-concentration glycolic acid, which can irritate the skin and cause PIH. The same can happen with retinoids, beta hydroxy acids and even the alpha hydroxy acids usually seen as gentler. Physical exfoliants are also a concern, as they can cause micro-injuries that lead to inflammation and PIH. Harsh soaps, alcohol and artificial fragrances can be drying and irritating, which causes ashiness and even PIH. Skin of colour therefore needs a careful balance of effective yet gentle skincare. Always patch test new products and start with lower strengths. Even better, seek the advice of a skincare professional experienced in treating skin of colour.
Laser treatments can be very effective for hair removal, skin ageing, scars, texture and hyperpigmentation. However, they must be used with caution on skin of colour. The laser’s energy is absorbed by dark pigment. This means darker skin can absorb too much of that energy, which risks burns, PIH and even scars. Certain chemical peels carry a similar risk, particularly aggressive ones like glycolic and TCA peels. Used incorrectly, they can cause PIH or even hypopigmentation in darker skin. None of these treatments are off limits though. It is just crucial to see a qualified practitioner who specialises in skin of colour. They will be able to choose the safest, most effective treatment for you.
Best Skincare for Skin of Colour
The best skincare for skin of colour addresses your concerns without unnecessary irritation or worsening pigment. There are plenty of products that work well and are safe to use. Below we go through the key ingredients to protect, treat and enhance your skin.
- Hydration and moisture: Look for products rich in vitamin B5, C and E, plus niacinamide and licorice root extract. These even out tone, smooth texture and reduce the appearance of pores. Humectants like glycerol, hyaluronic and polyglutamic acid boost hydration. Paired with emollients and occlusives like ceramides, squalene and shea butter, they seal in water and reduce ashiness.
- Actives: Retinoids speed up cell turnover, which improves hyperpigmentation, fine lines and wrinkles. They also help with acne and scars. It is crucial to start with a low-strength retinoid and build up slowly to avoid irritation. For acne, you can also use azelaic acid and benzoyl peroxide. For severe hyperpigmentation, hydroquinone works well, especially alongside tretinoin. Both hydroquinone and tretinoin are prescription-only, so you will need a doctor to access them and use them safely.
- Sun protection: Sunscreen is a must for every skin tone. Darker skin has more natural protection, but it is still vulnerable to sun damage and hyperpigmentation. A broad-spectrum sunscreen of at least SPF 30 every day helps protect the skin and keep tone even. Many physical sunscreens leave a grey cast. You may prefer a chemical one, or a formula designed to look good on skin of colour.
Professional Treatments for Skin of Colour
Exfoliating acids can be used safely in skin of colour. Start with low strengths and build up gradually as your skin tolerates them, and always patch test first. Among professional treatments, injectables like Profhilo, Botox and dermal fillers are generally safe in skin of colour. The same is true for microneedling and RF microneedling, which can boost skin quality and texture. If you are prone to hypertrophic scars or keloids, exercise caution. It is worth a consultation with a dermatologist who specialises in skin of colour first.
Chemical peels and lasers can be highly useful for acne, scars, ageing and hyperpigmentation. However, they only work safely if done with care and caution. To avoid burns, scars and PIH, see a medical practitioner experienced in treating skin of colour.
Best Skincare Routine for Skin of Colour
There is a whole world of products that work well for skin of colour. The best skincare routine depends on your concerns, goals and lifestyle. The core steps are:
- Cleansing: Opt for a gentle, sulphate-free and hydrating cleanser. This maintains your skin’s natural moisture and lipid barrier. To double cleanse, use a cleansing balm or oil first, then a hydrating foaming cleanser.
- Exfoliating: Avoid physical exfoliants. Use gentler chemical exfoliants like AHAs or BHAs sparingly to avoid damage and PIH. Enzyme exfoliants tend to be gentler than acids. Whatever you choose, go for the lowest strength, start slowly and patch test first.
- Antioxidant protection: Use antioxidants to combat free radicals and reduce inflammation. Try a low-strength or gentler vitamin C first. Then build up the dose and frequency as your skin tolerates it.
- Sun protection: Use a broad-spectrum sunscreen with SPF 30 or above. This helps prevent skin cancer, hyperpigmentation and early ageing.
- Moisturising: Look for moisturisers with humectants, emollients and occlusives. Ingredients like glycerol, hyaluronic acid and ceramides keep skin hydrated and support the skin barrier.
For targeting acne, hyperpigmentation and scarring, useful additions include:
- Benzoyl peroxide to spot-treat pimples.
- Niacinamide to improve texture, reduce the appearance of pores and ease early signs of ageing.
- Azelaic acid as a gentle option for acne, acne scars and hyperpigmentation in sensitive skin.
- Retinol or prescription retinoids like adapalene and tretinoin, started low and slow to reduce the risk of PIH.
- A short doctor-supervised course of hydroquinone for moderate to severe hyperpigmentation. Arbutin and kojic acid are gentler over-the-counter alternatives, though less effective in skin of colour.
- Silicone sheets or gels for keloids and hypertrophic scars, ideally under the care of a dermatologist or plastic surgeon.
Caring for skin of colour means understanding its unique characteristics and susceptibilities. It helps to know which treatments are problematic and to adopt a bespoke routine for your concerns. For prescription and professional treatments, always choose a doctor with experience in skin of colour. For keloids, skin changes and moles, see a dermatologist with that experience. They will be more likely to diagnose you correctly and manage you properly.
We are passionate about personalised skincare, which is why we set up our virtual skin clinic. Our doctors are experienced in delivering safe and effective treatments for skin of colour. We provide prescription skincare with ingredients like azelaic acid, hydroquinone and tretinoin to treat acne, hyperpigmentation, melasma and skin ageing where appropriate. Everything is personalised to your needs. Book an online appointment or use our online consultation form today. The journey to great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your skin or treatment options.
