Your complexion type is the blueprint for your basic skin-care regimen. That means the products you choose and cleansing/moisturizing routine you follow should be based on whether your skin is oily, dry, combination, sensitive, or normal. But skin tone plays a role as well. Regardless of race, we all have the same amount of melanocyte skin cells in our bodies, and those contain structures called melanosomes. It’s ultimately the melanosomes, and the melanin they produce (melanin is the pigment that colors the skin) that determine our skin tone. People with dark skin have melanocytes that contain larger melanosomes — and more of them — than people with olive or light brown skin, so their melanosomes make more melanin. People with fair skin have melanocytes that contain fewer and smaller melanosomes than people with medium skin tones, and their melanosomes produce less melanin.
Unfortunately, people with darker skin are more likely to develop pigmentation disorders, such as postinflammatory hyperpigmentation, vitiligo, and dermatosis papulosa nigra. With postinflammatory hyperpigmentation, an injury to the skin — anything from a pimple or a scrape to a cut or burn — can cause the skin to darken in that spot, either semipermanently or permanently, like a scar. Using sunscreen can help prevent hyperpigmentation, but if that doesn’t work, your dermatologist can prescribe bleaching medication, a chemical peel, or microdermabrasion to correct the pigment color.
Vitiligo causes splotchy white patches to appear when pigment cells are destroyed; experts believe this is caused by an autoimmune disorder. There are a number of different treatments, including steroid creams, laser and light therapies, intense pulsed light (IPL), and skin grafting.
Dermatosis papulosa nigra — also known as flesh moles — are small, raised brown or black spots that usually show up on the cheeks of African American women. The moles are benign, but a dermatologist can remove them for cosmetic reasons if the patient desires.
When a wound or skin infection begins to increase in size and extend beyond the borders of the original injury, the resulting condition is called a keloid. These can vary in shape and size and typically look like puffy, dark pink scars. No one’s sure why keloids are more common among people of color. There are many treatments available, including surgery, steroid injections, laser therapy, and cryotherapy (freezing), but the success of these treatments is variable. Your best bet: Ask your dermatologist what he or she recommends.
Skin Cancer Risk
It’s true that those with lighter skin tones have the highest risk of developing skin cancer, but that doesn’t mean people with deeper skin tones are immune to sun damage. That’s because while the extra melanin they possess makes the skin darker, it does not fully protect against the harmful effects of sun exposure. Research has also shown that melanoma can be more aggressive in darker skin and that people with skin of color are less likely to survive a melanoma condition. That’s why year-round sun protection is critical for everyone, no matter their race.
For people with darker-toned skin, it’s important to know that melanoma is more likely to develop on the palms and soles, on or in between fingers and toes, under the fingernails, in or around the mouth or nose, or on the genital area, according to the American Academy of Dermatology. If you notice a new mole, or if an existing spot changes in size, shape, or color — especially in one of these areas — schedule an examination with your dermatologist as soon as possible. In the meantime, continue to see your dermatologist annually for skin and mole checks, and protect your skin from the sun.
When choosing sun protection, look for a lightweight broad-spectrum sunscreen, such as a lotion, gel, or spray with an SPF of at least 15 (30 is even better) that will help protect your skin against harmful UVA and UVB rays. Steer clear of thick sunscreens that contain zinc or titanium, since those ingredients can make darker skin look ashy.
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