Common Ethnic Skin Issues

Acne

Acne is the most common skin disorder in dark-skinned adolescents and adults. People with ethnic skin tend to develop inflammatory acne, which is the most common type of acne. It is the highest ethnic skin complaint as it causes more damage to coloured skin than it does to Caucasoid skin.

Dark-skinned people tend to have less severe lesions but there is a higher chance of keloid scarring, especially on the chest and back, making effective acne prevention paramount. People with dark skin tend to have a higher incidence of post-inflammatory hyperpigmentation (marks left after acne). Some consider these marks worse than the acne itself.

The formation of keloid scarring is common after an injury to the skin amongst dark-skinned individuals. A keloid is the result of overproduction of collagen at the site of injury. The result of this is a pronounced scar that is painful, itchy, and unattractive and extends beyond the site of injury. As well as discomfort, these can cause disfiguration and functional disability.

Pigmentation

Ethnic skin is prone to patchy pigmentation. Post inflammatory reactions appear to be more common and more noticeable in patients with more skin colour. A minor pimple or scratch can cause melanin production to increase and this can result in dark patches on the skin. It can take months or years before these dark patches fade.

Dark skinned individuals are susceptible to developing a hyperpigmentation condition known as Melasma. This is more common among females and is associated with pregnancy, as it is triggered by the levels of hormones. Ethnic skin can also encounter is hypopigmentation. This can happen due to skin trauma or burns resulting in loss of pigment and lighter patches on the skin. It can also be due to a skin condition known as Vitiligo. Vitiligo affects 1 in 100 people around the world and can leave devastating effects.

Cold Climates

Ethnic skin is better adapted to the sun as it sweats and hydrates itself naturally. However, when exposed to a cold, dry climate, this system becomes less effective and the skin can lose its protective hydrolipidic film and its natural radiance. This results in the skin appearing dull and greyish.

Pseudofolliculitis Barbae (Razor bump)

Curled hairs and curved follicles predispose ethnic men to a condition known as pseudofolliculitis barbae. Statistically Afro-Caribbean men are particularly afflicted with pseudofolliculitis barbae. This affects the beard area when regular shaving is necessary. It occurs when the sharp end of a curled hair grows back into the dermis layer of skin. This causes a foreign-body reaction marked by inflamed papules and pustules on the skin surface. Hyperpigmentation and scarring may be severe.

Alopecia

Hair in ethnic patients, commonly Afro-Caribbean is curly, more difficult to comb, and lower in water content. It is also more easily fractured, especially when exposed to heat; therefore hair breakage is a common problem. Washing, drying, and grooming are far more time-consuming, and usually emollients or oils must be used liberally to allow efficient grooming and to combat the effects of dryness.

These hair-processing methods can eventually thin and damage the hair showing many broken hairs. In this condition, there are small beads along the hair shaft combined with cuticle loss.

Traction alopecia is caused by tight braids or hair extensions and weaves. These hair styles put continuous traction on hair follicles resulting in gradual thinning and loss of hair in the frontal and temporal areas. This condition can eventuate in scarring and permanent hair loss.

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