ethnic skin treatment considerations

In further observance of Black History Month, we’d like to provide information about the uniqueness of ethnic skin. Skin color is primarily determined by melanin, a pigment produced by cells called melanocytes. While everyone has the same number of melanocytes, ethnic skin produces more melanin. There are physiological differences between lighter and darker skin, and those with Fitzpatrick types IV and above are prone to certain skin conditions. Understanding these distinctive characteristics is essential to successfully treating ethnic skin.

Patients with higher Fitzpatrick types have different treatment options than lower Fitzpatricks.

Patients with higher Fitzpatrick types have different treatment options than lower Fitzpatricks.

hyperpigmentation and scarring

Melanocytes are more active in those with darker skin, which may lead to more severe reactions from common conditions. This results in skin discolorations such as hyperpigmentation and melasma. Hyperpigmentation can be caused by skin damage from wounds or rashes that leave dark marks as the skin heals. Increased or uneven pigmentation from melasma tends to be more prevalent in ethnic skin. Higher Fitzpatrick types are also at greater risk of keloids (raised scar tissue) from skin injuries.

acne and PIH

Post-inflammatory hyperpigmentation (PIH) is the result of any type of cutaneous inflammation, such as acne. Higher Fitzpatricks have larger sebaceous glands, leading to more oil production. This often presents as comedones and papules. Comedones in darker skin display significant inflammation, often resulting in PIH.


Studies show the stratum corneum in higher Fitzpatrick types contains more layers and has been shown to be thicker and more compact. The dermis of higher Fitzpatricks takes longer to break down and exhibits fewer visible signs of aging. In general, those with darker skin tend to look up to 10 years younger than other ethnicities. However, transepidermal water loss (TEWL) tends to be greater in the skin of higher Fitzpatricks, making moisturization all the more important to prevent the skin from appearing “ashy.”

skin cancer

Many people of color often don’t use sunscreen as sunburn is rare. While dark skin provides some built-in protection from ultraviolet (UV) light, even the darkest skin color cannot protect against all UV-induced DNA damage. All Fitzpatricks should use a broad spectrum sunscreen daily. Although skin cancer is less common among people of color, it is likely to be more deadly once it presents as it is usually not diagnosed until advanced stages.

sun sensitivity

Many drugs can increase sun sensitivity, which can result in skin discoloration. It’s especially important to apply sunscreen or avoid the sun altogether when taking certain medications. These include birth control pills, antibiotics and anti-acne drugs, as well medicine for high blood pressure, diabetes and heart disease.

vitamin D deficiency

Sunlight stimulates skin to produce vitamin D. Darker skin offers better protection from UV light, but can result in vitamin D deficiency. Research shows that dark-skinned people living at relatively high latitudes have inadequate vitamin D levels. Health authorities recommend daily vitamin D supplements for people of color.

Feel free to call us at 877.PCA.SKIN [722.7546] or email us at with questions about treating ethnic skin.


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