skin of color

In this two-part series we continue to cover various prescribed methods for evening out skin tones. Part 1 looked at hydroquinone and mequinol. Part 2 covers azelaic acid, corticosteroids, and more.

Azelaic Acid: Treat both acne and pigmentation disorders
This medication works wonders for acne, destroying acne-causing bacteria before they have the chance to cause outbreaks. An additional benefit is that it is a very effective treatment for post-inflammatory hyperpigmentation, much of which is caused by acne outbreaks. So it works on two levels – improves acne and some of the pigmentation disorders that appear with it.

In this two-part series we continue to cover various prescribed methods for evening out skin tones. Part 1 looked at hydroquinone and mequinol. Part 2 covers azelaic acid, corticosteroids, and more.

In my practice, one of the most common concerns among people of color is uneven skin tone due to hyperpigmentation, or irregular darkening of the skin. Over the past few months, I’ve written a number of posts about hyperpigmentation concerns – including irregular patches, spots and scars – and which conditions warrant a consultation with a dermatologist. 

Q: I am a black woman suffering from post-inflammatory hyperpigmentation. Is there anything you can recommend to improve the appearance of my legs?

Post-inflammatory hyperpigmentation (PIH) is a relatively common condition where the cells that govern skin pigment, melanocytes, respond to inflammation by generating an excess of coloring, or melanin. The excess melanin shows up as dark spots or scars in affected areas.

I didn’t suffer with acne until I was an adult. Just into my thirties, I noticed more breakouts. What’s worse, the annoying red pimples left brown marks on my skin for weeks to months! Now I understand why.

We human beings come in a delightful rainbow of colors, from porcelain to pink to olive and brown to darkest ebony. So while we’re not all dark skinned, in a way, we’re all “people of color,” and we have the innate intelligence of our bodies to thank for giving each of us the perfect skin tone for our native habitat.

As the globe shrinks via mobile technologies that allow people from many different cultures to interact instantaneously, the nuances of “ethnic diversity” become ever more apparent. Certainly, as we erase geographic borders, dermatologists are treating a much wider range of skin types. A loose terminology is developing in response to the changing patient mix.

Many of my patients, particularly women aged 20 to 50, are concerned about the same thing – a “mask” of mottled skin on the tops of the cheeks and temples. This common (and benign) condition is called melasma, a Greek derivation meaning “dark pigmentation of the skin.” Melasma can happen to anybody, but it is more common among darker-skinned people and those who tan easily.

Skin color is determined by cells called melanocytes that produce a pigment known as melanin. The variation in skin color we observe in people around the globe is determined by the type and amount of melanin produced by melanocytes.

A recent theory suggests that differences in skin color are a function of the skin’s ability to protect against ultraviolet radiation. Persons living closer to the equator produce more melanin because the ultraviolet radiation is more intense, and people living further away from the equator produce less melanin, resulting in lighter skin color.