Common Disorders Affecting Skin of Color

Dermatosis papulosa nigraSkin 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.

Skin disease occurs in people of all nationalities, regardless of their skin color, and some problems are more common in people with different hues of skin. A disorder sometimes seems more prominent because it visibly affects a certain skin color. The more common of these conditions in skin of color include the following:

Vitiligo, which manifests as white patches devoid of melanin. Entertainer Michael Jackson was perhaps the most famous sufferer of vitiligo. In the majority of cases, vitiligo is the result of an autoimmune or inflammatory attack on melanocytes. In these cases, topical anti-inflammatories and phototherapy are effective treatments.

Dermatosis papulosa nigra is also popularly called ”Morgan Freeman spots” and, more recently, ”Condoleezza Rice spots.” These are dark, raised papules that can occur on the forehead, cheeks, and neck. A special surgical technique, electrodesiccation, is most effective at removing these and often leaves no lasting sign of the condition.

Hypopigmentation occurs when melanocytes stop producing color. An example occurs in infants and toddlers of color where diaper irritation leaves light or white patches. With the appropriate treatment, the color almost always returns to normal within a few weeks.

Keloidal scars are thick, hard scars that spread and invade normal surrounding skin. Keloids develop in response to an injury, so when a keloid is surgically removed, the skin is being reinjured. Therefore, surgery may not eliminate the problem and can potentially make it worse. Treatments including anti-inflammatory injections, topical silicone-based preparations, pressure dressings, and laser treatments, which are usually successful.

There are many other persistent skin conditions in people of color. Although often irritating and sometimes embarrassing, they are almost entirely treatable.

Published on 09/01/2009 | Last updated on 12/20/2016