I’m Indian-American and have an Indian-American dermatologist. This wasn't something I sought out. He came highly recommended, he takes my insurance, and he’s taken my face from yikes to ‘Yonce on several different occasions, so it just worked out. I did realize though—after a few years of visiting Dr. Parikh sporadically—how valuable it is to have someone with my exact skin type advising me on how to handle and heal my skin.
Having a dermatologist that shares your ethnic background isn’t always possible, though, and that can suck royally when you feel as if the person you’re paying to help you live your best skin doesn’t seem to know it well enough. I’m not saying a white dermatologist isn’t well-versed in black and brown skin. In fact, all of my POC experts for this piece assured me that all board-certified derms are trained to treat every shade under the sun.
Still. If you are black, Latinx, South Asian, or any other ethnicity that hoards that blessed melanin, here are some things you should know—before walking into any dermatologist’s office—about what makes your skin different. Being armed with a little knowledge about the skin bag you’re in could help ensure you keep it taut, blemish-free, and as healthy as possible.
Black and brown people need to wear sunscreen, too.
People with darker skin tones are much less likely to develop skin cancer, but they should still smear on the SPF on a regular basis. “As people of color, we’ve got to wear sunscreen if for no other reason than to prevent blemishes, hyperpigmentation, and baked-in marks,” says my derm, Sherwin Parikh, assistant professor of dermatology at Columbia University and founder of Tribeca Skin Center in New York. “Part of the aging process for people of color may not always involve early wrinkles and lines that you’d see in people with fairer skin. But it does involve pigmentation abnormalities—discoloration, essentially.” And that, he tells me, makes people look older than they are.
Dark circles can be worse for us.
A lot of Parikh’s patients, even when they’re in their early 20s, tell him that they’re getting dark circles under their eyes. This can happen for a variety of reasons such as fatigue, a thinning of skin around the eyes, or genetics—you might be more susceptible to them if a parent has them. “Certain things that people do, like rub their eyes a ton—especially if they’re prone to allergies—can break capillaries, which can also create dark circles,” he says. These can be more pronounced on people with darker skin. Parikh says there's little to be done about this that's not invasive, so leave your eyes alone and perhaps get a little more sleep.
Skin cancer looks different for black people.
While melanoma is rare in black Americans, it does happen. And as opposed to finding moles on the back or legs—which are the most common locations on white men and women, respectively—on men and women of color, the most common location is on the bottoms of the feet, Parikh tells me. “If you’re of color, you should still have your moles checked and you can check them yourself. But the place you want to not forget is to look at the bottom of your feet and in between your toes.” Generally, you should check on any mole that is asymmetrical, has border irregularity, different tones within it, or one that you've noticed a change in.
Black and brown skin scars differently.
“People with darker skin tones are more prone to hyperpigmentation and any injury to the skin—infection, inflammation or trauma—is likely to result in hyperpigmentation.”,” says Jacqueline Minasso, dermatologist at Northwell Health and assistant professor of dermatology at the Donald and Barbara Zucker School of Medicine at Hofstra. And even if you choose to cover them up with makeup, they can be hard to conceal.
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All my experts hit with the expected Don’t pick at those things. It’ll likely exacerbate the scar, which can can be treated. “With darker skin types, you have to be careful about using laser the way you use it on lighter skin types,” as they can cause discoloration in the skin, Parikh says. There are laser treatments out there that are applicable to darker skin types but many people don’t even need to go there. “They can do well with a lightening gel that can make it fade, and spend less money.” Also, consider a supplement. He says that ones such as Heliocare, an antioxidant capsule, can help prevent hyperpigmentation from the inside, when taken in conjunction with consistent SPF use.
Which brings us to keloids.
“People of color are more prone to keloiding [a keloid is excess, fibrous scar tissue].” Minasso tells me. “When you scar, there’s a protein called collagen which gets deposited in the skin to form the scar tissue. But with a keloid, there’s an exuberant deposition of collagen which causes the area to be bumpy, firm, and larger than the scar should be.”
Being prone to abnormal scarring—keloids and hypertrophic scarring (which is similar to a keloid, but the scar is usually smaller and tends to fade over time)—can be a huge bummer for people who love the needle (both tatts and piercings). “It’s very difficult to prevent keloids because the healing response is genetically controlled,” says Charles Crutchfield, a Minnesota-based dermatologist and professor of dermatology at the University of Minnesota Medical School. “If it does occur, pay attention to it right away.”
“As soon as the scar starts to look like it’s larger than your average scar, you should get the attention of a dermatologist,” Minasso adds. “Typically for these, we do injections that flatten it out. It can look pretty good if you get it treated early.”
Darker-skinned women are more prone to blotchy spots.
Melasma is a hormone-triggered condition that causes dry patches on the skin. One variation—called ashy dermatosis—can cause gray-brown spots on the face, chest, and back. “Melasma’s tough enough to treat but you can do it,” Parikh says. “It’s hormonal, pregnancy, and birth control pill-related, along with sun exposure issues. EDP [another term for ashy dermatosis] is similar but it has a component of stress. When people are under a lot of stress they can pigment differently.”
Parikh says he sees it in most people of the lighter-skinned variation of their particular ethnicity, or in mixed-race individuals. “Basically, anyone who can tan really easily or well, all of a sudden one fine summer you find that your tan didn’t fade correctly,” he says. “It didn’t do what it was supposed to do and you get these blotchy pigment spots.”
Crutchfield tells me that there are several other skin conditions that tend to appear more frequently in people of color, and that just being aware of them can help you spot the signs as early as possible. Parikh recommends that anyone with melasma or similar conditions use sunblock that contains zinc, which provides the best shield from the sun's rays.
Common acne treatments may be drying for darker skin tones.
“Anecdotally speaking, I’ve found that a lot of patients of color don’t like benzoyl peroxide soaps. It’s a peroxide derivative and it’s harsh and drying, but it’s incredible for teenage acne,” Parikh says. He says many derms are quick to prescribe it in the form of Persa Gel or Panoxyl, “but the benzoyl peroxide can dry a lot of people of color out kind of terribly.” If you know this is the case for you, ask your derm for something that might be less aggressive.
Cocoa butter may not the best moisturizer, aka don't believe everything your mom tells you.
A lot of women adopt natural remedies that have been passed down for generations. But be careful about trusting anything just because it’s plant-based, Minasso warns. “People slather turmeric all over themselves in the name of it being natural; they think it’s going to work miracles as opposed to something what was born in a drug store,” she says. “A lot of natural products contain natural ingredients that some people might be allergic to. But everybody’s skin is different, so if you’re used to something and you feel like it works well for you, use it.” Coconut oil can have moisturizing and antimicrobial benefits (it can disrupt bacteria), the latter because of a fatty acid called lauric acid. Minasso, however, would not recommend it for acne prone skin as the oil can clog your pores and make the acne worse.
Note: While cocoa butter and shea butter are beauty-store staples many POCs swear by, they're not Minasso's go-tos. Depending on the manufacturer and the other emollients or ingredients used in the products, though, the average person can use it without any issues. She urges people to ask their dermatologist before trying to self-treat with anything. Parikh is a little more open about trying natural remedies, especially black soap. The West African soap has multiple ingredients in it, but they’re all generally more gentle than soaps with conventional lye, a strong chemical combined with fat and fragrances to make soap, he tells me.
“Usually, black soap will have things like cocoa pods, shea tree bark, palm tree leaves, and things like that," he says. "All those pods and leaves are [burned] and added to oil and that’s emulsified. So the soap is no longer a detergent. It’s a solidified oil-and-leaf mixture. It also is probably beneficial to those whose mom and grandma use it—it’s hard to introduce it to someone who’s never used it since it’s kind of intense-looking. But it’s been around forever.”
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