People of color may be more prone to certain conditions that affect the skin. These conditions can include post-inflammatory hyperpigmentation, pseudofolliculitis, and melasma, among others.

This article discusses skin conditions that are more common in people with dark skin.

It also explores some of the less common conditions, alongside their symptoms and treatment options.

Post-inflammatory hyperpigmentation (PIH) refers to the temporary pigmentation of the skin that develops as a result of previous inflammation or injury.

The condition presents as darkened patches of skin located at the site of the initial injury. The color of the skin patches can range from light brown to black.

Although it can affect anyone, it more commonly affects people with dark skin.

PIH occurs as an increased reactivity of melanocytes within the skin. This leads to an overproduction of the pigment called melanin.

A number of conditions can trigger the increased activity of melanocytes that leads to PIH. These conditions include:

  • acne
  • atopic dermatitis, or eczema
  • psoriasis
  • reactions to certain medications
  • infections
  • allergic reactions
  • burns
  • physical injuries
  • pseudofolliculitis

Treatment

Although the condition can resolve without treatment, it may take months or years.

According to one 2020 article, healthcare professionals commonly prescribe hydroquinone to treat PIH.

Depending on the cause, they may recommend one or a combination of the following treatments:

  • prescription-strength hydroquinone
  • azelaic acid
  • vitamin C cream
  • cysteamine cream
  • tretinoin cream
  • corticosteroid cream

Other forms of treatment can include chemical peels, laser therapy, and intense pulsated light therapies.

Some people may refer to this as razor bumps. Although it can affect anyone, it appears to be more prevalent among males of African ancestry and people with curly hair.

When a person shaves, the ends of their hairs become sharp, and the hairs can curve back into the skin, leading to inflammation.

Pseudofolliculitis can appear similar to a painful rash or acne. It can also lead to PIH.

Treatment

The American Osteopathic College of Dermatology notes that once the hairs reach a certain length, they will not grow in toward the skin.

A person should avoid shaving for 3–4 weeks and apply mild prescription cortisone cream.

When they are able to resume shaving, it may be beneficial for them to shave every other day and use an electric razor to do so. If a person opts to use a blade, they should first soften the hairs with a wet, hot washcloth for 5 minutes. They should then use a lubricating shaving gel.

It is also important to shave in the direction of the follicle and avoid stretching the skin, if possible.

A healthcare professional may recommend topical or oral antibiotics to help reduce inflammation.

Melasma is a common skin condition that presents as brown-gray patches of skin on and around the cheeks, lips, chin, nose, and forehead. It can also appear on the forearms or neck, though this is less common.

Melasma develops when skin cells become overactive and produce too much pigment in certain areas of the body. This can result from a change in hormones, such as during pregnancy or while taking birth control pills. It can also occur due to prolonged exposure to the sun.

People with dark skin are more likely to develop melasma. This is because people with skin of color have more active melanocytes, according to the American Academy of Dermatology (AAD).

This condition more commonly affects females and typically appears between the ages of 20 and 40 years. The AAD notes that only 10% of those who develop melasma are male.

Learn more about melasma on dark skin here.

Treatment

Melasma can appear similar to several other skin conditions. For this reason, a healthcare professional may perform a biopsy to confirm the diagnosis.

Melasma is treatable, but it is not currently curable.

First-line treatment is typically a topical hydroquinone cream or gel. Although these are available as over-the-counter medications, most people may need to use prescription-strength hydroquinone.

The AAD notes that the symptoms of melasma tend to fade on their own. However, some people can have melasma for decades or their entire life.

Even if the melasma does fade, a person may need to continue treating their skin. The condition can reappear if a person has prolonged exposure to sunlight.

An important element of melasma treatment is to avoid direct sun exposure. Some research suggests that this step is key in improving symptoms and preventing future recurrences.

Other treatment options can include:

  • corticosteroids
  • tretinoin, which is a vitamin A derivative
  • azelaic acid
  • kojic acid
  • chemical peels
  • laser therapy
  • dermabrasion

If a person notices further darkening of the patches or develops skin irritation or allergies to their prescribed treatment, they should contact a doctor.

Learn more about the treatment options for melasma on black skin here.

Acne keloidalis nuchae (AKN) is a long-term inflammatory condition that leads to inflamed plaques and papules on the head or neck.

Symptoms of AKN include:

  • small, firm papules on the lower end of the scalp or neck
  • occasional pustules, or bumps containing pus, on the scalp or neck
  • mild burning or itching around the affected site
  • small lesions or bumps on the crown of the head

This condition develops when the hairs on the back of the head or near the neck begin to grow into the skin, causing inflammation and scar tissue.

AKN affects about 0.45% to 9% of people around the world, most of whom have dark skin and curly hair.

Experts have two theories about the cause of AKN: injury to the skin or an irregular immune reaction.

Treatment

AKN requires long-term treatment and management to reduce the symptoms.

Depending on the extent of the symptoms and the person’s medical history, a healthcare professional may recommend topical antibiotics, laser therapy, injected or topical corticosteroids, or the surgical removal of the fibrotic lesions.

One 2016 systematic review suggests that people who receive intralesional steroids may show the most dramatic improvement in symptoms, compared with other treatment options.

Some small studies have examined the use of light and laser treatments to treat AKN. The 1064-nm Nd:YAG laser and 810-nm diode laser have shown promising results, leading to an 82–95% improvement in symptoms.

Dermatosis papulosa nigra (DPN) is a benign skin growth that appears as skin colored or hyperpigmented papules on the neck and face. These papules can also occur on the neck, back, and upper chest, though this is less common.

The growths are smooth, raised, and approximately 1–5 millimeters wide.

They most commonly affect people of African or Asian descent and typically appear during adolescence. As a person ages, the papules may increase in number and size.

Treatment

Treatment is not medically necessary. However, a person can seek to have them removed for cosmetic reasons, if they choose to.

A healthcare professional may recommend:

  • scissor excision
  • cryosurgery
  • electrosurgery
  • dermabrasion

It is important to note that the affected area of skin may change color following treatment.

Vitiligo is a skin pigmentation condition that appears as white or lighter patches on the skin. These patches may appear as individual or combined patches on one or more parts of the body.

Although vitiligo can affect anyone, it may be more noticeable in those with dark skin.

Depending on the areas affected, healthcare professionals classify vitiligo into two types: segmental, which means that it affects one side of the body, and non-segmental, which means that it affects both sides.

The exact cause of vitiligo remains unknown. Some research notes that it may be a type of autoimmune condition, wherein the body’s own immune cells destroy the melanocytes.

Since melanocytes are responsible for skin pigmentation, their destruction leads to white patches or decolorization of the skin.

The symptoms of vitiligo tend to be surface level, leading to discoloration of various parts of the body. Some people also experience itching or pain at the affected sites.

Some other symptoms include:

  • discoloration of eyebrows, eyelashes, scalp, and beard
  • whitening of the eyes and mouth
  • discoloration of the genitals

Learn more about vitiligo on black skin here.

Treatment

There does not appear to be a cure for vitiligo. However, if a person wants to, they can use cosmetics, makeup, and skin dyes to reduce the appearance of the condition.

The AAD notes that a person can apply a potent corticosteroid cream to the skin. About 45% of people regain some skin color with this method. However, results can take 4–6 months to appear.

Some other treatment options can include:

  • light treatment
  • PUVA light therapy
  • surgery

Some unconventional treatments include the use of certain vitamins, minerals, and enzymes that restore skin color. However, experts caution their use due to limited evidence of their efficacy for this purpose.

Some skin conditions are more prevalent among people with dark skin. Although some of these skin conditions do not cause physical discomfort, others may lead to itching, pain, or burning sensations.

A person can treat or manage most of these skin conditions with oral or topical medications. However, some cases may require additional intervention, such as laser treatment or surgery.