Skin Conditions in People of Color
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A range of skin conditions can affect people of color. Some are related to the amount of pigment in the skin, while others may be due to genetics, hormones or other factors.
With proper diagnosis, early intervention and appropriate treatment, many skin conditions common in people of color can be managed successfully.
Marcia Driscoll, MD, associate professor of dermatology at University of Maryland School of Medicine, specializes in general dermatology as well as skin conditions affecting people of color.
In her practice at University of Maryland Medical Center's dermatology department, Dr. Driscoll frequently sees patients with these skin concerns:
- Hidradenitis suppurativa
- Central centrifugal cicatricial alopecia
Hidradenitis Suppurativa (HS)
Painful red boils form in the folds of the skin in this condition. The boils typically begin to appear around puberty. If left untreated, there is a risk for scarring and disfigurement in the affected areas.
Though HS is most common in the African American population, it can be found in people of other ethnicities. “There is a high prevalence of hidradenitis suppurativa in the Baltimore area. It is a condition often misdiagnosed or diagnosed years after onset of symptoms,” Dr. Driscoll explained.
There is no cure for HS, but it can be controlled if caught early.
Causes of HS include genetics, hormones, inflammation and bacteria. Women are three to four times more likely to develop HS because of hormones. HS can also be associated with other conditions like depression, anxiety, obesity, diabetes, hypertension, high cholesterol, high fats and significant pain.
Because bacteria is a factor in HS, antibiotics can help improve this skin condition. “It’s important for patients to know that although there is a bacterial component that can cause HS, it is not related to hygiene – often a myth when discussing HS,” says Dr. Driscoll.
Melasma is a pigmentation disorder where parts of the skin look darker than the rest of the skin. People of all ethnicities can develop melasma, but the more pigment in the skin, the more likely it is to occur.
While the cause of melasma is not clear, it happens when some of the cells that produce the color in the skin release more pigment than others. Contributing factors to melasma include acne, oral contraceptive pills, hormonal imbalances, pregnancy and autoimmune disorders such as lupus.
If acne is a factor, it is essential to address the acne first. There are medications a dermatologist can prescribe, but something over-the-counter that may help is sunscreen. It is important to choose a sunscreen that contains the widest coverage of the ultraviolet spectrum and visible light.
Central Centrifugal Cicatricial Alopecia (CCCA)
This scalp condition is more likely to affect African Americans. CCCA occurs when the hair follicle is damaged and cannot grow back.
The exact cause is not known. However, some contributing factors may include hairstyles that pull the hair tightly, hair extensions and exposure to heat or chemicals.
Hair loss from CCCA typically starts from the central part of the scalp and spreads outwards. Seeing a skin specialist for evaluation soon after symptoms begin is important. If CCCA is not treated, scarring can occur, and it may not be possible to get the hair to regrow.
However, it is possible to stop the progress of scarring using anti-inflammatory medications. These medications may be applied to the scalp or given as an injection directly into the scalp. Also, non-prescription products that lengthen the growing phase of hair can be helpful.