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How the sun affects a person's skin largely depends on their skin tone. For example, individuals with dark brown skin are less susceptible to sunburns than people who are fair. Similarly, hyperpigmentation is more common in those with darker skin tones.
The good news is that dermatologists have been investing more resources into understanding and pursuing solutions to hyperpigmentation in African American skin tones.
One thing that makes things a little easier? While its presentation can vary by skin tone, the causes of hyperpigmentation are similar for everyone.
In its simplest form, hyperpigmentation refers to the skin darkening beyond its natural tone. It’s a general over-abundance of melanin, the pigment that gives skin its color. More often than not, hyperpigmentation speaks to the darkening of specific areas on the body. This can happen to people of any skin tone, but it’s generally more noticeable on darker skin tones. And, dermatologists find hyperpigmentation is often most difficult to treat when patients have darker skin tones. Over the years, this has sometimes discouraged people of color from seeking treatment, but dermatology has come a long way since. There are several treatments now made safe for darker skin tones or created specifically with hyperpigmentation and darker skin tones in mind.
Help from a dermatologist is a great place to start.
In 2016, a group of researchers set out to answer this question. They studied a group of 43 African Americans and 40 Caucasians to determine what caused skin color differences on the body. For most white people, skin color variations on the body depended on sun exposure. The same was not true of African Americans. This suggested to researchers that there were several other factors at play in the pigmentation of Black skin tones. Dermatologists are still working to discover what those differences are, and even small discoveries have led to leaps and bounds in treatment progress for persons with darker skin tones.
While the causes of pigmentation distribution might vary across skin colors, the causes of hyperpigmentation tend to be fairly similar. That's good news, making diagnosis and possibly prevention a little easier.
These are some of the most common causes affecting Black or African American communities and virtually everyone else.
Hormonal changes can trigger hyperpigmentation. When it happens to pregnant women, for example, it’s often called the mask of pregnancy. These cases tend to be melasma. Sometimes, women taking oral contraceptives and men taking hormones to treat prostate cancer can also experience this form of hyperpigmentation.
A common cause of hyperpigmentation is the skin rubbing against itself or rubbing against fabric. People who are overweight or obese are especially likely to experience hyperpigmentation like this under the breasts, on the belly, and on the inner thighs.
Exposure to the sun can increase the risk of hyperpigmentation for people already predisposed to this condition. In fact, for most people, hyperpigmentation tends to develop in areas that experience exposure to the sun, such as the face and shoulders.
Cancer and chemotherapy can take a serious toll on the body. Most people lose their hair and even their appetites. Because they're such harsh chemicals, chemotherapies can sadly also cost people their even skin tones and have been known to cause hyperpigmentation during and even after treatment.
Some health conditions can lead to darkening of the skin because of the way they affect the production of melanin. Addison’s disease is one example. It can lead to the darkening of areas exposed to sun and friction, such as the knees, elbows, face, shoulders and neck.
Sometimes trauma to the skin can lead to scarring in the form of darker spots. Pimples are the most common example of this. If you notice your skin scars easily or spots easily, reconsider popping pimples.
Healed wounds can also create this condition.
Cancer of the skin can lead to discolorations. African Americans often only receive diagnoses for this condition in the later stages because their skin types are so rarely affected compared to other demographics. Dermatologists consider this when diagnosing skin conditions.
It’s a reasonable argument that people of African descent have the most diverse skin tones of any demographic. African Americans also often carry genes from other parts of the world, which can further influence skin tones. Because of this, more than any other demographic, people of African descent require custom solutions. These are some of the puzzle pieces dermatologists fit together to form unique treatment plans when evaluating skin conditions.
Regularly washing the skin reduces contaminants that may cause pimples and other skin conditions. Moisturizing also helps reduce friction. Both of these can work together to reduce hyperpigmentation. The trick is finding products that don‘t irritate your skin, which may take a little trial and error.
If friction irritates your skin and causes hyperpigmentation, reconsider your fabric choices. Your clothes are an excellent starting point, but don’t stop there. What about your pillowcases, towels and bed linen? Even the sofa could create friction for your skin. Evaluate your causes, and consider the alternatives.
When there’s a big pimple staring back at you in the mirror, making it disappear is tempting. After all, if you don’t, people are likely to stare at it all day. Unfortunately, pimple-popping can lead to acne scars that stick around long after you find your acne solution. Short-term gain isn't worth the long-term pain in this case.
Pimples and papules aren’t always the culprit for skin scarring. Insect bites and allergic reactions can create a similar effect. If you have mysterious allergies, it might be time to work with a doctor to narrow down what’s causing them so you can avoid allergens altogether and spare your skin.
African Americans are among the demographic least likely to stay in the shade or wear protective clothing. One study found that as many as 81% of African Americans don’t feel particularly inclined to use sunscreen. While darker skin offers some protection, it doesn’t provide immunity from skin conditions that are caused or worsened by the sun.
Reduce exposure or slather on the SPF.
Some people have experienced promising results with chemical peels. Superficial chemical peels tend to deliver the best results for darker skin tones. Even so, it’s important to use the right products to avoid irritation, which may require some small-scale testing prior to application.
Of all the most hotly debated solutions, lasers top the list. When done incorrectly, they can lead to scarring, pain, or more damage overall. Lasers must be adjusted to match the skin tone, and this is not always done easily or properly – or at all. Make sure you're working with a trusted professional before going under the laser.
Sometimes, working with topical solutions to lighten specific areas that have developed excess melanin is the best way reduce hyperpigmentation. Your dermatologist can advise you on whether this is the best approach for you and the safest way to go about it.
Discoloration or hyperpigmentation of the skin is one of the most common reasons African Americans seek out dermatologists. With the prevention tips above, most dermatologists will recommend you start tackling hyperpigmentation before it starts: play it safe in the sun and take note if you have specific triggers. Hyperpigmentation in African Americans is common, but it's also preventable in many cases.
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