7 Conditions A Dermatologist Says Even Experts Miss On Skin Of Colour

SkincareA 2022 paper found “Significant racial/ethnic disparities in dermatologic care,” partly, they suggested, because non-white skin is “underrepresented in dermatologic education” and research.A lack of “minority groups in the dermatologic workforce” might also lead to blind spots, it reads.Speaking to Huffpost UK, dermatologist and skincare brand founder Dr. Vanita Rattan said that this can lead to misdiagnoses or missed skin issues, even among experienced doctors. Here, she says, are seven issues even experts “often” miss in skin of colour:1) Post-inflammatory hyperpigmentation (PIH)“Inflammation in skin of colour often triggers excess melanin production,” Dr Rattan told us. “This is because melanocytes (melanin-producing skin cells) in darker skin are more reactive to injury, producing more pigment as part of the skin’s healing process.” Something as small as a scratch, bite, or burn can leave a dark mark long after the initial incident; these can take months or years to fade without treatment.This is “frequently mistaken for permanent scarring or just naturally uneven skin tone,” Dr Rattan said, despite being treatable with actives and barrier-repair treatment.2) Keloid-prone scarring“A minor cut, a piercing, or severe acne can trigger an exaggerated healing response in skin of colour, resulting in raised, thickened scars known as ‘keloids,’” Dr Rattan added.Though these can occur in any skin tone, she says they are more common in those with more melanin.Keloids don’t ‘heal’ in the way a typical wound does,” she added, often remaining itchy or tender long after closing.“I would avoid most standard scar treatments, including lasers or dermabrasion, as they may worsen pigmentation or cause the protruding scar tissue to become harder.“Instead, opt for corticosteroids or silicone dressings under the supervision of a specialist.” 3) Melsma This “appears as brown or grey-brown patches on the skin, often on the cheeks, forehead, and upper lip,” the dermatologist explained.“In skin of colour, it’s commonly mistaken for general pigmentation or ‘sunspots.’ UV damage, as well as hormonal fluctuations during menstruation or pregnancy, can trigger flare-ups, making the condition highly recurrent. ”Though wearing sunscreen is key to great treatment, she said, “In fact, many cases of melasma might need a more targeted treatment with multiple tyrosinase inhibitors, like retinaldehyde and alpha-arbutin, to block the overactive melanin-producing enzymes.”4) Eczema with discolouration“In lighter skin, eczema is typically described as a red, irritated rash,” Dr Rattan explained. “But in skin of colour, the condition often presents as grey, purple, or dark brown patches, sometimes with less obvious redness or swelling.”That, she says, can lead to underdiagnosis or confusion with hyperpigmentation ― and because of the sensitivities in melanin-rich skin we mentioned earlier, leaving eczema untreated can then actually cause hyperpigmentation.“This is why a fatty moisturiser is essential for eczema care as it helps prevent dryness and itchiness, as well as lowers the risk of flare-ups through proper hydration,” the expert said. “So, make sure to look for moisturiser with ceramides and peptides to support the cell regeneration process, and humectants like glycerin to replenish the lost moisture.” 5) Seborrheic dermatitis on the scalpThis happens when inflammation leads to an overproduction of oil, which affects the scalp.“In skin of colour, it can present as flaking and visible scaling, which is why it’s often mistaken for dandruff,” she states.“However, while dandruff is a shedding of dead skin cells, seborrheic dermatitis involves redness and sensitivity, which can lead to itching, stinging, and sometimes even temporary hair loss if left untreated.” Though it’s important to get rid of the symptoms in the short term, the doctor says tackling the root inflammation is key.“This may require medicated antifungal treatments and adjustments in hair care routines. You can start by incorporating a lightweight anagen boost hair tonic, which protects the scalp and helps maintain a healthy environment for hair growth, especially in already thinning areas.” 6) Pseudofolliculitis barbae (shaving bumps)These are often seen in men with curly hair and women who wax, says Dr Rattan. It happens “when strands curl back or grow sideways into the skin instead of outward, causing raised, tender skin that can sometimes lead to persistent dark spots.” If untreated, it can “cause long-term scarring and ongoing pigmentation changes.” You can help to prevent the issue by changing your hair removal method, she added, but “you can also use a gentle chemical exfoliator with 5% mandelic acid and 5% lactic acid to unclog pores and reduce ingrown hairs without sensitivity, preventing further shaving bumps in the process.” 7) VitiligoThis is a pigment loss issue which can show up as sharply defined pale patches of skin. But it can be “subtle” in its early stages, Dr Rattan says, “sometimes only appearing as small spots that are slightly paler than your natural complexion”. This can be dismissed as sun damage, chemical lightening, or post-inflammatory hypopigmentation at the start, she adds. “However, vitiligo is an autoimmune condition, and without early intervention, it can progress to more noticeable patches that cover larger areas of the body.“While there is no cure, treatments such as topical corticosteroids, light therapy, or specialised cosmetic products like a ceramide-rich concealer with occlusives can help camouflage and protect smaller depigmented areas prone to sensitivity and dryness.” Related...Gordon Ramsay's Skin Cancer Can Show Up As A 'Spot' – Here's How To Check YoursSo THAT's What Those Tiny Itchy Bumps On Your Fingers AreSo THAT's Why The Skin Under Your Fitness Tracker Is So Red And Itchy

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