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or openers, let me state that black skin is firmer, stronger, and smoother than white skin and is much more resistant to photodamage and the aging process. A recent study comparing 40- to 50-year old white women’s skin to those of African-American women revealed that nearly all the white women in the study had wrinkles on the corners of the mouth and eyes (“crow’s feet”), while the black women had few of these wrinkles.
Black people, however, are troubled by unique skin problems. Also, their skin reacts differently to injury and various ailments.
Some skin disorders are more common – and more apparent – in black people: keloids, “razor bumps,” vitiligo, lupus erythematosus, tinea versicolor, acne due to pomades applied to the scalp, “ashy skin,” pityriasis alba, and others. Some diseases of the skin are considered unusual or rare among black people: scabies, head lice, and rosacea are some examples of these uncommon ailments.
Many skin problems in blacks are related to cosmetics designed for use on black skin and to fashion trends that are more common among blacks. For example, the use of creams and oils to reduce ashy skin color can cause hair follicle infections of the body and scalp. Also, cornrowing, hot combing, and hair-straightening chemicals often lead to scalp irritation and temporary hair loss.
Some allergies seem to show up more frequently in black people, as well. The most common cause of allergic reactions in black women is an ingredient (paraphenylenediamine) used in hair dyes. Allergies to nickel can cause a rash on the earlobes from earrings and on the ears and temples from the nickel in eyeglass frames. Black men have a tendency to develop severe and continuing allergies to chromium compounds in cement and leather. Because of the scratching and rubbing that goes along with allergy rashes, black skin usually thickens and develops excess pigmentation, which can become a cosmetic problem.
Care of Black Skin While its true that black skin is stronger and has the physiological advantage of resisting sun damage, and while it doesn’t show its age as easily as white skin, it doesn’t mean that you don’t have to take good care of it. To keep black skin healthy-looking, and to prevent the excess pigmentation that can develop on troubled and inflamed skin, follow these guidelines:
Let’s look at some of the skin and hair conditions that are common to black people.
SKIN CONDITIONS
Pigmentation Problems
Problems with skin pigment or color – too much or too little – can be a real concern if you’re black. They show up more and are more apparent because of the greater contrast between the normal and problem skin, and they last longer than pigmentary problems in others.
Even though this may sound strange, people of all races have the same number of color-producing cells in their skin. These cells are called melanocytes. The melanocytes in black skin produce more color or pigment and make it faster than white skin. Further, they are larger, more active, and are circulated differently from those in white skin. (See chapter on Pigmentation) Because of all this, pigmentary changes in black people are usually more obvious and longer lasting. The advantage of black skin is twofold: blacks rarely, if ever, develop skin cancer and they do not show the aging changes – the wrinkles – as readily as whites.
Many of the color variations in black skin are normal. For example, black skin is lighter on the palms of the hands and soles of the feet, and darker on the gums, the roof of the mouth, and the inner surfaces of the cheeks. Black people often have brown or black stripes on the nails of the thumb and index finger as well as lines of pigmentation on the upper arms.
Excessive pigmentation in black skin can be the result of a simple injury, a mild irritation, or from diseases such as acne or eczema. This extra- or hyperpigmentation shows the increased activity of the color-producing cells when the skin is injured or inflamed. It can last for months or years, which can be very distressing.
Hyperpigmentation is often seen in young black people who are being treated for acne. Blacks usually have a reaction to the drying and peeling medications used in acne therapy. The discoloration can last for years while the patient is using lotions and creams that contain the drying ingredients.
Other skin disorders that can cause color variations in black skin are eczema, psoriasis, lichen planus, tinea versicolor, and pityriasis rosea. These same conditions, paradoxically, can also cause a loss of pigment or hypopigmentation. Skin injuries and liquid nitrogen treatments used to treat warts and other tumors can also cause pigmentary changes.
While there is no easy cure for these annoying pigmentary changes, you can help some of them with cortisone-like creams and ointments, which your dermatologist will be able to prescribe. Other methods include some over-the-counter preparations that are discussed in the chapter on Pigmentation (page 000).
Ashy Skin
Ashy skin – simply dry skin – is a result of the body getting rid of dead skin cells. This normal shedding happens in every one of all races. This grayish, ashy-looking skin shows up more clearly on black skin because of the contrast between the dead, dry cells on the surface and the fresh, new ones that have replaced them. It’s not a sign of disease.
You can take care of this perfectly normal, healthy skin very easily, using the same treatment as for dry skin. (See page 000.) Wash with a mild, gentle soap or skin cleanser (like Cetaphil Cleanser), bathe in Alpha Keri Oil, apply a moisturizer (like Cetaphil Lotion) after your bath, and try to increase the relative humidity in your home to at least 40 percent.
Avoid the use of greasy and oily products – cocoa butter, cold creams, petroleum jelly – to attempt to alleviate this condition. You will only plug up your oil glands and you will develop acne bumps on your face and other areas.
Lichenification
Black skin appears to be especially susceptible to the development of lichenification. This harmless condition consists of thickened, hyperpigmented patches of skin with accentuated skin markings. It is a result of constant scratching that accompanies eczema, contact dermatitis, and some types of “nervous” itching. People who are under constant stress often develop itchy areas – back of neck, forearms, legs and ankles, and other areas – that they (naturally) scratch and rub. This persistent scratching and rubbing will cause the thickening and darkening.
Pityriasis Alba
This common condition occurs primarily in childhood – ages 8 to 12 usually – and is a marker – a sign – of eczema. Although it also occurs in white children, it is more noticeable in black skin. It consists of light – hypopigmented – patches of skin over the cheeks, and, occasionally other areas such as the arms and neck. It also has another name – furfuraceous impetigo – but rest assured, it has nothing to do with impetigo.
Dermatosis Papulosa Nigra
Dermatosis papulosa nigra is a condition, not a disease, seen almost exclusively in blacks. It occurs in about one-third of all black people and is twice as common in women as in men.
What does it look like? Tiny, smooth, raised, mole-like spots that appear on the face and neck that are darker than the skin around them. Resembling flat warts, they begin around the age of puberty, are inherited, can vary in number from just a few to hundreds, and become more numerous as a person gets older. They never become malignant; in other words, they are not precancerous growths. Some of the well-known people who have these “friendly” growths are Maya Angelou, Bill Cosby and Morgan Freeman.
If you have a lot of these tumors and are unhappy with the way they look, a dermatologist can remove them simply and easily with a variety of methods.
HAIR & SCALP CONDITIONS
Hair Loss & Hair Breakage
The woolly, kinky texture of black hair is uniquely different in its shape and structure from the soft, straight, flowing hair of white or Asian people.
Some hair-grooming procedures – such as curling, pressing and perming – stretch and stress the hair, causing it to break off or fall out.
Traction alopecia is a term used to describe symmetrical hair loss at the margins of the hairline; in other words a receding hairline. This condition can result from tightly braided or twisted hairstyles, tight rollers and heated curlers, and decorative cornrowing and dreadlocks. These can cause permanent hair loss.
Using a hot comb on chemically treated hair can result in hair loss over the crown or top of the head.
Using chemical relaxers and hair straighteners improperly or too frequently can cause patchy baldness by damaging the keratin of the hair, making it brittle and easy to break off.
Using a pick can fracture the hair shaft, also leading to hair loss.
To prevent or manage hair loss and breakage, ease the stress on your hair. This may mean changing your hairstyle, wearing looser braids, or using pin curls instead of rollers. Also, make sure you shampoo your hair at least once a week (I know it’s often difficult), and use a protein conditioner regularly.
“Razor Bumps”
The ingrown hairs of the beard in black men are called, technically, pseudofolliculitis barbae. Almost everyone knows what you mean, though, if you call them “ razor bumps.”
This irritation and swelling around an ingrown hair occurs mostly in young black men because the hair and hair follicles in blacks are more curved than in whites.
Razor bumps develop when the sharp, razor-cut tips of curly hair, sharpened by frequent shaving, cut into the skin in an arc and grow inward. Because of the natural curve of the hair follicles of African-Americans, the hair grows like a curved needle and grows back into the skin. This induces what is called a “foreign body reaction”: redness, swelling and pain.
Several factors make the condition worse:
There are no easy solutions to this common, painful inconvenience, but here are a few hints that can help:
• The simplest answer is to grow a beard and all the bumps will disappear in about a month. Why? Because by the time the hairs are about a half-inch long (in a month or so), the natural tension will cause the ends of the hairs to spring out of the skin. [See Figure B]
• Since you may not want a beard for the rest of your life, change your shaving routine as follows:
Don’t expect to get a smooth, clean shave the first few times you use this method. Be patient. After a while, you may be able to train your hairs to grow out straight, or at least straighter, rather than in a curl.
If this method doesn’t work, here are a few other suggestions:
The latest treatment for this troublesome and stubborn condition is with a special type of laser (the long-pulsed Nd:YAG laser). Ask your dermatologist about this new, promising remedy.
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For further information about black skin, log on to: www.aad.org 1-888-462-DERM x22 For more information about “ razor bumps,” write to: |
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