Acne Skincare for Black Skin: Effective Pimple Treatments and Tips for Preventing Hyperpigmentation

Acne Treatment for Black Skin: Top Solutions to Prevent Scarring and Hyperpigmentation

Acne is a commonest skin condition affecting children and adults in America ⁽¹⁾. Acne is characterized by formation of pimples or blemishes on the skin, varying in size and can be mild to acutely inflamed. Acne causes hyperpigmentation and scarring in anyone from any ethnical background. However, when it comes to people with skin of color or Black people, hyperpigmentation and scarring is more severe.

In this article, we will talk about how acne affects Black skin and what are the best acne treatment options and why is it important to find skin care and acne care which is suited to dark skin.

How are Black People Affected by Acne?

Acne is a common skin condition where there is formation of inflammatory and non-inflammatory lesions on the skin. Some of the acne lesions are whiteheads, blackheads, pustules, papules and cysts and nodules. Common causes of acne are diet, hormone changes, hygiene etc.

Black people are more vulnerable to post-inflammatory hyperpigmentation, which are the scars left behind after the acne has healed. Hyperpigmentation occurs when parts of the skin become darker than others and PIH is a side effect of acne and other such inflammatory skin conditions.

A study from 2018 shows significant differences in the way acne affects skin of color when compared to white people ⁽²⁾. This study showed that individuals with dark skin are at increased risk for having post-inflammatory hyperpigmentation after suffering an acne breakout.

What are the Best Acne Treatment Options That Work for Black People

The best person to chalk out a treatment plan for acne in black people is a dermatologist with experience in treating acne in dark skin, who will assess the symptoms and medical history to understand the type of treatment that is needed.

According to the American Academy of Dermatology, getting treatment early for acne is more important in Black people to prevent complications that come with acne, such as dark spots and scarring ⁽³⁾. The treatment for acne is generally same for all the skin types and consists of topical, oral or combination therapy and also depends on the degree of acne. Some of these treatment options also help in reducing the appearance of scars on dark skin.

Best Treatment options for Acne in Black people are:

Salicylic Acid: This is one of the popular ingredients in acne treatment which helps in reducing acne by exfoliating the skin and keeps the skin pores unclogged and clear ⁽⁴⁾. Chemical exfoliation is an integral part of the treatment for acne in dark skin as it reduces the risk of development of acne or pimples in the first place.

Benzoyl Peroxide: This is another popularly common treatment for acne and is more effective when used in conjunction with other treatments for inflammatory acne. It not only exfoliates the skin, but also kills the acne causing bacteria ⁽⁵⁾. It is thought that Benzoyl peroxide lightens or bleaches the skin; however, this is untrue and Benzoyl peroxide does not have any bleaching or lightening effect on the skin ⁽³⁾.

Retinol and Retinoids: Retinoids are derivatives of vitamin A and are a common treatment for acne and also help in improving the general appearance and health of the skin and decreases the appearance of blemishes and scars.

Topical retinoids reduce hyperpigmentation in individuals with skin of color suffering from acne ⁽⁶⁾. When these are used with other treatment options for acne, retinoids become more effective at improving the appearance of post-inflammatory hyperpigmentation.

Retinol is an ingredient which is commonly present in over-the-counter (OTC) products. Prescription-strength retinoids need to be prescribed by a doctor for severe acne and scarring.

Oral Medications: Oral medications are prescribed for severe acne and in cases where topical treatments do not work. These medications can also be prescribed with other treatment options such as:

Hormone Therapy: Fluctuating hormone levels are one of the primary causes of acne. So, it is important to stabilize the hormones to prevent or control the acne and its flare-ups. Birth control pills help in preventing acne flare-ups which occurs around menstrual cycle. Spironolactone can also benefit women having acne which is not getting better with other therapies. When taking spironolactone it is important to prevent pregnancy as this medicine can cause birth defects.

Antibiotics: Antibiotics for treating acne need to be taken daily and include tetracyclines and macrolides.

Isotretinoin:  This is popularly known as Accutane and helps in improving acne by decreasing the size of the glands present in the skin that produce oil and also by preventing the skin cells from clogging the pores. Isotretinoin is usually prescribed for individuals having acute cystic acne and has significant side effects. So, it is important to avoid becoming pregnant when taking isotretinoin as it causes birth defects in the fetus. 

Other Acne Treatment Options That Work For Black Skin:

Some of the treatments which along with treating acne also help in reducing the acne scarring, particularly in Black people, are:

Topical acids which are applied on the skin, such as ascorbic acid, azelaic acid and linoleic acid help in reducing the post acne scarring and hyperpigmentation ⁽⁷⁾.

Light therapy is where pulses of different wave lengths of light are used as a targeted treatment for specific layers of the skin to improve acne and the scarring.

Chemical peels when done under the care of an experienced dermatologist especially with treating acne in dark skin are beneficial in reducing the appearance of hyperpigmentation. The acids used in a chemical peel in a doctor’s office are of stronger concentration and they remove the upper layer of the skin and in some cases go down to the deeper layers of the skin to treat acne scarring and hyperpigmentation.

Whatever treatment option is chosen, it should be born in mind that it should treat acne along with reducing the development and appearance of acne and hyperpigmentation. 

Why Causes Acne in Black People?

The cause of acne is same, it occurs when the pores of the skin become blocked with bacteria, oil and skin cells. Acne can also develop due to hormonal changes, such as puberty or they can develop as a result of ingrown hairs. Some of the common causes of acne are ⁽¹¹⁾:

Genetics play a role in acne. People having a family history of recurrent acne are at increased risk of developing acne.

Hormones, especially androgens, cause an increase in sebum in the skin and lead to clogged pores and increase the risk of acne.

Sleep is important not only for overall health, but also for healthy skin. Sleep deprivation can increase the risk of getting acne breakout.

Stress greatly affects how your skin looks. Stress affects your sleep, hygiene habits and combined with other factors, cause and worsen existing acne breakouts.

Skin care which is suited to your skin type and skin of color plays an important role in keeping the skin free from excess oil, bacteria, dead skin cells, which clog the pores and cause acne.

Smoking is also bad for health and increases the risk for having acne ⁽¹²⁾.

Diet is another important part of a person’s lifestyle for a healthy life. A bad diet leads to poor skin.

What are the Disparities in Acne Care for Black People?

According to research, there have been potential disparities in treatment and care for Black people having acne. A study from 2020 showed that non-Hispanic Black people having acne are less likely to get prescription for oral medication to treat for acne when compared to non-Hispanic white people ⁽⁸⁾.

 Another study from 2017 showed that Black people having acne are less likely to consult dermatologist for treating acne ⁽⁹⁾. However, it was also found that when Black people having acne sought treatment by a dermatologist, they were more likely to get different treatment options, including oral and topical antibiotics and also isotretinoin.

This goes to show how important it is to get medical treatment for acne especially when having darker skin.

Seeking a Specialist for Treating Acne in Black People

It is also important to seek treatment from a doctor who has had experience in treating acne using different options suited to people with skin of color. So, one should look for the doctor’s credentials along with seeing that they are board certified from the American Board of Dermatology.

Their past experience should consist of treating acne and post acne scars in black people.  The doctor should also be able to offer various treatment options, such as procedures or medications to treat and reduce hyperpigmentation in black skin. They should be able to tailor treatment options for acne in black people.

Home Care for Treating Acne in Black Skin

Some of the home care treatment which helps in reducing the risk as well as severity of acne are:

Liberal Application of Sunscreen: People with dark skin absolutely need sunscreen as much as people with any skin color. In fact, it is shown that regular use of sunscreen helps preventing worsening of hyperpigmentation from acne in dark people ⁽¹⁰⁾.  

Early Treatment: It is better to start using OTC treatments early on, as treating acne as soon as it develops goes a long way to reduce the risk of scarring and hyperpigmentation.

Hair and Skin Care Products: Always check hair products as the hair care products which are meant to be used for Black people contain oils in them to help keep their unruly hair soft and tamed. Sometimes these oils can worsen an acne breakout.

Maintaining Hygiene: It is important to clean your hair brushes and combs, also wash your fabrics, such as sheets and pillow cases once a week. The bacteria and oils can seep into bedding and hair accessories can easily transfer to face and cause more acne.

Is There Any Way To Prevent Acne in Black People?

Some of the ways to prevent acne breakouts are:

• Maintaining a good skin regime to keep it healthy and free from dead skin cells, bacteria and other such debris, which clog the pores.
• Always use non-comedogenic skin care products and makeup.
• Never pop your pimples, as they cause skin damage and increase the risk of post acne scarring and hyperpigmentation.
• Apply OTC acne treatment on the area where you sense a pimple is erupting to reduce the risk of post acne spots and scars.
• Following a healthy diet and regular exercise also helps by keeping stress at bay and prevents acne.
• If you still get persistent acne flare-ups despite doing all the above seek medical consultation from a dermatologist to discuss different treatment options.

What’s the Outlook for Black People Having Acne?

The severity of post-inflammatory hyperpigmentation after acne is more in dark skin and it can take about 6 to 12 months for it to fade without treatment. Hyperpigmentation which goes down deeper takes longer to heal. However, with the right treatment, post-inflammatory hyperpigmentation in black people can be significantly improved. It is important to treat acne first before treating the hyperpigmentation. This needs visiting a dermatologist for prescription medications and for discussing other treatment options.

Getting the right treatment with a dermatologist who is experienced in treating black skin or darker skin would lead to reduction in acne and scarring in a few months.

Conclusion

Acne does not discriminate and affects anyone having any skin color or type; however, individuals having dark skin are at increased risk for developing more hyperpigmentation and scarring as a result of acne.

Treating acne early is the best way to prevent acne scars and hyperpigmentation in the first place. Always keep the skin clean and wear a sunscreen to protect the skin as sunrays can further increase the darkening and hyperpigmentation.

If the home treatment is not working, then seek consultation from a dermatologist who has treated acne in people having skin of color.

References:

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