Dermatologist's Tips for Deeper Skin Tones: Doctors' Notes

The skin is the body's largest organ, so we need to take good care of it. For the most part, all skin has similar needs - cleansing, moisturizing, wearing sunscreen and avoiding the sun.

But for people with richly pigmented brown or black skin tones, there are other specifics that must be considered.

First, there's a misconception that people with darker skin don't need to wear sunscreen. This simply is not the case. It's true that melanin, the natural pigment that gives everyone's skin colour, offers protection similar to an SPF 8 in deeper skin tones, but this isn't enough to prevent damage or sunburns. And although people with brown or black skin might have a lower risk of developing certain types of skin cancer, that doesn't mean there's no risk at all.

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Also, pigmentary changes - like skin that darkens after an eczema flare or acne breakout, or becomes lighter after a yeast condition called pityriasis versicolour - are a common reason why people visit my dermatology office.

Brown or black skin is more likely than white skin to show changes to its pigmentation if it is picked, or becomes injured or inflamed. As well, certain medication ingredients like benzoyl peroxide, which is commonly found in over-the-counter products to treat acne, can irritate deeper skin tones and lead to pigmentary unevenness.

People often confuse these localized changes to skin colour with actual scars, however scars result from trauma to the second layer of skin, called the dermis. Scars are permanent forms of injury that have disturbed the collagen and tissue below the skin's surface.

People with brown and black skin are often more prone to an aggressive type of scar, called a keloid. Our skin produces collagen to help us heal when we're wounded. But sometimes, collagen is overproduced and the scar grows thicker and becomes larger than the initial injury. These firm, raised scars can develop months after a bedside procedure or even a minor event like getting your ears pierced. There are therapies to improve the appearance of these thick scars, but unfortunately, they can't be cured completely.

Black and brown skin is also at risk of damage during laser therapy treatments. If you have this pigmentation, you should be aware that some of these high-tech tools are not appropriate for our skin. Deeper skin tones are at a higher risk for burns, scars and discoloration that can't be improved easily or reversed if the wrong laser is used, or if the wrong laser setting is programmed.

If you're considering laser therapy, you should seek a professional diagnosis from a dermatologist who will know whether or not laser is the right choice to help with your skin condition. They'll also be able to provide context for how much the treatment can or can't do - for example, whether you might see a 20 per cent difference versus an 80 per cent difference.

It's important to develop good habits early. My colleagues and I often meet people in our exam rooms that only start thinking about their skin care once they hit middle age. Although there are treatments that can offer improvements to skin's appearance as we age, there's no substitute for a history of good habits. So, start now, and protect your skin.

Dr. Renée Beach is a staff dermatologist in the Division of Dermatology, Faculty of Medicine at the University of Toronto and leads the Alopecia clinic at Women's College Hospital. She also works in private practice.Doctors' Notes is a weekly column by members of the U of T Faculty of Medicine. Email

Dermatologist's Tips for Deeper Skin Tones: Doctors' Notes 1

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