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SKIN OF COLOR
Most skin diseases that occur in Caucasians also occur in Hispanics and
African-Americans. Certain problems, though, are more common in skin of color.
Dry or "Ashy Skin"
Dry skin can be a problem for Hispanics and African-Americans. It's uncomfortable, and it's also easily noticed because of its grayish, "ashy" appearance. Using moisturizers can help, although these products may worsen acne pimples. Patients with acne should discontinue using moisturizers and seek a dermatologist's advice.
Ashiness can also affect the scalp. Pomades that make the hair more manageable can decrease scalp dryness. But if pomade spreads to the forehead during sweating it can block pores, causing pimples called acne cosmetica or pomade acne. If this occurs, stop using the pomade, or apply it one inch behind the hairline.
Pomade can also contribute to a bacterial infection of the scalp called folliculitis, pus bumps and redness around the hair. It can cause hair loss and the spread of infection. If this occurs, discontinue using the pomade and see a dermatologist.
Variations in Skin Color
Skin color is determined by cells called melanocytes. All races have the same number of these cells. In Hispanic and
African-American skin, melanocytes produce more pigment and produce it faster than does white skin.
Because of their skin color, Hispanics and African-Americans are better protected against skin cancer and against premature wrinkling from sun exposure.
Some pigmentary conditions common in patients with darker skin are too much color or too little color in certain areas. In the first case, areas of the skin may darken after an injury, such as a cut or a scrape, or after certain skin disorders, such as acne.
If breakouts occur, treat skin gently. Avoid picking, harsh scrubbing and abrasive treatments, unless prescribed by your dermatologist. Darkened areas of skin may take many months or years to fade, even with
medication.
Pityriasis Alba
People with Pityriasis Alba have round, light patches of the skin covered with fine scales. Most commonly found in children, the patches can occur on any part of the body, but are most noticeable on the face and upper arms. The white patches are the result of mild eczema, and the loss of color is only temporary. This condition can be treated by a dermatologist.
Dermatosis Papulosa Nigra
This condition, also called "flesh moles," occurs almost exclusively in Hispanics and African-Americans, and most frequently in women. The brown or black raised dark spots usually appear on the cheeks. They resemble moles or flat warts, although they are not the same. In fact, they are a variant of Seborrheic Keratoses. They are not cancerous but some patients have them removed for cosmetic reasons.
Keloids
When the scar from a deep cut or wound extends and spreads beyond the size of the original wound, it is known as a keloid. Keloids may vary in size, shape and location and are found more often in Hispanic or African-American skin.
Common on the ear lobes, neck, hands or forearms, keloids usually result from an injury or infection. Occasionally they occur spontaneously, especially on the
mid-chest area. Some persons develop keloids after surgery; they may appear on the ear lobes after ear piercing.
Depending on the location of the scar, treatment may consist of cortisone injections, pressure, silicone gels, surgery, laser treatment or radiation therapy. Unfortunately, keloids tend to return, even with treatment.
Folliculitis Keloidalis
Some Hispanic and African-American men develop
keloid-like scars on the back of their necks. The area may itch and sometimes becomes infected. The sooner these bumps and scars are treated by a dermatologist the better. They will continue to grow and become harder to treat.
Hair
African-American hair is unique in its shape and structure. The hair on the head, as well as in the beard, is likely to be tightly curled. Certain techniques and preparations used to treat black hair can lead to a variety of problems.
Hair Loss
Hair loss or broken hairs at the scalp margins in women may be a problem. It is caused by repeated or frequent tight braiding (traction alopecia), hair straightening agents (e.g. perms, relaxers) or tight rollers, or as a result of hair styled in a pony tall or single braid style. Dermatologists usually recommend changing hair styles if the hair is falling out or breaking off along the scalp margins. In most cases, the hair will grow back.
The use of a hot comb and oil to straighten hair can cause hair loss on the top of the head. Inflammation and scarring can result from the application of hot oil. If scarring occurs, the hair loss will be permanent. Otherwise, the loss may be only temporary.
Hair Breakage
Hair straighteners use strong chemicals to change the structure of the hair. While straightened hair is easier to style, it may also be brittle, breaking easily. Used according to package directions, hair straighteners usually do not cause problems. If used improperly or on previously damaged hair, hair breakage or other difficulties may arise. Excessive brushing,
back-combing, or other stresses also cause breakage. Most hair loss from breakage is temporary, because it does not affect normal hair growth. Hair will usually grow back, just as it does after it has been cut.
Tinea Capitis (Ringworm)
Ringworm is not caused by a "worm" but by a fungus. When it occurs on the scalp, it produces itching, scaling, and redness. It occurs most commonly in children and can cause hairs to break off. Sometimes severe inflammation and
boil-like cysts develop. It's contagious and family members, as well as classmates, can catch it easily. It usually requires many weeks of oral medicine to cure.
Ingrown Hairs of the Beard (Razor Bumps)
The hair roots of African-Americans are curved. This is true of beard hair as well as other body hair. After shaving, the beard's sharp pointed hair, may grow back into the skin. This causes a reaction resulting in bumps. Dermatologists call this condition
"Pseudofolliculitis Barbae."
Growing a beard is another solution. This will permanently cure this condition, but is not always an option.
Men with ingrown hairs should try different methods of hair removal.
Shaving with a safety razor may help. After applying lather or shaving cream, wait to let the soap soften the beard. Shave only in the direction of the hair growth, not against the stubble. Don't stretch the skin during shaving and don't shave on a daily basis. If hairs begin to ingrow, lift them up with an
alcohol-cleaned needle (don't tweeze or pluck) just before shaving. Occasionally using a toothbrush or rough washcloth before shaving or bedtime may loosen hairs about to grow inward.
Chemical depilatories remove hair, but should only be used every two days. They are not for everyone. They must be wiped off promptly according to package directions. Wash your face twice with soap and water immediately afterwards to guard against irritation.
Hair removal by a laser may be an effective solution for this problem. Consult your dermatologist about treatment options.
Nails
Dark streaks or bands in Hispanic and
African-American fingernails and toenails are normal. They tend to increase in number as a person ages. Increased darkening around the base of the nail could be a sign of a dangerous type of skin cancer called malignant melanoma and should be checked by your dermatologist.
The skin, hair and nail conditions common among Hispanics and
African-Americans are generally not serious. They can easily be recognized and usually are successfully treated. If you have any questions about skin problems, see your dermatologist.
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