Dr. Eric Schweiger - MD

Acne in Skin of Color

Clear Clinic has a special interest in the unique requirements of darker skin patients with acne. Patients with skin of color have different obstacles to achieve the best treatment of their acne than other patients. Acne breakouts occur from the same factors, regardless of your skin tone. However, treating acne can present some unique challenges for patients with skin of color. Patients with skin of color are prone to residual dark marks for weeks to months after acne breakouts. These left over marks are called “post-inflammatory hyperpigmentation” (PIH), which can be very difficult to treat and frustrating for the patient.

Post Inflammatory Pigmentation in Skin of Color

Darker skinned patients with acne are more likely to develop brown spots (post-inflammatory hyperpigmentation) after acne lesions. Post-inflammatory hyperpigmentation (PIH) results from an increase of skin pigment production after some injury or stress on the skin. Post-inflammatory hyperpigmentation often forms after an inflammatory reaction in the skin, like acne. In layman’s terms, PIH is when the skin becomes discolored or darkened in an area that was recently inflamed-like a painful acne cyst. Inflammatory acne lesions can cause post-inflammatory hyperpigmentation, particularly in skin of color. We tell our patients that it is like the ashes after a fire. The fire was the breakout (inflammatory acne) and the ashes are remnants of the fire (PIH) that indicate where the pimples used to be. These ashes can sometime stick around for a while without treatment.

Safe Acne Treatments for Skin of Color Patients

It is important that patients with skin of color see an acne specialist who is familiar with the intricacies of treating acne and acne scarring in darker skin types. At the Clear Clinic, we have numerous patients with darker skin types including African American, Indian, Asian, Native American, and Hispanic patients. To achieve the best results in these patients with use several different acne clearing modalities. Clear Clinic utilizes Red and Blue LED Light Therapy, Photodynamic Therapy and the Isolaz Laser Treatment for treating acne in skin of color.

Safe Acne Scar Treatments for Skin of Color Patients

Treatment of acne scars is safe and effective for patients with darker skin types with an experienced dermatologic laser surgeon. Newer fractionated resurfacing lasers leave healthy, intact skin in between the treated areas. This technique allows for faster healing and safer treatments for all patients, including patients with darker skin types. Patients with skin of color should begin use of a lightening cream, called hydroquinone, prior to the treatment and continuing use afterward to prevent post-inflammatory hyperpigmentation (or a tanned appearance after the treatment). Acne scars in patients with darker skin types are most often treated with the Fractional Erbium Glass laser at Clear Clinic. This is a fractionated resurfacing treatment that pokes tiny, microscopic holes in the skin. This process stimulates the production of healthy collagen to smooth out the skin’s texture. A series of Fraxel laser treatments can result in 50-70% improvement of acne scars. The fractional CO2 laser can be used for acne scar treatment in some patients with darker skin types. Both resurfacing treatments are safe for skin of color.h2