While it’s true that the cause of acne is the same for everyone, the way it affects different races and ethnicities can vary. In fact, one study found that non-white women experience breakouts later in life and in different areas of their faces than Caucasian women. [1] Researchers also found that Black and Hispanic women experience more post-inflammatory hyperpigmentation than their white counterparts. So it should come as no surprise that acne patients with darker skin need to treat their acne differently too. “As the dermatologist, I want target and treat the cause of acne, but often patients with darker skin are more concerned with the discoloration that may be left behind,” says Valerie Callender, M.D., a board certified dermatologist in Glenn Dale, MD and an Acne Store advisory board member. “We have to meet halfway.” This is how she does just that.

1. Treat dark skin with a mild cleanser

At-home skincare has to be gentle and compatible with the prescription or over-the-counter medication you’ll be using, says Callender. “Your cleanser should be gentle and hydrating,” she adds. In other words, pass on overly aggressive foaming products or those formulated with additional active ingredients—they may irritate your complexion and make things worse.  You want to knock out acne and discoloration with a one-two punch, but it’s best to cleanse with kid gloves. And whichever product you choose, Callender would like you to cleanse both day and night.

One study found that non-white women experience breakouts later in life and in different areas of their faces than Caucasian women.

2. Don’t forget to moisturize your face

Many acne sufferers already have oily skin, and adding more moisture can seem like stoking a fire that they’re desperate to put out. But, moisturizing twice daily is essential, says Callender. “You want to make sure you repair the outer layer of skin,” she adds. Your treatment ingredients won’t work as well if your skin’s barrier is compromised—moisturizer will help with that.

Also important to keep in mind is that your choice of moisturizer can shift based on the season. During colder months, dark skin can become dry and sensitive so you might want to use a thicker cream-based moisturizer. In the summer, humidity can make skin oiler, so a lighter lotion-based moisturizer or serum may be more appropriate.

3. Use serum with your sunscreen to fight hyperpigmentation

“Many of my darker-skinned patients believe they don’t need sunscreen,” says Callender. “We know that’s absolutely false.” In skin tones that may already be more prone to developing discoloration with their acne, slathering on SPF is essential for ensuring that hyperpigmentation doesn’t get any worse. You need protection so the sun doesn’t make hyperpigmentation on Black skin worse.

It can also be helpful to layer a vitamin C serum underneath your sunscreen every morning. This antioxidant may help boost your sunscreen’s protective powers, making it even more effective at heading off dark spots.

4. Balance active ingredients carefully

At night, apply your acne medication after cleansing and before moisturizing. It’s a balancing act: You want to be aggressive to prevent acne, but if you’re overzealous, it could lead to even more irritation. And irritation will only lead to more discoloration. Callender likes over-the-counter products that contain glycolic acid, salicylic acid, azelaic acid, or retinol as a safe acne treatment for Black skin. “All three are great options because they gently exfoliate the skin, helping to get rid of excess pigment,” she says. Salicylic acid, in particular, can also get deep down into pores to treat acne at the source.

Whether you use your medications as spot treatments or take an all-over approach depends on the severity of the acne. “If a patient is continuously getting new acne, she may need a treatment that helps to resolve the existing acne and prevent future breakouts,” explains Callender. “That’s when I’d recommend using a product all over the face.” For those who don't break out often—maybe one or two pimples here or there—a spot treatment with benzoyl peroxide or salicylic acid would probably be most beneficial.

And if you’ve gone the over-the-counter route and haven’t seen results after a few weeks, your next step is to see a board-certified dermatologist. “We can offer you prescription-strength topicals that are often more effective than their OTC counterparts,” Callender says. Either way, don’t suffer in silence: There are options out there that will keep breakouts at bay and effectively even out your skin tone.

References:

[1]: https://pubmed.ncbi.nlm.nih.gov/25053980/