You can go ahead and thank the melanocytesin your body for the skin color you were blessed with. Melanocytes are located in the outer layer of the skin and are responsible for producing melansomes — the tiny packets that contain the chemical melanin. Skin color is determined by the size and distribution of melanosomes. Dark skin is rich with large melanosomes — making it more adept at scattering energy from ultraviolet (UV) light and reducing the risks of sun damage that
can lead to cancer formation and skin aging.
(But sunscreen is still necessary!)
While the aesthetic beauty and protective benefits of having dark skin cannot be denied, people with melanin-rich skin should be aware of several skin conditions and diseases and ways to properly care for their skin. Gary Brauner, MD, wrote the very first textbook chapter on skin of color back in 1975. Since then, he has practiced dermatology in Bergen County, including at Englewood Hospital and Medical Center. He treats a host of skin issues that disproportionately affect the black community. Perhaps the most common issues Dr. Brauner’s melanin-rich patients contend with are hypopigmentation and hyperpigmentation —the loss of pigment and the rapid gaining of pigment in the skin.
Changes in pigment are often caused by skin injury such as a cut, a scrape, or even mild acne. Eczema, which is believed to occur twice as frequently in children with dark skin, also poses the threat of discoloration. “Any inflammatory rash can interfere with the pigment cells’ ability to move the pigment into the outer layers of the skin, preventing the surface of the skin from maintaining its normal color and turning it lighter,” Dr. Brauner said.
Treatment for pigment change is mainly about prevention. For eczema-prone skin, staying moisturized is key in managing symptoms. Dr. Brauner advises his patients to perform their moisturizing routines when they’re fresh out of the shower. If you do experience rash, eczema or acne, seeking help from a dermatologist to quell the initial symptoms quickly will go a long way in preventing pigment change. After the inflammation dies down, it may take weeks or even months for natural pigment to return to the skin.
During this time, sunscreen can be applied to darkened areas to prevent hyperpigmentation. If dark spots persist, bleaching agents can be used — but talk to your doctor about which agents are safe. “But if someone has had enough inflammation, the pigment cells that constitute the outer layer of skin can crack and allow the brown pigment to drop down into the middle layer of skin and become like a tattoo,” Dr. Brauner said. Whenever your skin experiences an inflammation or injury, the main way to prevent long-lasting pigment change or the formation of a keloid (a raised scar after an injury has healed) is paying attention to your skin and treating the initial symptoms quickly.
Paying attention to your skin means different things at different times in your life. As a child, you or your parents watch your skin for scrapes and rashes, as a teenager you watch for acne,and as an adult you watch for stretch marks, age lines and, hopefully, you’re also watching for abnormalities and signs of skin cancer.
“One thing that African Americans have to become more aware of is a rapidly lifethreatening skin cancer — melanoma,” Dr. Brauner said. Melanoma may show up as a new and unusual growth on the skin, or an unusual change in an existing mole. While the rate of occurrence of melanoma is indeed higher in Caucasian people, it may come as a surprise that this malignant mole is actually a deadlier force in the black community.
“African Americans get melanomas in places no one would ever think to look for them — places that have the least amount of pigment and exposure to the sun: the palms of the hand, under the fingernails, the soles of the feet, inside of the mouth and on the lips,” Dr. Brauner said. As a result, melanomas are diagnosed in the later stages of the cancer’s growth, when treatment is not as effective. This, coupled with the dangerous and categorically false belief that people of color do not need sunscreen or protection from the sun, form a deadly pair that leaves African Americans with a lower survival rate for skin cancer.
The answer to this is awareness and early detection. Do not stop paying attention to your skin as the years pass by, see a dermatologist when abnormalities appear, wear sunscreen, and, please, moisturize when you get out of the shower.
Your hospital for life.