What is the Best Acne Treatment for African American?

I am African American and have had some pretty bad acne for the past 2 years. My first year of college is coming up and I cannot seem to find anything that will help my acne. Are there special treatments for African Americans? Naturally we have different skin that Caucasian people. But would that change the treatments?

Hashtag1

M, 20, New York

People with darker skin types and complexions have to be very careful with the way they treat acne. African Americans and others with dark complexions are many times more prone to developing acne-related scars.

First, you should consult with a board-certified dermatologist who specializes in or has a lot of experience with treating people of color. If you've done any research online about treatment for dark skin, you probably already know that many people also seek help for dark spots, which can sometimes last longer than the acne. As you get rid of the acne, you'll likely want to get rid of the dark spots that can appear when the acne clears. If you already have dark spots, I’d recommend speaking to your dermatologist about treating both the acne and the dark spots at the same time.

This is done using a combination of therapies. For milder cases of acne, dermatologists usually recommend using products that contain retinoids and benzoyl peroxide. The former helps unclog pores and limits inflammation while the latter helps to remove the bacteria causing acne.

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Acne treatment for people of all skin tones can be demanding, but for darker skin types it's even more challenging. It’s imperative to not only treat the acne, but the any dark spots that may accompany them.

Blemishes usually start out the same way on everyone's skin.  However, not everyone's skin has the same texture, tone, ability to recover from inflammation, etc.  

Clindamycin and/or erythromycin are topical antibiotics usually prescribed (often in combination with benzoyl peroxide or tretinoin) to kill the bacteria that cause acne and are available in various vehicles:  creams, gels, solutions, and wipes. Retinoids (like RETIN-A or tretinoin, tazarotene, or adapalene) are often prescribed, which helps to reduce dark spots resulting from photo-aging or hyperpigmentation.

Again, one of the biggest concerns is addressing the blemishes left behind -- the dreaded dark marks --  known clinically as post-inflammatory hyperpigmentation (PIH). Darker skin tones are most prone to long-lasting PIH after an acne lesion has formed, regressed, and gone away. Many acne treatments like retinoids and chemical peels (containing any individual or combination of acids like salicylic acid, lactic acid, glycolic acid, etc. with or without hydroquinone or other bleaching agents) can help reduce them.

Of utmost importance is applying sunscreen/sunblock every day before leaving home and ideally again in the middle of the day if you work or study indoors. The dark marks created by acne will never go away as fast or as completely if you aren’t regularly wearing sunblock. Protection from visible light is additionally important as recent data indicates that it impacts darker skin more intensely than skin with a lighter tone. Specifically, darker skin types are at risk of PIH from visible light - including the light of your office, cafeteria, even at the library. The best protection from this kind of light damage is iron oxides, found in both untinted and tinted sunscreens/blocks. Check your ingredient listing to ensure that your sunblock contains iron oxides.

My advice is that you consult with a local board-certified dermatologist who has experience treating patients with darker skin, especially if you feel your concerns are not being addressed with your current provider.