Dr Stephanie Gallard
Executive Committee member, Primary Care Dermatology Society
There are over 10 million people in England and Wales with skin of colour. Western dermatology professionals are recognising the need to address challenges and differences seen with skin of colour.
According to the 2021 Census, 81.7% of the population is white. People from Asian ethnic groups made up the second largest percentage of the population (9.3%), followed by black (4.0%), mixed (2.9%) and other (2.1%) ethnic groups.
Educating the public on skin diversity
Organisations such as the Primary Care Dermatology Society and the British Association of Dermatologists are ensuring that the resources and information available to healthcare clinicians and the general public reflect the diversity of our population.
Erythema (redness) seen in inflamed skin can be harder to see in darker-toned skin. This means that the extent of the condition might be underestimated — or possibly not noticed or recognised at all.
Absorbing enough sunlight to produce vitamin D
may be difficult in our British weather, and vitamin
D supplements might need to be considered.
Sunlight and skin of colour
Darker skin has more active melanocytes, producing melanin. Absorbing enough sunlight to produce vitamin D may be difficult in our British weather, and vitamin D supplements might need to be considered. While darker skin is less likely to burn in the sun, all skin tones can burn and develop skin cancer with prolonged exposure.
People with darker skin who have skin conditions — such as photosensitivity, vitiligo or lupus — or take immunosuppressant medication also need sunscreen with prolonged UV exposure in sunny climates (usually abroad). However, facial sunscreen is also advised in the UK when dealing with facial pigment issues such as melasma.
Healing in skin of colour
Sometimes, the pigment left behind when inflamed acne or eczema has healed can be darker and longer-lasting than in paler skin. It can take longer for the pigment to clear afterwards than to treat the skin condition itself; this is known as post-inflammatory hyperpigmentation and can be very distressing for the sufferer.
Darker skin types also have a greater number of fibroblasts (collagen-producing cell, important for skin repair), so any skin trauma leading to scarring can lead to a thicker sort of skin repair called a keloid scar. This awareness of skin diversity can help ensure the skin health of everyone, with all skin tones considered.
