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Acne in Black Skin
There are some basic differences between black skin and white skin. These differences underlie some of the different reaction patterns which take place. For example, white skin tends to tan much more easily than black skin, and damage from the sun is always more severe in white people. Black skin has more oil glands than white skin is another difference. The response of white skin to injury is to turn red, whereas black skin turns darker than normal color. In black patients with acne, the skin may look normal, but under the microscope, there may be seen definite evidence of inflammation far in excess of what can be seen clinically. There is a layer of cells in the epidermis of black skin which, though thinner has more cells than the same layer in white skin, meaning the layer is denser in the skin of black people, called the stratum corneum. Not only are there more oil glands in black skin, but the oil glands are larger and are more prone to the formation of pimples. Under the microscope there is always more inflammation to be seen around even simple pimples in black people. The inflammatory reaction in black skin tends to be more violent than the reaction in white skin and larger scars are produced in black skin. The increased melanin formation, and the violent inflammatory reaction and the tendency of white blood cells to pick up the pigment and to migrate deep into the dermis are all factors responsible for the black spots that often occur in black people with acne.
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