Great skin is a journey, not a
destination
Dr Eckstein
Acne in Skin of Colour
Acne is extremely common in people with skin of colour and is one of the main reasons our clients seek help for their skin. Skin of colour generally refers to individuals with medium to deep skin tones, often described medically as Fitzpatrick skin types III to VI. This includes people from African, Caribbean, Asian, Middle Eastern, Hispanic, and mixed ethnic backgrounds. Acne affects these skin types just as frequently, if not more so, than lighter skin tones, particularly in adolescents and young adults.
The underlying causes of acne is similar in all skin colours and often due to several factors acting together. The oil producing glands in the skin, known as sebaceous glands, become overactive, producing too much oil. At the same time, the pores in the skin become blocked with dead skin cells, leading to the formation of blackheads and whiteheads. The excess oil provides a breeding ground for bacteria, which causes inflammation and results in red, swollen, or pus-filled spots. However, while the pathophysiology of acne is similar, the way acne looks, behaves, and heals can differ in skin of colour. These differences are important because they affect how acne should be treated and managed safely.
Skin of colour has a higher tendency to react to inflammation with pigment changes, which means that overly aggressive treatments can do more harm than good. This is why acne treatment must balance effectiveness with protection of the skin barrier and careful control of irritation. At Dr Mélanin, we approach acne in skin of colour with this understanding at the centre of care.
Frequently Asked Questions
There are a numbers of reasons why you may be struggling with acne but it is not related to hygiene. Some of these include hormonal conditions such as polycystic ovary syndrome (PCOS), certain medications including steroids or hormonal contraceptives or oily skincare products, greasy moisturisers, and some hair products. Often, there is also a family history of acne and there is some limited evidence of dietary factors (commonly sugar, gluten or dairy) having an influence on acne. Other factors include lifestyle factors such as stress, smoking or alcohol, skincare habits and sleep.
Skin of colour does not need specialist products simply because of skin tone. Acne treatment should be chosen based on skin type and the condition of the skin. However, treatments must be selected and introduced carefully to reduce irritation and the risk of pigmentation.
One key difference is inflammation. Studies show that acne in skin of colour often has a stronger inflammatory component, even in spots that may appear mild on the surface. This means that redness and swelling may be less visible, but inflammation is still present under the skin. Because inflammation drives many of the long-term complications of acne, controlling it early is especially important.
Certain acne patterns are also more frequently seen in skin of colour. For example, acne linked to hair and scalp products (sometimes called pomade acne) is more common due to the use of heavier oils, creams, or styling products that can block pores along the hairline and forehead. Understanding these lifestyle and grooming factors is an important part of effective acne management.
Another major concern in skin of colour is post-inflammatory hyperpigmentation or PIH, often referred to as dark marks left behind after spots heal. These marks are not scars, but areas where the skin produces extra pigment in response to inflammation or injury to protect the skin. In skin of colour, these marks are more common, more noticeable, and can last much longer than the acne itself (sometimes for many months or even years). For many clients, these dark marks are more distressing than active breakouts.
A healthcare professional can usually diagnose acne through a simple skin examination. Tests are rarely needed, as acne is easily recognised by the type and pattern of spots on areas such as the face, neck, chest, or back.
Acne is treated using a combination of approaches, tailored to the type and severity of acne, your skin type, and how your skin responds to inflammation. Skincare forms the foundation of all acne treatment and is essential for improving breakouts, supporting the skin barrier, and reducing the risk of pigmentation and scarring.
Topical medications may be prescribed to target clogged pores, reduce bacterial activity, and calm inflammation directly within the skin. In some cases, oral medications are used to address underlying drivers of acne, such as hormonal influences or more widespread or persistent breakouts. In-clinic treatments can also support acne management when appropriate. Chemical peels may be used to help with congestion, inflammation, and skin renewal, while selected injectable treatments such as polynucleotides may be recommended to support skin repair, reduce inflammation, and improve overall skin quality alongside medical treatment.
Most acne treatment plans involve a combination of skincare, medications, and in-clinic treatments rather than a single intervention. The aim is to treat active acne effectively, minimise long-term marks or scarring, and support healthier, more resilient skin over time.