Acne on pigmented skin

Abstract

Acne occurs in all races and ethnicities. In patients with pigmented skin, acne is very common. As far as the morphology of acne lesions is concerned, no significant differences exist between Caucasian and non-Caucasian skin; however, nodular acne is likely less frequent in patients with pigmented skin. The anatomic distribution of the lesions is similar in all races and ethnicities. Pomade acne is caused by the chronic application of oily products that are used to smooth the hair. It is characterized by more or less numerous closed comedones, with some papules and rare pustules, located on the forehead and temples. A very common and important complication of acne in patients with pigmented skin is postinflammatory hyperpigmentation. It is characterized by brown-to-black macules, of different morphology and size, located mainly on the face. Additional complications of acne in patients with pigmented skin are scars and keloids. The treatment of acne is superimposable in all phototypes. In order to improve tolerability and compliance of topical anti-acne therapy in patients with pigmented skin, it is helpful to begin the treatment with the lowest concentration of the drug, to use a cream or an aqueous gel as vehicle, to apply the drug every other day, with gradual increase to daily use, and to apply frequently a moisturizer. Furthermore, photoprotection is very important.