If you’ve ever searched your symptoms online only to find photos that look nothing like your skin, you’re not alone.
Many people with darker skin struggle to find accurate images and information that reflects how common skin conditions appear on their skin color. Whether it’s eczema, psoriasis, or acne, most visual examples in textbooks and online search engines overwhelmingly feature lighter skin colors. This lack of representation has consequences, ranging from delayed care to overall misdiagnosis. Lack of representation can also lead to feelings of invisibility or mistrust, which is a documented barrier to care.
But your skin matters. And the way these conditions show up on your skin matters too.
You may have heard of melanin before. Skin color is determined by melanin, a natural pigment that gives skin its tone. People with darker skin colors have more melanin, and this can also lead to certain diseases presenting differently on darker skin than lighter skin (that is less melanated).
For example, on lighter skin colors, psoriasis often looks red or pink, while people with darker skin colors might find that psoriasis appears violet or brown on their skin. Acne is another common example of how a diagnosis can manifest differently on different skin colors. Acne may appear as red, pink, or purple spots in light skin, and in darker skin, acne can present as purple or brown. Darker-skinned individuals are also at a much higher risk of hyperpigmentation (skin darkening) due to increased melanin production in response to inflammation (such as from an injury to the skin or a skin condition or illness).
Despite how differently skin conditions can present on darker skin, medical textbooks and resources have historically centered on lighter skin colors. An analysis found that only 3.1% of articles found in the Journal of the American Academy of Dermatology (JAAD) addressed skin-of-color communities in 2004. While this number increased to 7.1% in 2022, there is still a vast knowledge and academic gap on how diseases may affect your skin color.
So what can we do?
While the burden shouldn’t fall on patients, the reality is that self-advocacy can make a real difference in getting the right care.
- Speak up! If something doesn’t look or feel right, it’s okay to speak up and push for more clarity.
- Use tools like Skinsight. This image-based diagnostic tool helps you see how conditions appear on different skin colors. You can even bring those photos to your provider to guide the conversation. Or ask your medical professional if they use VisualDx. VisualDx is often available through health care institutions, and you can ask your provider if they use it. This helps bridge the gap between patient and provider tools.
- Seek out second opinions or medical professionals such as dermatologists who specialize in skin of color. It is important to find somebody who truly sees you.
Your skin deserves to be seen, understood, and cared for, just as much as anybody else’s. Whether you’re navigating a new diagnosis or simply trying to find answers that reflect you, know that you’re not alone. With the right tools, questions, and support, you can take charge of your skin health and get the care you deserve.
References:
Davis EC, Callender VD. A review of acne in ethnic skin: pathogenesis, clinical manifestations, and management strategies. J Clin Aesthet Dermatol. 2010 Apr;3(4):24-38. PubMedId: 20725545.
Mayo Clinic Staff. Psoriasis: symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840. Accessed 2025 Sept 4.
Wilson BN, Shah R, Ufongene C, Diaz AF, Murrell DF, Murase JE. Evaluation of skin of color publication trends over the past 2 decades in the Journal of the American Academy of Dermatology. JAAD. https://www.jaad.org/article/S0190-9622(23)00976-3/abstract. Updated 2024 Jan 9. Accessed 2025 Sept 4.