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Does My Ethnic Skin Require Special Acne Care?

By Megan Griffith

Reviewed for medical accuracy by Dr. Jaggi Rao,
MD, FRCPC Double board-certified dermatologist

I’ve spent some time as a formulator of cosmetic products for American and Canadian companies that sell their formulas around the world. From time to time, simply not knowing about ethnic skin and acne differences has created some very significant problems for the companies I serve.

acne treatment for different skin types
Different skin tones need different acne products to take care of the same skin condition.

One of my clients had a product that was very successful for removing lingering brown spots caused by acne for customers in China. The product got rave reviews. That is, until that day we got a hysterical phone call from our distributor. Women using the product were coming into our distributors shop with even bigger brown spots on their faces. One woman had big purple blotches. And several reported shades of pink and green.

We were at a loss trying to imagine what had gone wrong. We could imagine that somebody put the wrong chemical into the vat on the assembly line. Then we learned that an oil refinery in this city had released a massive load of toxic chemicals into the air while all of these customers were riding the bus to work. The chemical release combined with an otherwise safe ingredient in the skin lightening cream, but the combination only affected Han Chinese women1, not any other women who used the product who were exposed to the toxic cloud.


  • Skin tone makes a difference in choosing effective acne products. Darker skin is much more easily damaged by inflammation and irritation.
  • Women of Asian, African, Hispanic, and European descent sometimes need completely different products to take care of the same skin condition.
  • Folk wisdom about acne care can be very, very rightor very, very wrong. Usually the skin care practices of one group do not translate very well to another.

Ethnic differences are important in successful skin care2, especially for acne. This article will give you five examples of the most important ethnic and genetic skin care considerations.

1. Brown spots on the skin are treated in very different ways depending on ethnic origins3.

A dermatologist in Phoenix, Arizona, scheduled two patients the same afternoon for consultations about treating brown spots on the skin. Her first patient, Barbara, was an African-American woman who developed dark, brown spots on her skin where she had pimples. Her second patient, Hilde, was a visitor to Arizona from Iceland who had broken out in freckles.

All kinds of skin use the pigment melanin to fight inflammation, but since most persons of African descent are endowed with a great deal of melanin in their skins, they tend to develop especially dark spots after acne. Any treatment that traumatizes the skin to get rid of brown spots actually makes the spots darker, or triggers a condition called vitiligo, which destroys all of the pigment in the skin. The dermatologist prescribed Barbara a very mild antioxidant cream that promised to lighten her brown spots very slowly, but without danger of creating even worse skin problems.

Brown spots on fair skin are a lot easier to treat. Because fair skin contains relatively few melanocytes, the cells that make the pigment melanin, irritation of the skin is very unlikely to cause permanent pigmentation. The doctor offered Hilde a laser treatment that would make her freckles a thing of the past in just a few days4.

2. Detergent cleansers are hard on all skin types, but they are especially damaging to Japanese skin.

Many Asians, and especially many Japanese people, prefer to cleanse with oil-based bath and beauty products. They have to steer clear of any kind of shampoo, soap, or acne treatment that foams, and they should wear rubber gloves when using household cleaners to avoid acne-like bumps that are actually a form of hand eczema.

Most people of Japanese descent also have to avoid foaming benzoyl peroxide. A few may be able to tolerate foaming benzoyl peroxide applied to the back, but traditional herbal treatments, available anywhere in Japan and from the Tsumura company elsewhere in the world, are much more effective.

3. Certain hereditary enzyme deficiencies can cause acne treatment disasters.

Many people from all over Asia and Africa suffer a hereditary enzyme deficiency that causes a condition called ochronosis5. It causes a bluish-black discoloration of the skin, especially around the eyes and on the ears. The underlying problem is the lack of an enzyme that the body needs to use the amino acids phenylalanine and tyrosine, and a far more devastating (but unnoticed) symptom is cumulative damage to bones and joints. Surface ochronosis, causing bluing or blackening of the skin, however, is the symptom most likely to bring people to the doctor’s office.

The blue and black coloration of the skin occurs after exposure to benzene, certain industrial solvents, and hydroquinone6, a compound often used to lighten the skin. Many African-American and Asian-American users of hydroquinone skin lighteners, trying to get rid of brown spots left behind after acne, are horrified the next morning to see black and blue spots where light brown spots were once the problem. There is an experimental medication for treating the enzyme deficiency, but there is no medical treatment for spots caused by inappropriate skin care treatment.

4. Gorgeous skin is not limited to any ethnic group.

Many of the world’s “beautiful people” have the same dry, inflammation-resistant, tight skin of different shades and tones. The African-American film star Halle Berry, the Spanish actress Penelope Cruz, Kate Middleton who recently became the Duchess of York, Sophia Loren, and Lucy Liu all have the gorgeous skin that seems never to present any skin care problems. People of all races and ethnic groups can have this carefree skin7, although it is relatively rare in northern Europe.

So what’s not to love about this kind of skin? When people who have dry, tight, inflammation-resistant skin actually do get acne, it’s usually an especially severe case. Women who have this skin type may develop the dark black spots caused by acanthosis nigricans8. There are no over-the-counter treatments that relieve the condition. Both men and women who have “gorgeous skin” are especially vulnerable to acne when their hormone levels fluctuate, whether its contraceptive use in women or testosterone use in  men.

5. Skin color does not make as big a difference in acne care as skin moisture.

People who have light skin are more likely to have dry skin, and people who have dark skin are more likely to have oily skin, but it’s possible for a person with fair skin to have a problem with shiny face and it’s possible for a person with dark brown to nearly black skin to have a dry skin problem in the desert. The distinction between dry and oily skin—referring to the oil on the skin, lying in the pores, not the oil in the skin—makes a big difference in choosing effective acne products.

  • People who have dry skin should use alpha-hydroxy acids to exfoliate the skin and open clogged pores. People who have oily skin should use beta-hydroxy acids to exfoliate the skin and open pores.
  • People who have dry skin are more likely to suffer skin irritation and less likely to have long-term discoloration of the skin as a result of it. People who have oily skin are less likely to suffer skin irritation and more likely to suffer long-term discoloration as a result of it.
  • People who have dry skin usually react well to foaming products. People who have oily skin often develop inflammation and irritation when they use foaming products.
  • Harsh chemical detergents are never good for skin. Detergents applied to dry skin produce blackhead and whiteheads. Detergents applied to oily skin can cause permanent skin discoloration.


  1. Goh CL, Noppakun N, Micali G, Azizan NZ, Boonchai W, Chan Y, Cheong WK, Chiu PC, Etnawati K, Gulmatico-Flores Z, Foong H, Kubba R, Paz-Lao P, Lee YY, Loo S, Modi F, Nguyen TH, Pham TL, Shih YH, Sitohang IB, Wong SN. Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy. J Cutan Aesthet Surg. 2016 Apr-Jun;9(2):85-92.
  2. Shah SK, Alexis AF. Acne in skin of color: practical approaches to treatment. J Dermatolog Treat. 2010 May;21(3):206-11.
  3. Torres V, Herane MI, Costa A, Martin JP, Troielli P. Refining the ideas of “ethnic” skin. An Bras Dermatol. 2017 Mar-Apr;92(2):221-225.
  4. Yin NC1, McMichael AJ. Acne in patients with skin of color: practical management. Am J Clin Dermatol. 2014 Feb;15(1):7-16. Am J Clin Dermatol. 2014 Feb;15(1):7-16.
  5. Babanagare S V, Deshmukh S D, Khadilkar M S, Patil A A. Ochronosis: A report of three cases and review of the literature. Indian J Pathol Microbiol 2011;54:626-8
  6. Charlín R1, Barcaui CB, Kac BK, Soares DB, Rabello-Fonseca R, Azulay-Abulafia L. Hydroquinone-induced exogenous ochronosis: a report of four cases and usefulness of dermoscopy. Int J Dermatol. 2008 Jan;47(1):19-23.
  7. Patrick D. Cole. Daniel A. Hatef. Susan Taylor. Jamal M. Bullocks, Skin Care in Ethnic Populations. Semin Plast Surg. 2009 Aug; 23(3): 168–172.
  8. Popa ML, Popa AC, Tanase C, Gheorghisan-Galateanu AA. Acanthosis nigricans: To be or not to be afraid. Oncol Lett. 2019 May;17(5):4133-4138.
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gia Reply

i love my ethnic pretty brown skin!! thank you melanin!!

August 23, 2014 at 9:24 pm Reply

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