Scalp Psoriasis on Black Skin: Thick Scale, Gray Plaques
Scalp psoriasis on Black skin appears violaceous or hyperpigmented rather than pink, with thick dry silvery scale on sharply bordered plaques at the hairline, behind the ears, and at the back of the head. The standard medicated-shampoo regimen assumes daily washing, which does not fit textured hair. Oil-based vehicles, twice-weekly maintenance shampoo, and applying medicine to the scalp instead of the lengths make treatment usable, and pigment change left behind can take 3 to 12 months to fade.
Contact Dermatitis on Black Skin: When the Rash Is Not Red
Contact dermatitis is a reaction to something touching the skin. On darker skin it presents violaceous, gray-brown, or lichenified rather than bright red, so it gets missed and undertreated. The allergens that matter most here are paraphenylenediamine in permanent hair dye and in black henna temporary tattoos, fragrance and preservatives in leave-in hair products, nickel, rubber accelerators, and textile dyes. Clearing the rash quickly limits the post-inflammatory hyperpigmentation that follows it.
Alopecia Areata in Black Women: Smooth Round Bald Patches
Alopecia areata is an autoimmune disease that attacks hair follicles and produces smooth, round, nonscarring patches anywhere hair grows. It is separate from CCCA and traction alopecia, the two diagnoses Black women usually get. A cross-sectional analysis of two Nurses' Health Study cohorts found substantially higher odds of alopecia areata in Black women. Between a third and half of people with patchy disease regrow hair within a year untreated, injected steroids regrow hair in 60 to 67 percent of patients, and three oral JAK inhibitors are approved for severe disease.
Small Dark Bumps on Black Skin: Dermatosis Papulosa Nigra
Dermatosis papulosa nigra is the small dark facial papule that affects up to a third of Black adults in the United States, starts in adolescence, and runs strongly in families. It is benign, it is not a skin tag or a mole, and removal is cosmetic rather than medical. The risk that matters on dark skin is pigment change after the procedure, which is why dermatologists treat a small test area first. Insurance almost never covers it.
Keratosis Pilaris on Black Skin: Dark Rough Bumps on Arms
Keratosis pilaris is a plug of dead skin cells in a hair follicle, present in 50 to 80 percent of adolescents and about 40 percent of adults, with no racial predisposition. On Black skin it reads as brown or brown-black follicular dots rather than red bumps, so it is routinely mistaken for acne or razor bumps. Keratolytics plus moisturizer on damp skin control it, gentle beats aggressive because inflammation is what creates the lasting dark marks, and in a survey of dermatologists most saw lesions return within three months of a patient stopping treatment.
Stretch Marks on Black Skin: How They Look and What Works
Stretch marks are dermal scars, and on Black skin they often present hyperpigmented first and pale or skin-colored later, not the pink-to-silver sequence generic guides describe. Cocoa butter came out null in two randomized trials, one in 300 pregnant women in Jamaica. Only centella, hyaluronic acid, and daily massage carry a positive prevention signal. Tretinoin works on early marks and is off-limits in pregnancy; microneedling matched fractional CO2 laser with far less pigment risk.
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