This story is a part of The Melanin Edit, a platform in which Allure will explore every facet of a melanin-rich life — from the most innovative treatments for hyperpigmentation to the social and emotional realities — all while spreading Black pride.
Black is beautiful.
This phrase is echoed in Black households, rooted in the broad embrace of Blackness in America in the late 1960s; really, it's a cultural movement more than a phrase. It’s whispered by Black mothers to their babies, reminding them that their Blackness is good, is worth celebrating, that the melanin washed over their skin is so much more than the radical statement some people take it to be. To exist as a Black person, particularly in America, can feel at times like an act of civil disobedience. It can often feel like the powers that be would like to ignore how our melanin makes us different, and that is true even in dermatology.
After years of learning about and having my own experiences with medical racism, it wasn't a surprise to find that, historically, identification of conditions on darker skin tones has not been included in dermatology training, which has led to misdiagnoses and a large assortment of other issues. Many skin ailments can appear differently in more melanated skin. More often than not, changes in darker skin tones caused by a skin ailment can be signified by hyperpigmentation, the darkening of skin that occurs when an excess of melanin forms deposits in the skin, or the opposite, hypopigmentation, which is the lightening of skin due to a reduction in melanin production. Changes in color can also occur naturally in patients with darker skin, so it can be difficult to tell normal from abnormal, especially if a provider does not have much experience with Black patients and patients of color.
“In the past, there was no specific training focused on brown skin, and as a result the dermatologists who are most skilled to treat brown skin were those who had either trained in large, urban areas or those who had personal experience because they themselves had pigmented skin,” Crystal Aguh, a board-certified dermatologist at Johns Hopkins, tells Allure. “In fact, most images featured in dermatologic textbooks focused on patients with only fair skin. This drastically limited the number of dermatologists who felt comfortable treating conditions in those with more pigmented skin tones.”
As a result, many dermatologists still aren’t familiar with facts about dark skin, like how redness and inflammation tend to look more deep pink or purplish in hue instead of the bright orange, fiery red you see on lighter skin, or how difficult it can be to distinguish between light hypopigmentation and complete loss of color in the skin. And of course, it’s not just about the physical: “The psychological aspect of color loss is much greater in patients with darker skin because it can be so obvious that people may comment on the change in a public setting,” says Shauna Diggs, a Michigan-based board-certified dermatologist.
When treating any of these conditions, seek assistance from a board-certified dermatologist trained and experienced in diagnosing and treating skin of color. “Currently, we are seeing more effort from multiple dermatologic societies to increase the representation of images in dermatologic textbooks so that more dermatologists feel comfortable identifying conditions in a range of skin tones," say Aguh. "Additionally, more and more training programs have developed skin of color centers to address disparities in care.”
Beyond representation in the medical field, representation and visibility in all forms of media can help people with similar conditions find community, and the encouragement to seek treatment can lead to more diverse medical knowledge for everyone. Below, we talk to seven Black women with a wide range of skin conditions, including acne, keloids, keratosis pilaris, and a lot in between, about their Black skin, the path to diagnosis, and what makes them feel like their Blackness is beautiful.
New York City-based model Jeyza Gary’s life with lamellar ichthyosis began at birth, as is typical for people with this rare, incurable genetic condition. Infants are born with a shiny, waxy layer of skin, called a collodion membrane, that sheds after the first two weeks of life, revealing skin under the membrane that is dark, tight, and split, similar to scales or extremely dry skin. Gary is the first member of her family with the condition, and that threw her and her parents a curveball. "My grandma describes it as something that was not instantaneous: The doctors knew something was wrong with me at birth, [but] I wasn’t diagnosed officially until I visited my then primary care physician, and he referred me to Duke.”
Lamellar ichthyosis creates different types of challenges depending on the season: "In the summertime, I can’t be out in the heat too long because I will overheat. In the wintertime, I constantly have to shower and reapply various creams and lotions to maintain the moisture in my skin and prevent cracking," Gary explains. But that doesn't mean she can't enjoy herself. “Just because you have to amend certain day-to-day activities does not mean that you have to exclude yourself from access to them,” she says. "You are a human above all else, and your diagnosis is a secondary part of you as a person."
Much like other people featured in this piece, though, a lot of Gary’s work has also been internal. “As time progressed, I realized that I had to learn what beauty and radical self-acceptance were for me, so that I could not only exist but thrive in this world,” she says. Living with lamellar ichthyosis means that Gary hasn't had to adapt to the world, the world has had to adapt to her, and that gave her a sense of freedom; when discomfort is your norm, at a certain point you lose any ability to prioritize the comfort of those who wouldn't extend the same to you. "I never have to go into a situation ashamed of who I am, because visibly it has always been who I am."
For others living with lamellar ichthyosis, Gary wants them to know it shouldn't stop them from doing anything. “You may not be able to be out in the sun for as long as other people, but you still get to enjoy it; you may not be able to be out in the cool weather for as long as other people, but you still get to enjoy it,” she says. "You are not required to be a fountain of inspiration for people who don’t enjoy their lives; you are just required to live and be the best version of yourself that you can be."
And “you are not required to exclude yourself from things that people who are not faced with this condition experience,” Gary reminds us. She concludes, "If you don’t remember anything else from this, please remember that: You are limitless."
Esthetician-in-training Alicia Lartey's road to getting diagnosed with keratosis pilaris (KP) — a benign condition characterized by keratinous plugs at the sight of the hair follicle, usually appearing as small bumps on the arms, legs, or thighs — began with a misdiagnosis. Her KP developed early in childhood, when it was treated with steroid creams. “Initially, doctors and dermatologists ran with the idea that I had extreme eczema, which I came to accept for a long time,” Lartey says, "until I spoke to friends that had eczema and seborrheic dermatitis and realized…this was not what I was dealing with."
Lartey found that many doctors weren't concerned with fixing her condition, primarily because she wasn't in physical pain, which only exacerbated the level of emotional pain she was feeling. It wasn't until her early teens that a doctor who also had keratosis pilaris diagnosed her with the disorder and brought her a sense of peace. “Now that I am older and in the skin-care science space,” she says, "I can see that my diagnosis was prolonged because not many doctors were familiar with what severe KP can look like on someone with my skin complexion."
That not knowing what keratosis pilaris looks like in darker skin tones led Lartey to feeling dehumanized and having to battle offensive suggestions, like bleaching creams. Whenever she visits a new doctor, Lartey has to explain what her KP is so that they do not mistake it for a pigmentation disorder. “As a child, I [was] teased about my KP,” she recalls. "But now I use my KP as a point to drive innovation in how I look at skin and skin care."
Lartey wants to make sure people understand that reducing KP to a simple description like "chicken skin" can be dehumanizing and hurtful, especially for children — something to keep in mind, in particular, for Black children, who over and over again have experiences wherein they are reminded that some people do not believe in their humanity. Keratosis pilaris is not contagious and is largely due to genetics — 40 percent of adults are said to have it. “I often forget about my KP until someone says something horrible,” says Lartey. "Living with KP has allowed me to realize that, sometimes, you just have to work with what you have."
When model Yaya Rodriguez was 12 years old, she noticed a small white patch — she describes it as the size of a dot from a pen — on her right index finger. Her diagnosis with vitiligo, a long-term condition in which patches of skin lose their pigmentation, was fast and simple. “The dermatologist knew exactly what they were looking at, from just looking at my finger,” Rodriguez says. "I remember them looking down and saying, 'Yup, that's vitiligo.'"
At the time of her diagnosis, she wasn't aware of the effects vitiligo would have. “Before vitiligo, you never think about melanin — like, [really] think about melanin and losing the color of your skin," says Rodriguez. "You never think about not having control over how your body physically changes on the outside, while others witness it in real time with you." But she believes that vitiligo has enabled her to experience life as an extremely strong, independent, loving, nurturing, optimistic woman.
Vitiligo has impacted Rodriguez both internally and externally. Physically, due to the loss of melanin in the skin, she lost the extra protection against the sun's UV rays, which means she has to take extra precautions when she's exposed to the sun. Psychologically, vitiligo can affect your self-esteem: "You go through the emotional roller coaster of insecurities, and however you display and cope with those insecurities, [and] then having to talk yourself out of that rut,” she shares.
But Rodriguez says having vitiligo has also impacted her emotions positively. "I love meeting and connecting other people with vitiligo,” she says. “There's a certain type of connection and camaraderie you feel. It's also so rewarding when someone reaches out and tells me they never thought they'd see themselves represented in the media, and finally felt seen when they saw me on an ad."
Everyone has good days and bad days, Rodriguez wants readers to know: "If you're not feeling your best, remind yourself to always keep your head up — and I mean literally, physically, always keep your head up: Look people in the eye, remember you're beautiful, and push yourself to love on yourself every day."
“Accepting that having acne was my new normal, it opened up a portal in my life,” says influencer Nazhaya “Barce” Barcelona. In the fall of her sophomore year of college, she returned to school with her face in an acne breakout that only worsened over time. “I couldn't put my finger on the root of the issue for years," she recalls. "I blamed it on so many things: skin-care products, hair products, food, the water in my college town."
Unlike many of the other skin ailments featured in this piece, acne is something most people encounter (up to 85 percent of us, in fact). But, as Aguh explains, it can present differently on darker skin, and treatment may look different as well. While acne pimples look similar in all skin tones, Aguh explains, acne is more likely to leave behind spots of discoloration in more deeply pigmented skin tones, which feels like a problem caused by another problem. “For this reason, when treating acne in brown skin, it is very important to use medications that will not only treat the active, inflamed acne pimples, but also are designed to treat the discoloration as well,” says Diggs.
For Barcelona, a visit to the dermatologist meant she had medical intervention: "My first time going to the dermatologist, I was very excited to get a topical prescription that was medically engineered to clear my skin."
But a doctor's prescription can only do so much; treatment required work on her mental health too. Barcelona felt that acne had tainted her membership in the community of "beautiful people." With acne, Barcelona shares, "self-love and self-discovery presented itself to me in a way I would've never experienced if I had clear skin all my life." She explains, “I had to navigate social interactions, romantic relationships, and self-reflection with a new face. Acne created a mental and spiritual wound that was very painful and uncomfortable to wear every day. It blinded me to who I really was.”
“Then, one day,” Barcelona continues, "I decided to be brave. I was exhausted from trying to hide and feeling shame about how I looked. I told myself that I wasn't going to torture myself like this anymore. I wasn't sure if people really thought I looked as disgusting and scary as I thought I did, but I decided that day that even if they did, I didn't care anymore. I was beautiful before the acne, and I'll continue to be beautiful with it."
This shift resulted in Barcelona changing her idea of what “beauty” really is. “My beauty looked like passion and impact — I put so much passion into things I loved to do and felt my beauty shine there,” she says. "I noticed my mannerisms more because my face was no longer my selling point when I met people; instead, it was my aura and confidence when I spoke. Acne truly was a blessing in disguise. It forced me to grow in ways I wouldn't have if life simply allowed me to have clear skin and never challenge the standard of beauty in society, as well as within myself."
Entrepreneur Mercedes Matz has lived her entire life with chronic eczema, after it was noticed first by her mother, who spotted a rash on her baby's face. It never went away, even after treating it with products like Vaseline. A pediatrician determined it was eczema and prescribed an over-the-counter corticosteroid cream for Matz. For a long time it was a mild case of eczema, which occasionally flared up; she noticed it was particularly bad in the winter months.
But at age 13, Matz's eczema took a turn for the worse. “I'm not sure what triggered it, but it became a nuisance,” she recalls. "It started to spread throughout my entire body, with emphasis on my hands and face." At the time there weren’t medications to treat severe atopic dermatitis, so Matz resorted to various steroid creams, which can have side effects and lose their effectiveness with prolonged use. After working with multiple doctors and trying many different treatments, Matz found herself crippled by the pain she was in. “I used to hate the way I looked,” she shares, "so much so I would wear sweaters and long pants in the summer."
"My skin condition caused me so much anxiety and I suffered from horrible self-esteem issues. I simply did not want to exist at some points," Matz says. It took a lot of daily work, wherein she reminded herself of one thing she liked about herself over and over until she believed it. "I decided that I could no longer live a life of shame, especially with something that I had no control over."
It wasn't until she began working with Dove’s DermaSeries that Matz met someone else living with her same level of severe eczema. “I was able to sit down with some of the most amazing women I had ever met in my life and we shared stories about what life was like, living with a chronic skin condition. I felt so seen,” she remembers. "That was something I had never experienced before. I no longer was alone in the world. I had met people who I could go to, who actually knew what I was talking about, with no judgment." The Dove campaign gave her the emotional strength and support she needed to talk about her experience with eczema, enabling her to find her voice. “Once I was able to put my fear of being vulnerable aside,” she says, "that's when life became worth living."
That voice has now worked with the National Eczema Association at its yearly conference to help kids and teenagers share their own stories and give them the space to access a life worth living. Matz only wishes there had been a space like that for her in her younger years, imagining how beneficial it would have been for her as a child. “One of the biggest issues that I overcame was wearing what I wanted to wear,” she says. "I now am able to walk out of the house in a short-sleeve shirt and shorts, or now, since it's warmer, I'm always in a bodysuit because I am proud of the skin I'm in. My battle scars tell my story, and I hope it can be an inspiration to others to live free in the skin that they're in."
Aspiring model and content creator Michelle Nyasha's journey with chronic psoriasis started with one spot that turned into a patch that spread to become dry, itchy, scaly uncomfortable patches of skin that would split and break. She visited a doctor as a child in Zimbabwe, prior to moving to the United Kingdom. The doctor there had recommended cream for treatment, applying restraint before a dermatologist could consult; the cream didn't work, and a visit to the dermatologist led to a chronic psoriasis diagnosis.
Nyasha remembers her childhood as being “pretty regular”: “The diagnosis did not really mean much to me until I got older,” she says. "My main concern at the time was whether or not this sickness would affect my ability to go and play with my friends."
After Nyasha was diagnosed, her dermatologist put her on medication for the itching and scratching and provided advice on how to take care of her skin and eliminate triggers. “Having the diagnosis was somewhat empowering as we finally knew what it was and what could be done about it,” Nyasha says. "I liked knowing my triggers and what to do about [them], because, in some ways, it felt like I had some power left that this condition had not taken from me. I can do what I need to do to manage it and live a 'normal,' happy life." She takes steps to make her life more manageable, like keeping her skin moisturized and avoiding getting too warm, as sweat can lead to itchiness.
What Nyasha struggled with most was explaining to people that psoriasis isn't just having itchy skin: “It's not just a skin problem; it’s basically my immune system plotting against me every day.” Being the only member of her family to struggle with psoriasis didn't help matters. At times she felt alone in her discomfort and pain, without anyone to relate to.
"Psoriasis works on my mental health. On harder days I find myself in this constant loop of 'why me?' and comparing myself to beauty standards that are not even attainable," says Nyasha. "It takes a lot to be able to pull myself from the dark places my mind can go because of my condition. But I always remind myself that tomorrow is coming. Even though today is terrible, tomorrow is coming, and that is another chance to try again."
Psoriasis isn't just on the skin's surface, and it can be devastating for those who suffer from it. "The fear of what people will say can be crippling to the point where you never want to face the world. You go to extreme lengths to cover yourself up so that nobody ever sees," Nyasha explains. But she's hoping those with and without psoriasis know the importance of acceptance and self-love. After a period of accepting her psoriasis but not loving it, she found herself asking God why her, and it wasn't until a moment of peace and acceptance between God and herself that Nyasha's mindset changed. “Loving me for me and not for who I think others want me to be. Making peace with who you are — diagnosis or no diagnosis — frees you in ways you never imagined possible."
Keloid advocate Bianca Lawrence had acne beginning at the young age of 11, and she was eventually referred to a dermatologist who prescribed Roaccutane. "After taking Roaccutane, I realized I had small, hard bumps on my body which weren’t going away," she says. Those hard bumps were keloid scars, raised scar tissue that occurs more commonly in people with dark skin. Her keloid scars were quickly diagnosed, but she now feels the treatment — injecting the keloid with a corticosteroid — was too much for her 13-year-old self to endure.
Lawrence knew her acne spots weren't like the acne spots shown in modern media. Before her diagnosis, she spent a lot of time questioning what the issue was. “I was curious and just wanted them to disappear," she recalls. "I just wanted normal skin, like other girls who I was around at school.”
Lawrence's keloid scars led her to hide away, afraid to show her skin to the world: "I would cover up with hair extensions, loads of makeup, chunky necklaces. I wore turtleneck jumpers in summer. When I used to walk past someone, I pretended I was on the phone or pulled my hair around so you couldn’t see my scars. I never wore my hair up. The list is exhaustive — anything and everything to cover up, or sometimes not even leave the house [unless] I had to for school, college, university, work."
Lawrence struggled with her mental health in her teenage years and was diagnosed with anxiety and depression, finding the exercise of hiding her scars to be emotionally exhausting. Fortunately, she had the support of her mother, and in her 20s, Lawrence's keloid specialist, dermatologist Anthony Abdullah of the Birmingham Skin Centre, who showed her the “correct” way to inject a keloid. “He’s truly helped reduce them correctly,” she says, "even though they’re still prominent on my face, neck, and shoulders."
Lawrence encourages those interested in treatment to find a doctor who specializes in keloids before starting treatment, and to remember that you're not alone on an island. “Living with keloidal skin isn’t easy, especially with the stares and comments,” she says. "We think we're alone, but we’re not — there are so many keloid warriors in the world. It can be difficult to come to terms with, but I promise you, you’re never alone."
Lawrence's experience has been a period of self-growth and self-love. In February 2017, she posted side-by-side photos of herself on Instagram, one side featuring the edited version of her skin, sans keloids, and the other showing herself in all her scarred glory. She wrote her story in the caption, and then turned off her phone. "I was nervous and scared, as I thought I would receive negative comments. But to my surprise, I received nothing but love, positivity, and support," she says. Lawrence considers that day to be her first baby step: "I’ve always said baby steps are still steps and they still move you forward. Each day can be tough, [but] I’m tackling each day as a free person who isn’t hiding anymore."
Anyone who wants to contact Lawrence can do so via Instagram @keloidsupport. Lawrence says 2021 featured the first Keloid Day of Awareness, February 16, which she calls "a day to appreciate our scars, a day to appreciate us."
Read more stories from The Melanin Edit:
- Why Isn’t There More Black Skin in Dermatology Books?
- How Colorism Shapes Black Girlhood
- The Best Sunscreens for Darker Skin, According to Black Editors
Now watch Alicia Key's quick and easy beauty routine:
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