This is the second of three articles in our series entitled Care of Melanated Skin. See below for links to the other two articles and a Resource Guide. – Editor

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Black skin comes in many tones, from the light caramels of Halle Berry and Jasmine Guy to the deep ebonies of Oprah Winfrey, Samuel L. Jackson and Viola Davis. But what all shades of “skin of color” have in common is the higher presence of melanin. Melanin is a substance in the body that produces skin pigmentation as well as the color of hair and eyes. Because melanin-rich skin has unique attributes, it’s helpful to be knowledgeable when caring for these richly pigmented complexions. And since the skin is the largest organ of the body, understanding overall skin health can contribute significantly to whole-body health and wellness.

While African Americans make up just three percent of board-certified dermatologists in the U.S., Atlanta is home to Black dermatologists, naturopathic doctors and estheticians who specialize in skincare for melanated skin. Four outstanding specialists share their knowledge here.

Perhaps nothing feels more like summer than DJ Jazzy Jeff and The Fresh Prince in the classic 1991 track “Summertime.” But summer is more than just fun at the cookout; it’s the time for special skin protection. According to Dr. Sumayah Taliaferro of Atlanta Dermatology and Aesthetics, “spring and summer are peak seasons” for skincare concerns as people head outdoors with less clothing and more skin on display. 

While people with darker skin tones have a lower incidence of skin cancers, the importance of sunscreen is still there, not only to lower the possibility of cancer but to reduce one of the biggest complaints among people of color: hyperpigmentation or “dark spots.” According to Taliaferro, “Hyperpigmentation is intensified and stays longer if you continue to get a lot of sun exposure without protection.” While Black skin doesn’t wrinkle in the same way as lighter skin tones, Taliaferro warns that “one of the signs of aging [for skin of color] is a certain degree of hyperpigmentation.”

For that reason, sun protection, such as that provided in Black Girl Sunscreen products, is a good idea. Instead of using zinc oxide, which creates an ashy effect, the brand is specially made for Black skin and contains alternative ingredients. Taliaferro also likes Neutrogena’s Ultra Sheer, Sheer Zinc and baby sunscreen products. “Sunscreen only lasts two to three hours,” she cautions, so when a day at the beach is in the plans, be sure to reapply sun protection throughout the day. Or, if sunscreen is applied in the morning before going to work, she recommends that it be reapplied if the workday ends at 3 or 4 p.m. and the drive home occurs when the sun’s rays are still strong.

Topical sunscreens fall into three main types: mineral, chemical and hybrid. 

Mineral sunscreens. These contain either titanium dioxide or zinc oxide, which act like a thin wall of protection against ultraviolet radiation. It’s this thin wall that tends to look like a white shadow or ashy film on darker skin tones. 

Chemical sunscreens. These have active ingredients that absorb and neutralize harmful UV rays without leaving the white cast that many people of color want to avoid. Typical ingredients include avobenzone, homosalate, octisalate and octocrylene. 

Hybrid sunscreens. These offer both mineral and chemical sunscreens, offering “the best of both worlds,” providing some of each type of protection and less of a white cast.

Natural sunscreens. This is a misnomer because there are no true “natural” substitutes for sunblock. However, carrot seed essential oil can sometimes be used as a topical ingredient. In addition to being a powerful antioxidant, carrot seed oil contains a compound that absorbs UVB light. However, there’s no evidence that carrot seed oil is safe to use alone as a sunscreen. While it has some ability to block UVB light, it doesn't protect against skin cancer or damage from the sun, according to Dan Brennan, M.D., of WebMD.

Dr. Breana Davis is a naturopathic doctor at Progressive Medical Center, an integrative functional medicine and health and wellness center in Dunwoody. While she recommends traditional topical products, when asked about natural products, she says, “Honestly, it’s [about] antioxidant support.” Some supplements act like an internal sunscreen, she says, “because you take it and … the antioxidants help to neutralize any of the free radical damage that may come from being out in the sun. So, things like glutathione and ALA, or alpha lipoic acid, are always really helpful—they’re going to help skin-wise. … But good antioxidant support is going to help any and everywhere in the body.” She suggested Heliocare products as a popular option. It is widely available from drug stores and online retailers nationwide. 

While topical lotions are assigned a sun protection factor (SPF), clothing is assigned an ultraviolet protection factor (UPF), measuring the amount of UV radiation that can penetrate fabric and reach the skin. According to Oprah Daily, for example, wide-brimmed summer hats offer 50+ SPF along with their seasonal style. The American Academy of Dermatology (AAD) also recommends lightweight and long-sleeved pants and shirts, sunglasses with UV protection, and shoes that cover your feet. While dark colors can be less desirable because they hold heat in warmer weather, they are more protective than lighter colors. For example, a long-sleeved blue denim shirt can provide a UPF of about 1700, while a white T-shirt only offers a UPF of 7. It’s important to note that dry clothing offers more sun protection than wet.

Acne is a common concern for African Americans. Blackheads, whiteheads and pimples can take away from the skin’s natural beauty. With darker skin tones, acne scarring is more prone to leaving dark spots, which can be exacerbated by sun exposure. 

 Dr. Dione Marcus Super, founder and CEO of Super Dermatology, says about half of her patients are people of color. “I trained at Henry Ford Hospital in Michigan in their dermatology residency, where we had a Skin of Color Clinic. I’m very fortunate that I was trained by the leaders in ethnic skin.” Her specialized training helps her to understand and treat Black and ethnic skin tones. “[For] people who are battling hyperpigmentation, I usually have them go up to SPF 50, whereas the typical person, I would say SPF 30.” She recommends oil-free products “because obviously, you don’t want to be trying to help your hyperpigmentation and develop acne because you’re not thinking about that part.” Along with Neutrogena and Black Girl Sunscreen, Super approves of sun care products from global superstar Rihanna’s Fenty Beauty brand, which offers protective moisturizers, tinted moisturizers and sunscreens. 

Super says a lot of the acne she sees in new patients is self-induced. “They may be using a tea tree oil blend or, more commonly, cocoa butter or Vaseline. Or [they tell me,] ‘I’m using Jergens on my face because I use it on my body.’” Instead, Super says, “CeraVe is a ceramide-based moisturizer that is inexpensive. It’s very good, light, and our skin tends to do really well with it.” Ceramides are fats found in the skin cells that make up about 35 percent of the outer skin, or epidermis. She also offers Cetaphil as a good oil-free moisturizer option. 

For more complex acne, a wide range of treatments are available, including topical creams, oral medications and chemical skin peels. Laser treatments can also be used to minimize scarring and dark spots and remove unwanted hair, which can become ingrown and cause bumps. Because thick, raised scars known as “keloids” are more prevalent in the Black community, practitioners familiar with them can be more helpful. 

The use of lasers on Black skin also requires special knowledge. Super says, “I definitely tell people don’t always go for the Groupon unless you really know what you’re getting. Because it’s two things: you want a laser that’s safe with skin of color. And then you also need a well-trained and experienced laser technician that’s familiar with skin color and [knows] how to adjust the settings so that it’s effective—but not going to give you a lot of unwanted damaging side effects.” 

Sun exposure can cause dark spots. Acne can cause scarring. Scarring can cause more dark spots. Without being informed about holistic skin health and without the motivation and resources to put that knowledge into practice, it can become a vicious cycle.

Dr. Sonza Curtis is a naturopathic doctor and founder of Three D Wellness in Roswell. She explains that many skin issues begin in the gut. “When you look at the skin and you look at the gut, they both have what we call a microbiome,” says Curtis. “We have over 38 trillion bacteria in our body [yet] … for every cell, we have ten bacteria.”

According to Curtis, skin issues can often be a sign of an underlying issue such as food allergies or sensitivity, thyroid disease, nutrient deficiencies, autoimmune disorders, hormonal imbalances or uncontrolled stress. “But the number one cause of a lot of discomfort for people with skin issues is a vitamin D deficiency because vitamin D is very imperative for anybody with skin issues. I always have to check their vitamin D levels.” Because higher melanin levels reduce the body’s ability to synthesize vitamin D, deficiencies among African Americans are common; approximately 75 percent of the population tests at below-recommended levels. Diagnosis involves comprehensive testing. 

Other common concerns for skin of color are eczema and psoriasis. Curtis explains, “I treat it from the inside out.” Her treatment options include homeopathic remedies, topical vitamin D sunscreens and topical B12. While giving the patient guidelines on what to do to heal the gut, Curtis works on the skin. “One lady in particular, she called it the ‘miracle cream.’ When she came in, she really looked like a fish scale. We treated her from the inside, and then we put the cream on. And I would say, within a matter of four weeks, her skin was back to normal.”

Because care by a naturopathic doctor isn’t typically covered by health insurance, Curtis will be launching a new membership program in August. “It’ll be where people can actually be a part of the community,” she says. “Because it takes more than just one person to heal; it takes a village to heal.” Her program will offer savings through referrals with the dermatologists, estheticians and other practitioners within her “Wellness Circle of Influence.”

Holistic treatment of skin health is rare. According to Curtis, “If you think about three percent of dermatologists are Black, then it’s probably one percent of people of color that are treating other people of color in this way.” ❧

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According to Davis, good skincare management can be simple. “I know a lot of people will have these 12-step skincare routines. I have a 3-step [routine].” She recommends a gentle cleanser, a spritz-like rosewater, a gentle moisturizer and SPF throughout the day for sun exposure. Rosewater offers both antioxidant and anti-inflammatory properties. “Exfoliation should happen maybe once a week. You definitely don’t want to be doing that every day.” While exfoliation is important to uncover new skin, too much exfoliation can be irritating to the skin. Dr. Davis likes the products offered by two Black-owned businesses, Herb’N Eden and Urban Skin Rx. 

In addition to caring for the physical skin itself, any holistic skincare routine includes a healthy sleep routine, proper hydration, solid nutrition and stress management. The latter might express itself in spiritual activities such as prayer or meditation, journaling, practicing gratitude, physical exercise or time spent in nature gardening or hiking.

The human body is a complex organism that is uniquely interconnected within itself and with other living beings. Connection to healing resources and community is paramount to maintaining overall health. ❧

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There are many types of specialists who work to improve the condition of the skin and create a desired healthful glow.

Commonly thought of as “skin doctors,” dermatologists are medical doctors or doctors of osteopathic medicine specializing in treating skin, hair, nails and mucous membrane diseases and disorders. They can address issues ranging from acne and eczema to more serious and life-threatening conditions like skin cancer. Some dermatologists also offer cosmetic procedures to enhance the appearance of skin. 

Unlike dermatologists, naturopathic doctors (NDs) take a holistic approach, considering the body as a whole and trying to identify how symptoms of the skin can be addressed as indicators of overall health. Education and licensing for NDs typically include a four-year graduate degree program and a licensing exam.

Often found in spa environments, estheticians focus on bringing out the beauty of the skin. They can help with topical treatments like facials and even chemical peels. Estheticians typically attend cosmetology school or a college program and pass a written exam; however, they cannot diagnose or treat medical conditions.

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Trish Ahjel Roberts is our consulting editor for African American issues. She is also a transformational coach, professional speaker, book coach and author of the new book, The Anger Myth: Understanding and Overcoming the Mental Habits That Steal Your Joy. Learn more at TrishAhjelRoberts.com.