Acne care for patients with skin of color requires a culturally informed, individualized approach that accounts for hair care practices, post-inflammatory hyperpigmentation, and disparities in treatment access. Jenna Lester, MD, emphasized that oils, waxes, and pomades commonly used by patients with Afro-textured or tightly coiled hair can worsen acne, but clinicians should avoid simply telling patients to stop using culturally important products. Instead, they can ask about hair routines and recommend strategies such as water-based formulations, applying oils only to hair ends, using “pre-poo” methods to reduce buildup, and minimizing oil migration to the face.
Lester also highlighted the importance of preventing and treating post-inflammatory hyperpigmentation (PIH), noting that dermal pigmentation can be resistant to therapy and may warrant being treated as a scarring equivalent when considering systemic acne treatments such as isotretinoin. She emphasized sun protection as a key part of PIH management, particularly sunscreens with iron oxide to block visible light and zinc oxide for UVA protection. The presentation also addressed disparities in acne treatment and the need to screen pediatric patients for bullying, especially among racial, ethnic, sexual, and gender minority groups. Clinicians are encouraged to assess bullying severity, frequency, and impact while working with families and schools when needed.
Reference: Steinzor P. Addressing Acne in Patients of Color. AJMC. Published July 24, 2025. Accessed June 12, 2026. https://www.ajmc.com/view/addressing-acne-in-patients-of-color
