Rosacea can produce unique symptoms and may require specialized treatment in people with darker skin tones.
Rosacea is a chronic skin condition in which the skin — most typically on the nose, cheeks, and forehead — appears flushed and red, sometimes with pus-filled bumps. Several subtypes of rosacea exist, and some subtypes produce symptoms other than just red skin.
Below, we’ll share everything you need to know about rosacea in Black people and people of color, including some of the possible causes, symptoms, and treatment options.
Can Black people get rosacea?
Yes! While rosacea appears to be more common in people with white skin, it’s believed that this condition is frequently underdiagnosed in Black people.
One of the primary reasons for this is that rosacea can affect darker skin tones differently, making it more challenging to detect.
When it comes to different skin conditions — including rosacea — health experts tend to discuss symptoms through the lens of white skin. For example, one of the most commonly used descriptions of rosacea is having “red or flushed skin.”
But inflammatory skin conditions don’t always appear pink or red when someone has darker skin. In fact, conditions like rosacea remain frequently underdiagnosed in Black people because it can look different in those with darker skin tones.
Instead of pink or red patches on the nose or cheeks, for example, rosacea in people of color can make these areas of the skin appear dusky or dark. Rosacea flares may look purplish or simply discolored from your usual skin tone.
Other symptoms of rosacea in Black skin and skin of color may include:
- facial flushing
- broken blood vessels
- dry, rough, or scaly skin
- sensitive, burning, or swollen skin
- subtype 2: acne-like facial breakouts
- subtype 3: thickening of the skin on the nose
- subtype 4: swelling or irritation of the eyes
Symptoms can range from mild to severe and vary from person to person. Some research even suggests that certain symptoms may be more likely to affect people of color.
A 2019 research review found that facial redness was a less commonly reported symptom in people of color with rosacea. Instead, mouth, nose, and eye lesions and acne-like spots — also known as papules and pustules — were much more likely to appear in people of color.
The study’s results also found that people of color were more likely to experience post-inflammatory hyperpigmentation. Hyperpigmentation develops when the skin becomes darker, making it even more difficult to see other symptoms in skin of color, like redness.
Health experts still aren’t entirely sure what causes rosacea, although multiple factors appear to play a role, including genetics and environmental exposures. These factors appear to be the same for everyone, regardless of skin color.
Outside of possible causes, there are also certain factors that can lead to flare-ups and affect the severity of someone’s symptoms — these are known as triggers.
According to the American Academy of Dermatology Association (AAD), some of the most common rosacea triggers include:
- sunlight
- harsh weather
- stress
- spicy foods
- alcohol
- coffee or tea
- body care products
- makeup
- exercise
- medications
- microorganisms
While triggers can vary from person to person, skin color doesn’t appear to be a factor that affects what someone’s triggers might be.
Rosacea treatment is generally the same for all skin tones, although certain treatment options
Medications
Topical, oral, and systemic medications can help manage rosacea symptoms like redness and lesions.
Medication options tend to vary depending on the symptoms targeted, but some potential options include:
One important thing to note about rosacea medications is that certain medications can increase the risk of hyperpigmentation in Black skin and skin of color. Talk with a doctor or dermatologist if this is a concern for you.
Light therapy
Light therapy, also known as phototherapy, is a common treatment for skin conditions. It uses different wavelengths of UV light to treat skin inflammation.
Laser therapy is a similar approach that uses lasers to treat skin inflammation and thickening.
Similar to other treatment options for rosacea, certain stronger light and laser therapies may increase the risk of scarring or hyperpigmentation in people of color. Talk with a dermatologist to ensure you fully understand the risks before any procedure.
Lifestyle changes
One of the most important treatment approaches for rosacea is making lifestyle changes that can help avoid flare-ups. Some of the most beneficial changes include:
- Recognizing and avoiding triggers: Everyone’s triggers are different, so it’s important to find out what your triggers are so that you can avoid them.
- Following a gentle skin care routine: Avoiding harsh chemicals in body care products can help reduce flare-ups while keeping the skin clean and moisturized.
- Using sun protection when outside: Sun exposure is one of the most common rosacea triggers, but protecting your skin can help reduce this risk.
Cultural competency in rosacea treatment
Diagnosing and treating rosacea on Black and brown skin requires specialized understanding. That’s why having diverse and culturally competent doctors is so important. While only a small minority of doctors in the U.S. identify as Black, many organizations are working to change that.
Ask your primary healthcare professional if they have any recommendations or resources for Black dermatologists in your area.
Rosacea is one of the most common inflammatory skin conditions, but it’s often underdiagnosed in Black people and people of color. While redness and flushing are common symptoms, other symptoms — like acne spots and hyperpigmentation — are common in skin of color.
If you’ve noticed any symptoms like dark patches of skin, acne-like spots, or other new skin symptoms, reach out to a doctor to discuss your concerns.