Dermatologic Conditions in Men of African Ancestry

Marcelyn K Coley; Andrew F Alexis


Expert Rev Dermatol. 2009;4(6):595 

In This Article

Abstract and Introduction


Distinctive properties of darkly pigmented skin contribute to epidemiologic, clinical and therapeutic differences in persons of color. Men of color – particularly those of African ancestry (e.g., African–Americans, African–Caribbeans and Africans) – are a subset of this population in whom several skin disorders present more commonly or almost exclusively. These include pseudofolliculitis barbae, acne keloidalis nuchae and dissecting cellulitis of the scalp or perifolliculitis capitis abscendens et suffodiens. Keloids, although seen in all races and both genders, are more common in darker-skinned racial/ethnic groups and are a leading dermatologic concern among men of color. This article highlights these skin conditions, their medical and surgical management and recent advances in research.


'Skin of color' refers to the range of darkly pigmented skin types that characterize non-white racial/ethnic groups, including persons of African, Hispanic, Middle Eastern and Asian descent. Most recent projections indicate that non-white individuals, populations with skin of color, will comprise over half of the US population in the next 40 years.[201] Several challenges become apparent when treating patients with skin of color based on inherent structural, functional and cultural differences that influence skin and hair, and clinical manifestations of various skin conditions. Many dermatologic conditions either occur more frequently or have unique presentations in persons with skin of color. As such, understanding racial/ethnic differences in the epidemiology, clinical presentation and management of skin disorders is of increasing importance.

A number of conditions that are more prevalent in men of African descent are associated with a considerable psychosocial impact and are therapeutically challenging. These include pseudofolliculitis barbae (PFB), acne keloidalis nuchae (AKN), dissecting cellulitis of the scalp (DCS) and keloids. Here we review recent advances in the pathogenesis and treatment of these disorders, as well as their clinical presentation and epidemiology.