African American Guide to Plastic Surgery: Skin


Although skin varies very little from race to race. African American skin can be prone to hyperpigmentation (darkening of the skin), hypertrophic scarring (raised, widened scars), and keloids (raised, reddish nodules). As a result, plastic surgeries in African Americans must be performed with careful attention to the healing pattern of the skin. Both patients and doctors have to be aware of this and understand how to minimize hyperpigmentation, hypertrophic scarring and keloid scarring.






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Hyperpigmentation in African Americans

Hyperpigmentation is darkening of the skin from inflammation which occurs after trauma to the skin, such as a cut, scrape or severe acne. Hyperpigmentation affects African Americans fairly often and can be difficult to treat. Some African Americans with hyperpigmentation find that the dark spots will fade on their own as the skin injury heals. For others, the hyperpigmention can remain for months to years. Treatment of hyperpigmentation includes topical hydroquinone, corticosteroids, tretinoin or glycolic acid. Chemical peels, microdermabrasion and professional laser treatments may also be employed to treat hyperpigmentation. Be sure to consult with a skin care professional, who has experience treating African Americans skin before beginning a treatment regime.

Hypertrophic Scars in African Americans

A hypertrophic scar looks similar to a keloid. However, hypertrophic scars grow only within the border of the affected area. Hypertrophic scars tend to heal themselves, decreasing in pain and swelling over a period of time (usually about a year or more). The healing process may be aided with the help of steroid topical ointments, steroid injections, or compression therapy utilizing silicone gel sheets. Surgical scar revision is frequently utilized as a treatment for hypertrophic scars. In general, scar revision includes excision of scar and closure of scar with minimal trauma to the skin edges, and minimal tension. However, recurrent hypertrophic scarring may occur.

Keloids in African Americans

Keloids are more common in African Americans than any other ethnic group. Keloids usually appear following a skin injury, and develop into a type of growth that extends beyond the injured area itself. Keloids are sometimes painful or itchy, as well as being very unsightly. The best initial treatment is to inject steroid into the keloid once a month. After several injections with steroids, the keloid usually becomes softer and flattens in three to six month’s time. Earlobe keloids are often surgically excised, followed by steroid injections. For severe cases, the keloid can surgically excised and given radiation to the site immediately afterwards. Despite surgical excision, keloids can recur in up to 50% of individuals.

Flesh Moles in African Americans

Flesh moles is a condition that more commonly affects African American women. Flesh moles can appear on the face, shoulders, back, arms, and usually appear darker than the surrounding skin. Also known as dermatosis papulosa nigra, flesh moles are benign and shouldn’t be painful or pose any serious health threats. Removing African American flesh moles is most often a cosmetic procedure. Mole removal can cause moderate trauma to the skin surface, or even inflammation and hyperpigmentation, so consult with a doctor about African American mole removal risks before undergoing treatment.

Skin Cancer in African Americans

No one is immune from the threat of skin cancer. Although skin cancer is less common in African-Americans, when it does occur, it’s usually diagnosed at an advanced stage. Which means it is less likely to be cured. Squamous cell cancer is the most common type found in African-Americans. This type of cancer is usually curable, but it could be more serious in skin of color than in Caucasians. Melanoma, typically the deadliest form of cancer, is much less common in African-Americans. However, when it does occur, it is very deadly. Melanoma is usually found under the nails, on the palms of the hand and on the soles of the feet in African-Americans.

Contact Us

If you would like to learn more about Plastic Surgery in African Americans, we invite you to meet with Dr. Olivier who is a female, board certified plastic surgeon for a private consultation at our Brooklyn, New York office, located at One Hanson Place.  Contact us by calling 718-783-0934.
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