How Psoriasis Affects Black People and People of Color

Psoriasis affects people of all races, including Black people, African Americans and people of color. Media representations of psoriasis often only show how it affects people with lighter skin tones. Psoriasis may cause a similar symptom of itchiness for everyone, but symptoms look different from person to person.

What Does Psoriasis Look Like on Dark Skin Tones?

Psoriasis plaques are usually described as “pink to red.” These are characteristics of psoriasis on light skin tones. On dark skin tones, a psoriasis plaque can range from light to dark brown, purple or gray. Sometimes, skin discoloration isn’t visible on dark skin tones. Each type of psoriasis can look different based on the type and where it is on your body, but if you have a non-white skin tone, it’s unlikely that you’ll see pink or red skin discoloration as a symptom of psoriasis.

Psoriasis may also leave evidence of a flare-up on darker skin tones rather than on medium to light skin tones. While areas of thickened skin will disappear, discoloration from psoriasis plaques can remain on your skin for up to a year. Discoloration isn’t permanent, and a healthcare provider can offer treatment to speed up your body’s healing process.

How will different types of psoriasis look on darker skin?

There are several types of psoriasis that affect different parts of your body and have unique characteristics in addition to skin discoloration, including:

• Plaque psoriasis: A thick patch of skin that’s purple to gray with scales.
• Inverse psoriasis: A patch of moist, smooth, shiny skin.
• Guttate psoriasis: Small, pinhead-sized bumps (papules) with flaky, silver scales.
• Erythrodermic psoriasis: A scaly skin rash (plaque) that covers a large area of your body. It looks like a burn.
• Nail psoriasis: Tiny indentations in your finger or toenails (pits) with a brown spot, also known as an oil spot. Your nails could thin and fall off.

What does plaque psoriasis look like on dark skin tones?

Plaque psoriasis looks different on medium to dark skin tones. While the description of a psoriasis plaque is usually “red,” redness doesn’t look the same on people of color as it does on people with light skin tones. You’ll most likely have a discolored patch of skin that could be a range of light to dark:

• Gray.
• Purple.
• Brown.

Scales and skin flakes caused by plaque psoriasis are usually silver on darker skin tones.

Will scalp psoriasis affect my hair growth?

Scalp psoriasis occurs when plaques form on your scalp and at your hairline. This can cause temporary hair loss until your flare-up goes away. Your hair will regrow when your psoriasis symptoms clear up.

Does psoriasis cause more than physical symptoms?

Yes. The effects of psoriasis on dark skin tones go beyond the physical symptoms and can affect your mental health. You may feel stressed or frustrated about your symptoms or your ability to receive an accurate diagnosis and effective treatment quickly. Diagnosis may take some time, as your physical symptoms may look similar to other common skin conditions. In addition, psoriasis can impact your self-esteem due to more visible changes to your skin than skin discoloration among people with lighter skin tones.

If your physical symptoms affect your mental health, you may find comfort in speaking with a mental health professional.

Can Psoriasis Be Misdiagnosed in Black People and People of Color?

Yes, you could receive a misdiagnosis for psoriasis, but it’s not common. The main reason for misdiagnoses is because underrepresentation of skin conditions on dark skin tones in medical textbooks and educational material for healthcare providers.

Common conditions that look and feel similar to psoriasis that can lead to misdiagnosis include:

• Eczema.
• Seborrheic dermatitis.
• Rosacea.

It’s possible to have more than one skin condition at a time, like eczema and psoriasis. If you believe you have a psoriasis misdiagnosis, meet with a healthcare provider who specializes in skin care, like a dermatologist.

How Is Psoriasis Treated on Medium to Dark Skin Tones?

Several options for psoriasis treatment are available because each person’s skin reacts to treatment differently. The best treatment option for you might not work as well for someone else. Common treatment options for psoriasis include:

• Topical creams or ointments.
• Medicated lotions or shampoos.
• Steroid creams.
• Medications or immune therapies.
• Light therapy.

Do people of color need stronger treatments for psoriasis?

There isn’t a specific treatment for psoriasis that works for everyone. Some studies have found that people with darker skin tones have more success with long-term psoriasis treatment, as signs of the skin plaque may last longer on dark skin tones than on light skin tones. Depending on the thickness of your psoriasis plaque, you may need a stronger dose of prescription medication to clear the plaque, but that isn’t exclusive to dark skin tones.

Managing psoriasis triggers

Symptoms of psoriasis can flare up if something in your environment triggers your immune system to overreact. You can manage common psoriasis triggers by:

• Reducing your stress.
• Wearing protective gear to prevent injuries and taking care of your injuries to prevent infection.
• Regulating your body temperature by staying inside if the weather is too hot to too cold outside. Temperature changes can affect your skin.
• Learning about the potential side effects of any medications you take regularly and speaking with your provider if your medications cause symptoms of psoriasis to flare up. Don’t stop taking a medication unless your provider tells you that it’s safe.

When Should I Visit a Dermatologist for Psoriasis?

If you have a flare-up of psoriasis that isn’t going away with usual treatment, visit your dermatologist. If psoriasis develops on a large area of your body, see your healthcare provider or dermatologist.

A note from Cleveland Clinic

Psoriasis is a common condition that affects all races and skin tones. And it can be frustrating to feel like your symptoms of psoriasis are severe because you don’t have a basis of comparison available during a quick internet search. While psoriasis is a condition that affects your skin, it can also affect your mental health. It’s normal to meet with a dermatologist several times before you find a treatment option that works best for your skin to help you feel better.