Skin conditions can show up completely differently on different people, and how skin reacts to sunlight, scarring or even aging can completely differ depending on your skin type. Take eczema for example: on lighter skin tones the symptoms often appear sore and red, but on darker skin, it can appear as purple or silver tones. If you don’t know what to look out for, finding the right way to care for your skin can become increasingly difficult.

The reality is, not all skin is the same, and that's perfectly okay. Depending on your skin tone and genetics, how you look after your skin - and finding a routine that works for you - may vary. There’s no one-size-fits-all answer, and knowing your skin’s unique needs is vital. But for Black people in particular, accessing information on skin - and finding specialists who understand all skin tones - isn’t always that straightforward. Especially when you are a minority within your country.

So, what exactly should you know about your skin if you are Black, and in what ways does it differ from other skin tones?

Black and Brown people get their darker complexion from melanin, the natural pigment. Eumelanin, to be even more specific, is a brown-black pigment and the most common form of melanin that gives humans their skin, hair and eye colour.

People with darker skin tones do have some natural protection from UV. “Melanin helps protect the cells of the epidermis, or outer layer of the skin, from UV light,” says Dr Ingrid Wilson, Director of Crewe Hair and Skin Clinic in Cheshire. “This protection extends to all forms of UV light (UVC, UVB, and UVA) as well as blue light. It does this by absorbing the UV light before it’s able to damage the sensitive DNA of the skin cells.”

“Skin colour increases the diversity in the structures of the skin,” says Dr Wilson. “Darker skin tends to have a thicker dermis layer and smaller collagen fibres. Darker skin provides greater protection from ultraviolet (UV) exposure than fairer skin because there is a larger amount of melanin in keratinocytes.”

This, however, doesn’t mean Black people should forgo using sun protectors or are resistant to sun damage. “Black skin can actually sunburn,” explains Dr Wilson, noting the signs of sunburn are different on darker skin. “Look for peeling of the skin rather than redness,” she adds. “Wherever there is sunburn there is damage to the DNA. This is important because dark skin can still get skin cancer.”

Melanoma (a form of skin cancer) often appears on the palms of hands, or the sole of feet, for Black people and people of colour. This was the case for Bob Marley, who was diagnosed with melanoma under his toenail and later died from it. “There is greater morbidity and mortality for skin cancers in black people because of lack of awareness and late diagnosis.” The British Association of Dermatologists advises that you check your skin regularly, with a particular focus on your palms, soles, nails, genital regions, and mucous membranes.

It’s not just UV protection where Black skin differs: “People with darker skin have enhanced protection from the sun, better wound healing, [and] reduced ageing related to the sun (photoageing) including the later formation of wrinkles.”

But there are also some conditions that are more common among people with darker skin. Keloid scars for example - a raised soft scar caused by the overproduction of collagen in the skin. Hyperpigmentation - patches of darker skin caused by blemishes, injuries or sun damage - is also more commonly seen in people with darker skin tones.

While having more melanin in your skin is beneficial when it comes to natural UV protection, it also means melanated skin can prevent the production of a healthy amount of vitamin D3. Vitamin D is needed to keep bones and muscles strong and healthy in humans and it’s made from direct exposure to sunlight. Those living in cooler climates in the northern hemisphere - like the UK - are more likely to have a deficiency of vitamin D.

“Wearing sunscreen with a sun protection factor of 30 reduces vitamin D synthesis in the skin by more than 95%,” says Dr Wilson. “People with a naturally dark skin tone have natural sun protection and require at least three to five times longer exposure to make the same amount of vitamin D as a person with a white skin tone.” A simple way to still wear sun protectors and to increase vitamin D is through supplements.

“Vitamin D is the only supplement for which there are national recommendations to take a supplement during the winter month,” says Dr Wilson. According to the NHS, “In the UK, sunlight doesn't contain enough UVB radiation in winter (October to early March) for our skin to be able to make vitamin D”. The UK government also suggests that adults, young people and children over 4 years old should consider taking a daily supplement containing 10 micrograms (400 units) of vitamin D throughout the year if they have little or no sunshine exposure because of their dark skin.

There are more than biological differences that affect how darker skin is treated, and often neglected, in the medical profession. There is still an overwhelming lack of images of darker skin tones in medical books, meaning Black people could potentially be going under the radar by medical professionals and individuals, leading to missing out on vital treatment. “In white skin, the hallmark of inflammatory skin disease is erythema, which presents as shades of pink and red of varying intensity,” says Dr Wilson. Yet in darker skin “inflammation may present as shades of violet and purple, or as an increase in pigmentation leading to a darkening of the skin.” But doctors may not spot this if they lack the knowledge.

“Historically there has been a Eurocentric bias in medical textbooks which means that medical practitioners have no frame of reference to draw upon," says Dr Wilson.

And with the population of black and mixed people set to rise in the UK, its crucial medical books reflect the diversity of the population.

This lack of images of darker skin can even be seen in the reporting of covid-19 symptoms, Dr Wilson explains. “The images of the skin changes that can be seen in Covid infections - which were published for medical professionals to read up to May 2020 - did not show images of people with darker skin tones. And only a few images were published of how people with darker skin were affected by covid after that,” she notes.

It doesn’t stop there: it’s key for medical books to reflect the diversity of Black populations. “There is heterogeneity between different ‘black’ populations,” added Dr Wilson. “African American and African Caribbean black populations are likely to be more genetically diverse than Black African populations. Therefore it is important for clinicians to be exposed to a range of images to refer to and learn from.”

Now there are a plethora of resources emerging specifically for darker skin. Platforms like the Black Skin Directory give individuals access to dermatologists and skin care professionals who specialise in darker skin. There’s also Mind The Gap, a new handbook of clinical signs and symptoms in black and brown skin. Ultimately, understanding and catering to our varying skin tones will only help more people, especially marginalised groups who have not always had access to key and sometimes life-saving treatments.