Psoriasis on Different Skin Tones

Skin color can make a difference when it comes to a chronic skin condition like psoriasis. Few studies have looked at psoriasis in people of color. But we know that psoriasis appears differently in terms of color and severity in people of color.

These differences can lead to disparities in diagnosis and treatment.

What does psoriasis look like on different skin tones?

Psoriasis shows up in different ways on diverse skin tones. On lighter skin, it appears with red, scaly plaques (erythema). But on darker skin, it may look purple, gray, or a dark brown color. Lesions may also be thicker, especially for Black people with the condition.

Many times, psoriasis is also more severe in some people of color. A study published in the Journal of Drugs in Dermatology found that psoriasis covers more body surface area in Asian people compared to other racial groups. The condition may also be harder to treat.¹

Emotional impact and disparities in psoriasis care

Differences in how psoriasis appears on different skin tones mean that psoriasis goes untreated more often in people of color.

Researchers looked at healthcare data by race. They discovered that Black, Asian, and Native American people with psoriasis are 40 percent less likely to see a dermatologist for their condition than white people.

This equals more than 3 million fewer doctor’s office visits for racial minorities with psoriasis. The findings were consistent regardless of socioeconomic or health insurance status.²

Having psoriasis can also take a toll on your quality of life. But for racial minorities, the impact is magnified. In a survey from the National Psoriasis Foundation, 54 percent of white people said psoriasis interferes with their quality of life. The number jumped to 72 percent for people of color. This group was also more likely to feel insecure, ashamed, angry, and helpless about their psoriasis.³

Treating psoriasis in different skin tones

Psoriasis treatments are the same across the skin tone spectrum. But some people with the condition may need stronger therapies that last longer. Standard psoriasis treatments include:⁴

• Topicals
• Phototherapy or light therapy
• Systemics (biologics and oral treatments)
• Complementary and integrative medicine

Since people with darker skin often have thicker lesions, they may need to take higher doses of medicine for a longer time.

The impact of treatment

If creams do not clear up lesions, light therapy is another choice that could work well. Keep in mind that it can cause hyperpigmentation (dark patches), which is easier to spot on darker skin. It may fade on its own, or you can try to lighten it with bleaching creams.

Researchers also see positive results from biologics. A 2011 study of one of these immune system drugs found that after 3 months, psoriasis diminished by 50 percent across all races.

Researchers are continuing to study the effects of these therapies on different skin tones. Beyond psoriasis, they are also addressing the need for more inclusive language for skin color.

Using photos and descriptors, researchers in the United Kingdom have developed a booklet that details signs of illness in people with black and brown skin. The goal is to help healthcare experts provide better care to people of color.^3,5