Psoriasis on skin of color can be challenging to diagnose since the lesions often appear differently. Learn about common symptoms and treatment options.

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Psoriasis On Skin Of Color: Appearance, Symptoms, And Treatment

08/21/20228 min read

Do those itchy, scaly rashes on your skin mean you have psoriasis? Everything you read about the condition says you'll see red patches. But yours aren’t red, so what’s going on? Does psoriasis on skin of color look different?

Yes, it can. The symptoms of psoriasis can vary depending on your skin tone. And while we obviously can't diagnose you over the internet, we can give you some more information about what psoriasis is and what symptoms you might notice as a person of color.

Table Of Contents

What Is Psoriasis?

A patch of psoriasis on skin of color

Psoriasis is an autoimmune condition that causes your skin cells to grow too quickly. As a result, they build up, forming scaly patches that can be itchy and painful.

While scientists haven't yet found a cause for psoriasis, we know it's not contagious. So you can't "catch" it from someone else.

However, there is a genetic factor involved. If you have a family member with psoriasis, you're more likely to develop it yourself. And if you have it, there's a greater chance that your children will inherit the condition.

How Common Is Psoriasis?

Psoriasis affects over eight million people in the United States. It's common in Caucasians but can occur in people of any race. For example, 1.9% of African Americans have psoriasis. That’s slightly lower than Hispanics, with 1.6% of the population affected.

While the condition can develop at any age, it typically manifests before age 40. However, many people notice their first symptoms between the teenage and young adult years.

Symptoms And Outcomes Of Psoriasis In People Of Color

Most articles on psoriasis symptoms mention thick, red patches covered in silvery-white scales, but that's not always the case with psoriasis on skin of color. People with darker skin tones may notice light pink, violet, or brown patches covered in silvery, gray, or white scales.

You’ll often notice these patches on your hands, knees, elbows, and scalp, but psoriasis can appear anywhere on your body. It can even affect your nails, causing them to become pitted.

No matter where these patches are, they often cause your skin to feel itchy. In addition, you can knock the scales off if you scratch, leading to bleeding and infection.

Though the scales may eventually get better on their own, once one clears up, you’ll likely notice that your skin is a different color in that area. It can be darker or lighter.

This is known as hyperpigmentation or hypopigmentation, respectively. These discolorations can take up to a year to resolve, creating another aspect of the condition you must treat.

Other symptoms of psoriasis are the same regardless of skin tone. These can include:

  • Joint pain
  • Burning sensation on the skin
  • Thickened nails
  • Swollen lymph nodes

Psoriasis can be excruciating, making it difficult to sleep. It can also wreak havoc on your mental health, leading to depression and anxiety.

What Psoriasis On Skin Of Color Looks Like

As mentioned above, psoriasis on skin of color can look different from the textbook description. The patches can take on a different color, like violet or brown. The scales are also often less visible since they’re commonly gray or white.

These color variations make psoriasis patches harder to spot on people of color because there's less contrast between the lesion and your skin tone. In addition, you may notice that the scales are thicker and more widespread across your body.

Diagnosis Difficulties

Since psoriasis presents differently in people of color, it can make diagnosis difficult, even for experienced dermatologists. Doctors often misdiagnose it as a different skin condition, such as eczema or Lichen planus.

Because of these difficulties, many people of color report having to visit several doctors to get an accurate diagnosis.

That's why it's crucial to find a dermatologist with experience treating psoriasis on skin of color. They're more likely to be familiar with the different ways the condition can present and give you the correct diagnosis during your initial visit.

If your doctor isn't sure if it’s psoriasis causing your skin concerns, they may order a skin biopsy. This involves taking a small sample of your skin tissue and examining it under a microscope.

After performing the biopsy, dermatologists can often tell you definitely what your diagnosis is. Once you have an accurate diagnosis, you can begin treating your condition.

Treatment For Psoriasis On Skin Of Color

A woman using a cream to treat psoriasis on skin of color

While there's no cure for psoriasis, treatments are available that can help alleviate symptoms and improve your skin. Below are a few of the options to talk to your dermatologist about.

Topical Options

If your psoriasis is mild, you may be able to treat it with topical options. These can be found in most drugstores and include things like:

Consider trying some alternative remedies to help soothe your skin. Common ones include:

  • An oatmeal or Epsom salt bath
  • Dietary changes, like taking omega-3 supplements or following an anti-inflammatory diet
  • Apple cider vinegar wash for your scalp

You may need to experiment with a few options before finding one that works for you. If your psoriasis is moderate to severe, you'll likely need something more powerful.

Prescription Medications

For more severe cases of psoriasis, it’s best to get a doctor involved with your treatment plan.

They'll often start with a cream or ointment with a higher corticosteroid concentration than available over the counter. Then, if this treatment doesn't work, they'll try something even stronger or switch to a different type of medication.

Biologics are often successful in treating psoriasis. These medicines target your immune system to help reduce inflammation. They're typically injected and begin healing you from the inside out.

However, these drugs are pretty new. And most of the clinical studies were done on a non-diverse group of patients. So, doctors don't have as much data to show how well they work on people with darker skin tones.

But that's changing. Researchers are currently doing trials to see how different medications affect people of color with psoriasis. It'll be exciting to see what the results are and to learn what types of treatments are most effective.

Speak to your healthcare professional to determine the right treatment for you given your skin type.

Light Therapy

A young woman getting light therapy

Another treatment option for psoriasis is light therapy, also called phototherapy. This involves exposing your skin to ultraviolet (UV) light regularly to help reduce symptoms. Your doctor will choose between two different types of UV light: UVA and UVB.

UVA light is longer in wavelength and can penetrate your skin more deeply. UVB light is shorter in wavelength and doesn't penetrate as deeply into your skin. It can be used alone or in combination with UVA light.

Since there are some risks associated with UV light, this type of therapy is done in a dermatologist's office. This way, they can ensure you wear the proper protective equipment and don't get too much exposure to the light.

Lifestyle Changes

In addition to medical treatment, lifestyle changes might help reduce your psoriasis symptoms. Here are a few to try.

Keep Your Skin Hydrated

Dry, cracked skin can make psoriasis symptoms worse. Using a daily moisturizer is vital to keep your skin hydrated. Also, consider using a humidifier in your home to help add moisture to the air.

Wear Loose-Fitting Clothing

Tight, constrictive clothing can irritate your skin and make psoriasis symptoms worse. It's best to wear loose-fitting, breathable fabrics.

If you're going to be outside in cold weather, dress in layers to protect your skin.

Choose Gentle Skincare Products

When you have psoriasis, it's important to be gentle with your skin. Look for skincare products designed for sensitive skin.

Our Sensitive Skin Moisturizing Body Wash is a great option, as is our Psoriasis Soothing Spray. Both are designed for sensitive skin.

Avoid triggers

Some things can trigger psoriasis flare-ups. These include:

  • Stress
  • Cold weather
  • Sunburns
  • Smoking
  • Excessive alcohol consumption

Keeping a journal can help you look for patterns and identify your triggers. Then, once you know what makes your psoriasis worse, make sure you avoid that thing if possible.

You Deserve Better Skin Days

A man scratching psoriasis on skin of color

While psoriasis on skin of color can be challenging, you aren't facing this skin condition alone. And you don't have to suffer forever.

With the right treatment, skincare products, and lifestyle changes, you can get your symptoms under control and experience more good skin days.


British Society of Rheumatology
Dermatology Times
Johnson & Johnson
National Library of Medicine
National Psoriasis Foundation
The Psoriasis and Psoriatic Arthritis Alliance

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