When treating acne, people with dark skin are at greater risk for developing pigmentation changes. Compared to Caucasians, African Americans are up to 15 times more likely to develop acne-related scars. The biggest distinction between treating light and dark skin is that medication most successful in treating and preventing acne, benzoyl peroxide and salicylic acid, can cause irreparable damage in African Americans.
Clindamycin (sold as Cleocin T and Benzaclin) and erythromycin (sold as Akne-Mycin, Erygel and Benzamycin) are topical antibiotics prescribed to kill the bacteria that cause acne. These medications come in creams and gels.
Oral antibiotics are more effective at controlling acne compared to topical antibiotics; however, they're not intended to cure acne. Oral antibiotics like doxycycline (sold as Vibramycin) and minocycline (sold as Minocin) work by killing the bacteria that cause pimples. They also reduce the inflammation caused by acne lesions.
Retinoids work by unclogging pores. They are used to treat acne bumps, pustules, blackheads and whiteheads. The American Academy of Dermatology reports that retinoids are prescription formulations of vitamin A that safely and effectively treat acne in skin of color. Popular retinoid acne medications include adapalene, tazarotene and tretinoin (sold as Differen and Retin-A).
African Americans often use moisturizers and other cosmetics to eliminate dry skin and ashiness, as well as products that enhance or even skin color. Because some cosmetic products are linked to causing breakouts, it's recommended that they purchase "Noncomedogenic" (products that won't clog pores) cosmetic products.
Sometimes the best treatment for acne is avoiding products that trigger breakouts. The American Academy of Dermatology's online journal, AcneNet, indicates that more than 70 percent of people with color who use hair oil or ointment developed forehead acne. Using an oil-based hair product 1 inch behind the hairline could prevent breakouts.