Ep 83 – Management of dry skin conditions in skin of colour

Dry skin is an extremely common condition that occurs in all skin colours and ethnic groups; however, differences in skin colour can cause significant differences in the incidence, presentation and treatment of different skin conditions. Although dry skin may cause similar symptoms among different skin tones, the appearance may make it more challenging to easily recognise – a fact highlighted by hospital admissions linked to eczema being up to six times more likely in people of colour than in people with light skin.

In this podcast, Dr Roger Henderson looks at the reasons for this, what impact skin of colour can have on both diagnosing and managing dry skin conditions and how best to manage dry skin in people with skin of colour.

Key references

1. Krutmann J, et al. Br J Dermatol. 2023;188(2):168-175. doi: 10.1093/bjd/ljac046. 
2. Zaidi Z. J Pak Med Assoc. 2017;67(2):292-299. 
3. Wan DC, et al. J Clin Aesthet Dermatol. 2014;7(6):25-32. 
4. Adawi W, et al. Dermatol Clin. 2023;41(3):417-429. doi: 10.1016/j.det.2023.02.003. 
5. American Academy of Dermatology Association. Dry skin: who gets and causes. Accessed 16 November 2023. 
6. NICE. Eczema – atopic: emollients. October 2023. 

Key take home points

• Remember to have a heightened awareness of the possibility of dry skin conditions and its consequences during consultations with people of colour.
• Treating dry skin early and optimally with emollients is vital in preventing longer-term post-inflammatory hyperpigmentation (PIH) which can cause significant distress. As a result, reducing skin inflammation should be a key focus of treatment.
• Ensure that the patient knows how and when to use their emollients. Liberal use of moisturisers and short, warm (rather than hot) baths and showers are essential for managing dry skin.
• In skin of colour there may not be the "classical" signs of redness and inflammation typically seen in Caucasian skin. Always take an in-depth history and examine the skin under natural light whenever possible.
• Reassure the patient that with the right treatment, both dry skin and PIH can be treated.
• Remember that chronic dry skin problems are strongly associated with symptoms of anxiety and depression. Always ask someone presenting with dry skin about how they are feeling and be prepared to spend time discussing mental health issues if these are raised.
• Ask about their normal skincare routine. Many people with dry skin use products that worsen skin dryness and inflammation but may not realise it.
• Once an accurate diagnosis has been made, in most cases the management of dermatological conditions is the same regardless of skin type.
• If emollients in combination with other topical treatments do not control a dry skin condition, consider referral to a dermatologist.