Today, more and more men and women of color are showing interest in enhancing their appearance through surgical and non-surgical cosmetic procedures. African Americans have natural features that are unique. Thus, they have different cosmetic concerns. Appreciation and respect of these differences is required to obtain the best cosmetic results. 

Although skin varies very little from race to race, African American skin can be prone to hyperpigmentation (darkening of the skin), hypertrophic scarring (raised, widened scars), and keloids (raised, reddish nodules). As a result, plastic surgeries in African Americans must be performed with careful attention to the healing pattern of the skin. Both patients and doctors have to be aware of this and understand how to minimize hyperpigmentation, hypertrophic scarring and keloid scarring.


Hyperpigmentation is darkening of the skin from inflammation which occurs after trauma to the skin, such as a cut, scrape or severe acne. Hyperpigmentation affects African Americans fairly often and can be difficult to treat. Some African Americans with hyperpigmentation find that the dark spots will fade on their own as the skin injury heals. For others, the hyperpigmentation can remain for months to years. Treatment of hyperpigmentation includes topical hydroquinone, corticosteroids, tretinoin or glycolic acid. Chemical peels, microdermabrasion and professional laser treatments may also be employed to treat hyperpigmentation. Be sure to consult with a skin care professional, who has experience treating African Americans skin before beginning a treatment regime.

Hypertrophic Scars

A hypertrophic scar looks similar to a keloid. However, hypertrophic scars grow only within the border of the affected area. Hypertrophic scars tend to heal themselves, decreasing in pain and swelling over a period of time (usually about a year or more). The healing process may be aided with the help of steroid topical ointments, steroid injections, or compression therapy utilizing silicone gel sheets. Surgical scar revision is frequently utilized as a treatment for hypertrophic scars. In general, scar revision includes excision of scar and closure of scar with minimal trauma to the skin edges, and minimal tension. However, recurrent hypertrophic scarring may occur.


Keloids are more common in African Americans than any other ethnic group. Keloids usually appear following a skin injury, and develop into a type of growth that extends beyond the injured area itself. Keloids are sometimes painful or itchy, as well as being very unsightly. The best initial treatment is to inject steroids into the keloid once a month. After several injections with steroids, the keloid usually becomes softer and flattens in three to six month’s time. Earlobe keloids are often surgically excised, followed by steroid injections. For severe cases, the keloid can be surgically excised and given radiation to the site immediately afterwards. Despite surgical excision, keloids can recur in up to 50% of individuals.