provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content

Here’s What Psoriasis Looks Like in Black People and Brown Skin Tones (With Images)

Maria Robinson, MD, MBASophie Vergnaud, MD
Updated on March 12, 2024

Key takeaways:

  • Psoriasis doesn’t look the same in everyone. In Black people with darker skin tones, psoriasis is more likely to show up as patches that are purple, brown, or gray with a silver scale.

  • Psoriasis can take longer to diagnose and take more of an emotional toll on Black people and other people of color.

  • Psoriasis on darker skin can create light or dark spots that take months to heal. So it’s important to account for this when making a treatment plan with your healthcare team. 

A Black woman with psoriasis is looking at a rash on her arm.
Viktor Cvetković/E+ via Getty Images

Psoriasis is an autoimmune skin condition that affects more than 8 million people in the U.S. People of all races and ethnicities can get psoriasis. But it doesn’t look the same in everyone. 

Psoriasis can affect the skin of Black people and other people of color differently, making it harder to get the right diagnosis. One reason for this is that skin conditions affecting Black people are underrepresented in medical textbooks and public resources. 

If you want to know about how psoriasis looks in darker skin tones, you’re in the right spot. Let’s take an in-depth look at how psoriasis affects Black people, including signs to look for and what to consider when getting treated. 

Telltale signs of psoriasis on the skin of Black people and brown skin tones

In white people, psoriasis usually forms red patches on the skin that are covered in a thick, white scale. But in Black people, psoriasis can look quite different. This can make it more challenging to diagnose, especially for providers who don’t have much experience working with darker skin tones.

Some signs of psoriasis in people with darker skin tones include: 

  • Raised skin patches that can be purple, brown, or gray

  • Skin scales that are silver or gray rather than white

  • Scaly patches in the scalp that can look like dandruff

  • Healed psoriasis that leaves behind flat patches of darkened or lightened skin

Keep in mind that psoriasis may affect just a small portion of skin, like the elbows and knees. But it may be more widespread.

What do different types of psoriasis look like in Black people and brown skin tones?

Psoriasis in Black and brown people with darker skin tones can look different depending on its type and location. Here are some descriptions of this common rash in darker skin types, as well as some images to help you see the features. 

Plaque psoriasis 

Plaque psoriasis is the most common type of psoriasis. It can affect any part of the body. It causes thick skin patches that show up as violet or brown with overlying gray or white scales. 

After it heals, psoriasis can leave dark patches that can take months to heal. This is called post-inflammatory hyperpigmentation.

Close-up of skin with small, thick, brown patches covered in white scale caused by psoriasis.
Plaque psoriasis on darker skin tone with post-inflammatory hyperpigmentation.
Close-up of the back with several violet, scaly patches in psoriasis.
Plaque psoriasis on brown skin tone.

Guttate psoriasis

Guttate psoriasis is a type of psoriasis more common on the arms, legs, and torso. In darker skin tones, small, round skin patches look pink, violet, or brown in color, usually with white or gray scales.

Close-up of small, round, scaly patches in guttate psoriasis.
Guttate psoriasis on darker skin tone.
Close-up of back with small, violet-pink, scaly patches in guttate psoriasis.
Guttate psoriasis on brown skin tone.

Inverse psoriasis 

Inverse psoriasis usually affects skin folds, like the armpits, genitals, buttocks, and underneath the breasts. In darker skin tones, patches of psoriasis look shiny violet or brown. Typically, inverse psoriasis isn’t very scaly.

Close-up of an armpit with a thick, dark-brown and violet, scaly patch in inverse psoriasis.
Inverse psoriasis on darker skin tone.
Close-up of a chest with thick, dark-brown, scaly patches under the breasts in inverse psoriasis.
Inverse psoriasis on darker skin tone.

Pustular psoriasis 

Pustular psoriasis forms small, white-filled bumps called pustules. They may be surrounded by red or violet patches that can be scaly. Pustules can be on large areas of skin, or on certain parts of the body (like the hands and feet).

Close-up of skin with many tiny, white pus bumps and round scaly patches.
Pustular psoriasis on darker skin tone.
Close-up of an elbow with many white pus-bumps on a light pink patch.
Pustular psoriasis on brown skin tone.

Nail psoriasis

Psoriasis can cause many changes in the nails. These are the same, no matter your underlying skin color. Common changes you may notice are tiny pits in the nail, nail thickening, discoloration, and short or misshapen nails. One nail may be affected — or many. And while nail psoriasis is more common in the hands, it can affect the feet too. 

Here’s what nail psoriasis can look like in darker skin tones.

Close-up of nails with many tiny pits in nail psoriasis.
Psoriasis causes many tiny pits in the fingernail.
Close-up of short, thick, and discolored fingernails with many tiny pits from psoriasis.
Psoriasis can also cause nails to become short, misshapen, and discolored.

How does psoriasis affect Black people with darker skin tones?

All types of psoriasis can affect all people — no matter their skin color. Psoriasis does seem to be less common in Black people than in white people. But this may be because psoriasis isn’t diagnosed so readily in Black people. So, more people with darker skin tones may have psoriasis without knowing it.

When it comes to complications of psoriasis, Black people seem less likely to have psoriatic arthritis. But Black people are more likely to experience complications more severely when they do occur. This includes physical as well as emotional complications of living with psoriasis. 

Here are some of the reasons why people with Black people experience psoriasis differently than white people: 

  • It can take three times longer for Black people to get a diagnosis of psoriasis.

  • Black people are four times more likely to need a skin biopsy to get diagnosed.

  • Psoriasis is often more severe at the time of diagnosis on darker skin because it takes longer to diagnose.

  • Black people with psoriasis are more likely to have skin symptoms in the hands and feet, which can interfere with many day-to-day functions.

And the difference in experience doesn’t end with diagnosis. Black people are also less likely to be represented in the clinical trials that study new psoriasis medications. This means there isn’t as much information about what works best for treating psoriasis in Black people. And this can make it difficult to find a treatment that works. 

Psoriasis treatment options for people with darker skin tones

For the most part, psoriasis treatment is the same for all skin tones. The treatment you start will depend on how severe your psoriasis is, whether or not you also have psoriasis affecting your joints (psoriatic arthritis), and your personal preferences. 

For mild psoriasis, you may just need medicated creams that you apply to the skin. For more severe psoriasis (or if you have psoriatic arthritis), you may need stronger medication that works throughout your body. These are pills or injections. Phototherapy — or ultraviolet (UV) light treatment — is another option for more severe psoriasis. 

Although the treatment options are the same for psoriasis on all skin types, there are a few important things to consider when choosing the best treatment. This is because psoriasis and psoriasis treatments can have unique effects on darker skin tones.

Before starting treatment for psoriasis, here are some talking points to cover with your dermatologist or primary care provider:

  1. Phototherapy treatment can cause skin to darken. This can cause previous dark spots to become even more noticeable. If this is a concern for you, it may be worth exploring a different treatment option.

  2. After treating psoriasis, there can be long-lasting skin pigmentation changes. In other words, you may be left with light or dark spots on the skin. These spots can often take many months to go away, and they can bother people as much as the psoriasis rash itself. Explore psoriasis treatments that lighten the skin at the same time, like Tazorac.

  3. With scalp psoriasis, it’s important to consider hair texture, styling, and how often you wash your hair, when selecting the best treatment for you. For example, oils or foams may be a better option than shampoo for applying medication.

When to see your healthcare provider about psoriasis

If you have a skin rash and you think it could be psoriasis, see your dermatologist or primary care provider. You may need to find someone with experience in treating skin of color — and the Skin of Color Society can help. It has a searchable database, so you can find an experienced provider near you.

And, if you have psoriasis that isn’t getting better with treatment, then that’s another sign you need professional help. You may need to try a new strategy or a different combination of treatments. 

The bottom line

Psoriasis is a common autoimmune skin condition that affects people of all skin tones. But it doesn’t look the same in everyone. In Black people, psoriasis looks purple, gray, or brown, with silvery scales. Because healthcare professionals are often less familiar with the unique features of psoriasis in darker skin tones, many Black people with psoriasis face delays in diagnosis. 

The treatments are the same for psoriasis on Black skin. But light or dark patches may appear after treatment, and these can take months to heal. 

why trust our exports reliability shield

Why trust our experts?

Maria Robinson, MD, MBA
Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.
Sophie Vergnaud, MD
Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.
Karla Robinson, MD
Reviewed by:
Karla Robinson, MD
Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Images used with permission from VisualDx (www.visualdx.com). 

References

Alexis, A. F., et al. (2014). Psoriasis in skin of color: Epidemiology, genetics, clinical presentation, and treatment nuances. The Journal of Clinical and Aesthetic Dermatology. 

American Academy of Dermatology Association. (n.d.). Can you get psoriasis if you have skin of color?

View All References (6)

Dickerson, T., et al. (2022). Racial disparities in the diagnosis of psoriasis. Cutis. 

Jesitus, J. (2021). Psoriasis strategies in skin of color. Dermatology Times. 

Kerr, G.S., et al. (2014). Psoriasis and psoriatic arthritis in African-American patients--the need to measure disease burden. Clinical Rheumatology. 

National Psoriasis Foundation. (2022). Psoriasis statistics.

National Psoriasis Foundation. (2024). Locations and types.

Onorati, M. (2022). ​​Why is psoriasis often misdiagnosed in skin of color? National Psoriasis Foundation.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

Was this page helpful?

Subscribe and save.

Get prescription saving tips and more from GoodRx Health. Enter your email to sign up.

By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.