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Regardless of your skin color, the factors contributing to breakouts are virtually the same for everyone. Dead skin and excess oil can clog the pores and lead to a blemish. Treatment options -- especially with mild to moderate acne -- typically begin with over-the-counter acne creams before moving on to prescription medications if breakouts persist. From there, your dermatologist can determine what other treatment options best suit your needs.
Development
As with any skin type, acne often develops when your skin produces an excess of sebum -- the oily substance that gives your skin its sheen. As oil builds, it can easily affect the shedding of dead skin cells. Instead of falling from the body, these cells may begin to stick together on your skin. If they cluster inside a pore, a soft plug can form. Plugs clog pores, resulting in blemishes.
Self-Care Measures
Good skin care is key to treating -- or preventing, for that matter -- blemishes on dark skin. Washing with a gentle cleanser can help remove the dead skin cells and oily sheen left on your skin. Applying an OTC acne cream is also essential. Look for products made with benzoyl peroxide or salicylic acid. You may also see an improvement with creams containing sulfur or resorcinol. Don't just reserve these creams for active blemishes alone; apply the medication to acne-prone areas as well. Acne creams also help to remove dead skin and dry excess oil, reducing the frequency of breakouts.
Medical Treatments
For moderate to severe acne, OTC creams likely will not improve your complexion; a stronger medication is often necessary, so talk to a dermatologist. He can prescribe topical preparations containing retinoids, antibiotics or dapsone -- a relatively new acne medication. These medications work by promoting cellular turnover, drying excess oil, killing bacteria, reducing inflammation and unclogging your pores. If your dermatologist determines a prescription medication is unable to treat your blemishes, you may then need an actual procedure, such as laser therapy, light therapy or chemical peel, to control the acne.
PIH
The only real difference in the treatment of blemishes on dark skin comes into play during healing. Many people with darker complexions tend to develop what’s known as post-inflammatory hyperpigmentation (PIH). The residual inflammation left after acne lesions heal can cause the skin to produce additional melanin, leading to small patches of discoloration. These will eventually fade, but your dermatologist can suggest a medication to encourage fading. Some of the more common medications include retinoids and hydroquinone.

