Skin of Colour
Understand · Respect · Treat Correctly
Specialist Expertise — Every Complexion — Excellence on Harley Street
Darker skin tones are not simply a variation of lighter skin — they behave differently, react differently, and develop distinct conditions that standard dermatology training frequently underserves. Expert care for skin of colour requires specific knowledge, specific protocols, and a clinician who understands the difference.
London is one of the most ethnically diverse cities in the world, yet dermatology and aesthetic medicine have historically been built around lighter skin tones. The evidence base, the training curricula, the diagnostic photographs in textbooks, and the default assumptions embedded in clinical protocols have all, until recently, reflected a narrow portion of the population they are intended to serve. The consequences for patients with medium-to-deep skin tones are real: delayed diagnoses, inappropriate treatments, avoidable complications, and the chronic experience of being seen by clinicians who are uncertain how to help.
At PHP Aesthetic-Wellness, Dr Philippe Hamida-Pisal and Dr Jihyun Byun have built a practice that places skin of colour at the centre, not at the margins. Every protocol we use for Fitzpatrick types IV–VI is specifically adapted to the physiology, reactivity, and healing patterns of darker skin — not repurposed from protocols designed for types I–III and applied without modification. This distinction matters clinically, and it matters to our patients.
“Darker skin is not more resilient — it is differently reactive. A treatment that carries minimal risk in a lighter complexion can cause significant and lasting harm in a deeper one if the protocol is not adapted accordingly. Knowing that difference is the beginning of treating it correctly.” PHP Aesthetic-Wellness, 22 Harley Street
Understanding the Fitzpatrick Scale
The Fitzpatrick skin phototype classification system grades skin by its response to UV exposure, from always burns and never tans (Type I) to never burns and tans very deeply (Type VI). It is the clinical standard used to guide treatment selection, product choice, and risk assessment in both dermatology and aesthetic medicine. Our specialist expertise centres on Fitzpatrick types IV through VI — though we treat every skin type with equal precision.
Types IV–VI (highlighted above) are the focus of our ethnic skin clinic. These skin tones share biological characteristics — greater melanocyte activity, a stronger post-inflammatory response, and different wound-healing patterns — that fundamentally change how conditions present and how treatments must be designed.
Why Darker Skin Needs a Different Approach
The physiological differences between lighter and darker skin tones are meaningful and clinically significant. Understanding them prevents the most common and most damaging errors in treating skin of colour.
Melanocyte Reactivity
Melanocytes in darker skin tones are more numerous, more active, and more sensitive to stimulation. Any inflammation — from acne, trauma, or an inappropriate treatment — can trigger a disproportionate melanin response, producing post-inflammatory hyperpigmentation that may take months or years to resolve.
Keloid & Hypertrophic Scarring
Darker skin types have a significantly elevated risk of keloid and hypertrophic scar formation following skin trauma, surgery, or inflammation. This risk must be assessed before any procedure that breaks the skin and influences the choice of treatment at every stage.
Different Ageing Patterns
Darker skin tones typically retain more structural collagen for longer, age more slowly in terms of fine lines and laxity, and instead show ageing primarily through dyschromia, textural change, and volume loss rather than wrinkling. Treatment priorities and aesthetic goals differ accordingly.
Diagnostic Challenges
Many conditions present atypically in darker skin. Rosacea may not display the classic central facial redness. Skin cancers, particularly melanoma, are frequently diagnosed at a later stage. Eczema may appear grey or violet rather than red. Clinical experience with diverse skin tones is essential for accurate diagnosis.
Conditions We Treat
Our ethnic skin clinic addresses the full range of dermatological and aesthetic concerns as they present in medium-to-deep skin tones — with protocols specifically designed for each.
Treatments Adapted for Darker Skin
Every treatment we offer in the ethnic skin clinic is assessed for suitability at each Fitzpatrick level before it is recommended. The protocols below are those we use — adapted, sequenced, and supervised specifically for skin of colour.
Chemical Peel
Mandelic and lactic acid peels are preferred for darker skin tones for their lower irritancy and reduced risk of post-inflammatory pigmentation. Glycolic acid is used with caution and at conservative concentrations. TCA is avoided. Peel selection, concentration, and frequency are adapted to the Fitzpatrick type at every session.
Learn more →Mesotherapy
Microinjections of vitamin C, glutathione, tranexamic acid, and brightening complexes deliver active ingredients directly into the dermis, bypassing the skin barrier. A valuable brightening and pigmentation correction tool for patients with PIH and melasma where surface exfoliation alone is insufficient.
Learn more →Exosomes
Regenerative cell-signalling vesicles that regulate melanin synthesis, support barrier repair, and accelerate healing. Applied following a gentle procedure, exosomes help to normalise the hyperactive melanocyte response characteristic of darker skin and reduce the risk of PIH following in-clinic treatment.
Learn more →Polynucleotides
Dermal injections that rebuild the extracellular matrix, improve hydration, and restore barrier integrity. A safe and effective structural treatment for all Fitzpatrick types, with no risk of triggering post-inflammatory pigmentation when correctly administered.
Learn more →LED Therapy
Red and near-infrared wavelengths reduce inflammation, support barrier repair, and calm the reactive immune environment that drives conditions such as PIH, acne, and seborrhoeic dermatitis in darker skin. Entirely safe for all Fitzpatrick types, with no downtime and no risk of pigmentary change.
Learn more →Prescription Topicals
Targeted prescription agents — azelaic acid, tranexamic acid, kojic acid, niacinamide, and retinoids — are selected for their efficacy and safety in darker skin. Hydroquinone is used where clinically indicated, under close supervision and for defined courses. SPF 50 is prescribed as an integral part of every pigmentation protocol.
Learn more →Why PHP Aesthetic-Wellness
Patients with darker skin tones have often experienced a consistent pattern: clinicians who are uncertain, protocols that are not designed for them, and outcomes that are disappointing or, in some cases, make the original concern worse. We understand this experience, and we have built a practice specifically to address it.
Genuine Specialist Expertise
Dr Hamida-Pisal and Dr Jihyun Byun have extensive clinical experience treating skin of colour across the full Fitzpatrick range. This is not a supplementary service — it is a clinical specialism that sits at the core of the practice.
Protocols Built for Your Skin
Every treatment recommendation for a patient with Fitzpatrick types IV–VI is assessed against the specific risks and response patterns of darker skin before it is made. We do not adapt lighter-skin protocols as an afterthought.
Cultural Understanding
We recognise that aesthetic priorities, attitudes to treatment, and the meaning of skin concerns vary significantly across cultures and communities. Consultations are unhurried, and we take the time to understand what matters most to each individual patient.
Honest Assessment
We tell patients clearly what we can help with, what requires referral elsewhere, and what treatment options carry risks that outweigh benefits for their specific skin type. Honesty about the limits of what we offer is as important as the quality of what we do.
Related Services
Our ethnic skin clinic connects directly with two other specialist services at PHP Aesthetic-Wellness:
Skin Cancer Screening
Skin cancer in darker skin tones is more frequently missed and more frequently diagnosed at an advanced stage. Our screening appointments include specific examination of the palms, soles, and nail beds for acral lentiginous melanoma, alongside full body dermoscopy assessment.
Learn about screening →Moles & Lesion Assessment
Dermoscopy-guided assessment of moles and pigmented lesions, with same-week referral where indicated. For patients with darker skin, accurate identification of benign lesions — including dermatosis papulosa nigra and seborrhoeic keratoses — is as important as detecting the rare malignant one.
Book an assessment →Book an Ethnic Skin Consultation
PHP Aesthetic-Wellness — London’s Ethnic Skin Specialist
22 Harley Street, Suite 8, London W1G 9PL
Book Online →