The pathogenesis of acne vulgaris is multifactorial and is almost similar in both light and dark skin phototypes. Treatment modalities are, therefore, similar in all ethnic groups and designed to address multiple aspects of disease pathogenesis simultaneously. Specific aetiological agents, clinical characteristics and sequelae of the disease differ in darker skin phototypes, and as such, this group of patients needs special attention. The most critical issue related to acne in patients with dark skin is the development of sequela- like post-inflammatory hyperpigmentation (PIH) and scarring. Acne hyperpigmented macules are very common in patients with ethnic skin. PIH may develop in response to the acne itself, or to aggressive acne treatment. It is important to address PIH at an early stage and manage this concomitantly with the active acne lesions.

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