It is often difficult to determine the role race may play in diagnosis, most notably in patients with deeply pigmented skin. Among the members of any population, there are a significant range of skin colors and hair types which makes generalizing impossible. Deep pigmentation can mask anticipated cutaneous reactions or predispose to severe postinflammatory hypopigmentation and hyperpigmentation. It is imperative that professionals in dermatology recognize reactions in patients with deeply pigmented skin in order to diagnose and treat effectively.