The term skin of color encompasses a wide range of ethnic groups, skin complexions, and cultures that characterize individuals with deeply pigmented skin. Structural and functional variations, as well as cultural practices, contribute to variations in clinical presentation and prevalence of dermatologic conditions. Cultural perceptions of beauty also impact the leading cosmetic skin concerns observed in skin of color and may influence patient expectations. Here, the authors review common cosmetic concerns of patients with skin of color. By understanding ethnic variations in perceptions of beauty, skin structure and function, and aesthetic goals, the cosmetic dermatologist will be well equipped for the successful management of diverse patient populations.