Raechele Cochran Gathers, MD Does your dermatologist feel comfortable treating skin of color? Did your dermatologist even receive training on treating skin conditions in people of color?
It’s estimated that by the mid 2040’s the majority of Americans will be persons with skin of color. The term ‘skin of color’ refers to those with pigmented (brown) skin. This includes African and Caribbean Americans as well as those with Asian and Pacific Island ancestry, Native Americans, Latinos and those with ancestry from India and many parts of the Middle East.
As of 2016, five US states (Hawaii, Texas, New Mexico, California and Nevada) were majority-minority. Also included in the majority-minority category: Washington DC. With the quickly changing demographics of our country, if you have skin of color, it’s vital that your dermatologist be both comfortable and knowledgeable when it comes to taking good care of your skin and hair and its unique needs.
Treating Skin of Color
Skin of color responds differently to injury and rashes, and it’s more likely to get some skin diseases and less likely to get others. Skin of color ages, like all skin—but it does so differently. Skin of color is more likely to respond to injury by making large and deforming scars, called keloids. Those with skin of color get skin cancer, but it often looks and behaves differently than the skin cancers most common in Caucasians.
Dermatology Training in Skin of Color
Persons with skin of color are getting more and more cosmetic procedures, from fillers to lasers to chemical peels. But physicians doing these procedures on skin of color can risk permanently scarring or discoloring skin of color if they’re not familiar with what procedures work best on darker skin types.
Additionally, African Americans suffer disproportionately from some types of hair loss and hair disease, causing emotional and physical pain. It’s important that their physicians be able to accurately diagnose hair loss conditions that are more common in this population.
Several studies suggest that some dermatologists are inadequately trained to take the best care of their African American patients and others with skin of color. In one study, only about half of dermatology chief residents (dermatologists completing their training) reported that their training programs provided them lectures on skin of color.
In another study, nearly half of dermatologists surveyed said that their medical training was inadequate on training them on skin conditions in blacks. In another survey study of black women, only 32% felt that the dermatologist that they saw understood African American hair.
These are sobering statistics. A key factor in health equity and in promoting equal health outcomes is ensuring that physicians that care for a diverse patient population are well trained in meeting the needs of the populations for which they care. This is why training in skin of color is vital.
