Skin of Color in Dermatology: Why Representation Matters - Gladskin

Skin of Color in Dermatology: Why Representation Matters

Sensitive skin comes in all colors, types, and tones. But dark skin isn’t adequately represented in dermatological literature—flip through a dermatology textbook, and you’re likely to see pictures of light skin. That’s a problem for patients: when doctors aren’t adequately trained to recognize skin conditions and concerns in darker skin, it can lead to misdiagnosis and lack of appropriate treatment.

Dermatologists recognize that when it comes to representation of skin of color, their field has some catching up to do, and efforts to diversify dermatology are underway. Here’s what you need to know about common skin concerns in skin of color, how skin of color is (and isn’t) represented in dermatology, and how to find a healthcare provider who’s experienced in treating skin like yours.

Common Skin Concerns in Skin of Color

Common skin concerns occur in people of all skin types and tones. But some are more likely or more severe in skin of color. Common skin concerns among people with skin of color include:

  • Acne and acne scarring: acne is the most common skin condition among skin of color patients. 
  • Eczema: Black and Hispanic children are more likely to have severe eczema than white children. 
  • Dyspigmentation: dark spots (hyperpigmentation) or light spots (hypopigmentation) are more common in people with darker skin tones. Acne, eczema, and other skin conditions can result in post-inflammatory dyspigmentation. 
  • Razor burn: irritation of the hair follicles after shaving, formally known pseudofolliculitis barbae, is common among people with skin of color. 
  • Keloid scars: Raised scars, also known as keloids, occur more frequently in people with darker skin tones. 

Certain cosmetic skin concerns are treated with laser therapy. But for people with skin of color, laser therapy carries the risk of scarring and pigment changes. If you are interested in pursuing laser therapy, always seek out an experienced, board-certified healthcare professional who uses lasers that are appropriate for darker skin

Skin of Color in Medical Literature + Education

Skin concerns look different across different skin tones. Many skin conditions are often described as “red,” because that’s how they appear in lighter skin. But in people with darker skin, skin inflammation can appear purple, brown, or gray and may not be as easy to spot. That’s why healthcare providers need training. But educational resources often fall short: a 2020 study found the majority of images in 4 major dermatology textbooks depicted patients with lighter skin. A study that analyzed 25 years’ worth of photographs in 7 leading plastic surgery and medical journals found that only 22% of images showed non-white skin.

The good news: An increasing number of dermatology textbooks are focused on skin of color. Academic institutions are sharing skin of color imagery in an effort to level the playing field. And medical schools and dermatology residency programs are working to improve the skin of color training they provide. A 2008 study showed that only about half of residency programs contained lectures focused on skin of color. More recent data from 2022 found that while 60% of dermatology residents were satisfied with the education they received around skin of color, only 11% completed a dedicated skin of color rotation.

Diversity Among Dermatologists

Data shows that patients are more satisfied with their care when they see a doctor who looks like them. But finding a dermatologist with skin of color can be difficult: only 3 percent of American dermatologists are Black and 4.2 percent are Hispanic. The American Academy of Dermatology has launched a program to increase the number of practicing  dermatologists who are part of underrepresented minorities. Becoming a dermatologist requires years of study, so it’s a goal that will take time. 

Skin of Color: Finding a Provider

If you’re looking to find a dermatologist with skin of color, check out the Black Derm Directory, Allure’s list of 52 Back dermatologists in the US, the Skin of Color Society’s Find a Doctor Database, or search the American Academy of Dermatology’s provider database by typing “skin of color” into the practice focus bar.