Dermatology Has a Problem With Skin Color

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Nearly half of dermatologists and dermatology residents say they were not adequately trained to treat skin conditions in people of color. For Black patients, that often translates into a prolonged, disheartening search for the right diagnosis.

When Tierra Styles, 31, of Auburn, Ga., asked her pediatrician about a rough patch of skin on the back of her toddler’s neck, the doctor said it was nothing. On later visits, it was diagnosed as scabies, then eczema. But the prescribed ointments had no effect.

Finally, Ms. Styles took her son to a dermatologist who was Black. She said the sandpaper-like patch was a benign skin condition called keratosis pilaris.

“The doctor tried to pull up a picture on the internet, but she couldn’t find one,” Ms. Styles said. “There was not one picture of an African-American person that she could show me.”

Ellen Buchanan Weiss, a white mother of a multiracial child in Raleigh, N.C., was so frustrated by her fruitless online searches for information on her child’s skin rashes that she started her own repository of skin images in an Instagram feed called Brown Skin Matters.

Anyone can submit a photo; a physician reviews the images before they are posted.

“It started as a casual reference for other mothers,” Ms. Weiss said. “What’s been surprising to me is that it’s been used mostly by clinicians — doctors, nurses, professionals teaching in medical schools.”

Many Black patients prefer to see Black dermatologists, who may be more familiar with and have a greater understanding of not only skin issues — like acne, which can leave dark, hyperpigmented spots on dark skin — but hair predicaments, said Dr. Natalie Moulton-Levy, a dermatologist in Manhattan.

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