Considering that the skin is our largest organ, it is not surprising that at some point in life you may need care for a dermatological condition. From “cradle cap” to eczema to acne to dandruff to psoriasis, prompt, proper diagnosis and treatment are essential for a lifetime of healthy skin. 

This is especially true for people of color who suffer from dermatological conditions in greater numbers than white patients. There are several illnesses that fall into the increased risk category. Included is eczema, which may occur at any age, and can be triggered by mental stress and environmental hazards found in underserved communities. 

As with many acute illnesses, successful treatment requires early, precise diagnosis. However, a correct diagnosis can be limited by a doctor’s capacity for identifying skin conditions they rarely see or treat. This highlights the need to significantly increase the number of Black dermatologists, who through personal and professional experience have a keener awareness of the unique healthcare needs of dark-skinned patients.

Unfortunately, this sound, straightforward way to address a persistent ethnic/cultural barrier to treatment, is hindered by the astoundingly low number of Black dermatologists. “More than 13 percent of the U.S. population is made of people who identify as Black or African American — but only about 3 percent of U.S. dermatologists consider themselves a person of color,” according to a 2016 report published in the Journal of the American Academy of Dermatology (AAD).

For African Americans this means, “a wide swath of Black patients is not always getting proper care for their skin, hair, and nail conditions,” says the ADD. The lack of Black providers notwithstanding, the Academy recommends adults should go to the dermatologist at least once a year to maintain the optimum health of your skin, especially since darker skin tones can suffer from skin ailments presented differently than Caucasians.

Increasing the number of Black providers will require Baltimore City’s two medical colleges to implement a formalized strategy for recruiting medical students of color to specialize in dermatology. This critical shortage could be kickstarted with a grassroots awareness campaign led by patients and community healthcare stakeholders.     

“Skin Deep,” a series of future articles on the challenges of skin conditions and food allergies frequently found in communities of color, begins this week with a closer look at childhood eczema.  

Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that can affect people of all ages and ethnic backgrounds. However, the ADD, states “research has indicated that Black children may be more susceptible to the condition.” The health and advocacy organization advises the following factors can contribute to the higher incidence of eczema among Black children:

  • Genetic predisposition: Genetic factors play a significant role in the development of eczema. Certain gene variants may be more common in specific racial or ethnic groups, leading to a higher risk of eczema in those populations.
  • Environmental factors: Environmental factors, such as climate, pollution, and allergens, can influence the prevalence of eczema. Different regions may have varying levels of these factors, which could affect the occurrence of eczema among different racial groups.
  • Socioeconomic factors: Socioeconomic status can also play a role in the development and management of eczema. Access to healthcare, hygiene practices, and living conditions can impact the severity and prevalence of eczema
  • Skin characteristics: Skin physiology varies among different racial and ethnic groups. Black skin is often more susceptible to certain skin conditions, including eczema, due to differences in structure and function compared to other skin types.

There is also a mental health component to childhood eczema. According to the American Eczema Association, research suggests children with eczema have higher rates of depression and anxiety. “They are more likely to experience bullying in school and depression because of activity restrictions due to the disease.”

Back to School Tip: It is a good idea to discuss your child’s eczema diagnosis with the teacher at the start of the school year. To help the teacher make your child’s school experience as normal as possible, set up a meeting to discuss your child’s eczema and what you have learned about coping with the disease. A teacher who is familiar with eczema can help your child manage the practical aspects of the condition and respond with any social or emotional issues that may arise in the classroom.

Jayne Hopson
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