Cosmopolitan posted "Dermatology Has a Race Gap. Here’s How to Get Good Treatment Anyway" featuring Dr. Purvisha Patel.
The article includes Dr. Patel's expert insights on the deal breakers to keep in mind when working with a dermatologist, warning to be wary of doctors that provide fast and furious treatment plans.
When I first landed my job as a beauty editor, I said yes to just about every treatment that hit my inbox (I mean, can you blame me?). And for awhile, it was all fun and skincare games—in the name of research, of course—until I went to see a dermatologist for a Fraxel laser treatment. Fraxel is used to help improve skin tone and texture, and this particular doctor, who is white, assured me they knew how to use the powerful tool on my deep skin tone. You can probably guess what happened next:
I woke up the following morning to find my normally spot-free skin covered in patchy, dark marks. This happened despite the fact that I have access to the best dermatologists and experts in the country. It was a frustrating reminder that, like so many women of color, I need to vet my doctors extra thoroughly before I let them anywhere near my face, because the truth is that many don’t know enough about deep skin tones to treat them properly.
The lack of awareness starts early: Most medical textbooks depict proportionally fewer skin conditions on people of color (these pics, btw, are critical for proper
diagnosis, says Lynn McKinley-Grant, MD, former president of the Skin of Color Society). And because issues like eczema and melanoma look different or can be located in different places on various skin tones, doctors can misdiagnose or miss them entirely, which can have deadly outcomes.
What’s more, people of color are often underrepresented in clinical trials for Rx treatments—making this stuff potentially ineffective or unsafe for us to use. Also alarming: Only 3 percent of U.S. dermatologists identify as Black and 4.2 percent identify as Hispanic, according to a 2016 article in the Journal of the American Academy of Dermatology.
So, yeah, the medical community clearly needs to figure its shit out. Every board- certified dermatologist should be able to properly treat all skin tones, full stop.
In the meantime, I was able to find a new derm who is helping me reverse my Fraxel damage (the routine includes gentle brightening ingredients and daily sunscreen). And to help you navigate all this too, I’m here with this been-there-done-that-learned-the-hard-way guide.
Derm deal breakers
If your doctor does any of these things, it’s time for a new one.
Strike one: They say that all skin is the same.
Sure, race is a social construct (ty, Sociology 101), but that doesn’t mean different levels of melanin don’t affect how skin should be treated. “Certain concerns are unique to melanin-rich patients, like hyperpigmentation and scarring,” says dermatologist Mona Gohara, MD. A one-treatment-fits-all narrative is a big no.
Strike two: Their treatment plan is fast and furious.
Melanated skin is sensitive to inflammation, and harsh products like strong acids and retinoids can cause irritation, sending melanin production into overdrive and resulting in dark spots and marks, says dermatologist Purvisha Patel, MD. Any “quick fixes” will likely do more harm than good.
Strike three: They skip the cancer convo.
People with deep skin tones can get skin cancer. In fact, Black patients are often diagnosed later than white ones are—and with worse outcomes. Make sure your doctor takes this as seriously as you do by having them perform a full-body skin check during your visit, says Dr. Gohara. Oh, and if they’re not reminding you to wear daily sunscreen with SPF 30 or more? Look for the exit sign.
4 ways to advocate for yourself (and your skin)
Look For A Derm With The Right Experience
The goal is to find someone who has worked with different skin tones, regardless of their race, says dermatologist Corey Hartman, MD. Spend time on a doctor’s IG and/or website. If you see a wide variety of skin colors, there’s a good chance they’ll be able to treat you. Also, google to see where they trained. Big cities generally = more experience with all skin shades.
Don’t Be Scared To School Your Doc
Say you’re going to see a doctor for dandruff and they prescribe something that requires you to wash your hair every day. That’s a time to speak up, says Melynda Barnes, MD, chief medical officer at Ro. “Let them know that with your hair type, you wash it only weekly or every two weeks. Then ask for other treatment options.”
Scope Out Patient Reviews
You don’t hit up a new restaurant without an extensive Yelp session, so why be any less picky about your face? Take a minute to read some reviews before making an appointment with a new derm—sites like Zocdoc, Vitals, and Healthgrades make it easy to see ratings and get intel from existing patients on everything from bedside manner to office wait times.
Read Up On Ingredients Too
Your MD should be doing their own homework, but it’s still important for you to have a basic understanding of active ingredients, says oculofacial plastic surgeon Chaneve Jeanniton, MD. It’ll make you a smarter shopper and better informed when you’re talking to a derm about curating a topical regimen. Try the Paula’s Choice online ingredient dictionary as a resource.