5 Things People of Color Should Know About Taking Care of Their Skin

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Visiting the dermatologist’s office can be a cumbersome process for anyone. But what if they’re kind of clueless about your needs as a woman of color? What if, for example, they don’t know why certain treatments won’t work for someone with your hair texture?

You, like everyone else, deserve to see someone who can care for your individual skin needs, which may be different if you have a little (or a lot!) more melanin in your skin. Everything from sunburns to acne scars can present differently in skin of color. So we spoke to a couple of experts to help figure out where to start—and how to find a dermatologist who really gets you.

1. Some skin issues affect people of color more frequently.

Although hyperpigmentation issues can affect anyone, people of color are more likely to develop them, Temitayo Ogunleye, M.D., assistant professor of clinical dermatology at the University of Pennsylvania, tells SELF.

Two of the most common pigmentation-related concerns are melasma, a condition that causes patches of brown skin and is commonly related to hormonal shifts, and post-inflammatory hyperpigmentation (PIH), which causes dark spots to appear after an inflammatory event, such as eczema or acne.

Both of these conditions are rooted in an abnormal increase in the production of melanin, the pigment that darkens skin. And those who already have more melanin in their skin, are more likely to develop hyperpigmentation after an inflammatory issue. It’s also more likely to stick around for a longer period of time, Dr. Ogunleye explains. So anyone with skin of color—which includes those with Black, Hispanic, Asian, Pacific Islander, or Native American heritage—is more likely to see these concerns.

Although these pigmentation issues can be stubborn, a dermatologist can help lighten those areas with prescription topical treatments or in-office procedures like chemical peels or laser treatments, the American Academy of Dermatology (AAD) explains.

Keloid scars, which may show up after severe acne, are particularly common among Black people, Nada Elbuluk, M.D., clinical assistant professor of dermatology at the University of Southern California and founder and director of the USC Skin of Color Center and Pigmentary Disorders Clinic, tells SELF. This type of scarring results in raised areas of skin that may take months to appear after the initial skin issue or injury. Keloids are notoriously stubborn and hard to banish permanently, but they can be minimized using a variety of treatments such as corticosteroid injections, surgery, and laser treatment.

There are also small mole-like dark spots called dermatosis papulosa nigra that are more common among people of color, Dr. Elbuluk adds. They’re completely harmless, but can be carefully removed via electrocautery in a dermatologist’s office.

2. Yes, you still need to wear sunscreen.

Both Dr. Ogunleye and Dr. Elbuluk said patients of color come to them with questions or misconceptions about sunscreen. One common misconception is that having darker skin is sufficient protection against the damage of UV rays. But even people with darker skin need sunscreen to prevent sunburns and skin cancer, Dr. Elbuluk says.

Although people of color, particularly non-Hispanic Black people, are less likely to develop melanoma than other racial groups, they are more likely to be diagnosed at a later stage, SELF explained previously. This, combined with a whole bunch of other factors, makes melanoma more deadly among Black people compared to white people—and sunscreen remains the essential first line of defense against sun damage, which can occur even if you don’t get a burn.

One rare type of skin cancer, acral lentiginous melanoma, which shows up on areas of the body not usually in the sun (like the soles of the feet and palms of your hands), is actually more common among people of color than among white people.

Plus, as Dr. Ogunleye points out, wearing sunscreen—and avoiding UV exposure via protective clothing and sticking to the shade—is important to prevent any worsening of hyperpigmentation issues.

When picking a sunscreen, make sure to use one with broad-spectrum protection and at least SPF 30. There are a lot to choose from!

3. Different types of hair loss affect women of color more frequently—especially Black women.

There are many different kinds of hair loss, Dr. Ogunleye explains, which can be caused by genetics, the use of certain types of hair products, or wearing hairstyles—like braids, dreads, or weaves—that put chronic tension on the hair.

Traction alopecia, which occurs after repeated pulling or tension on the hair follicle, usually leaves hair thinner around the hairline and is especially common among Black women. If left untreated, it can progress to scarring alopecia, in which scars cover the hair follicles and hair permanently stops growing there. But traction alopecia can be treated in its earlier stages with lifestyle modifications (changing or limiting tighter hairstyles, primarily) as well as topical, oral, or injected treatments.

That said, we still don’t completely understand why women of color are more likely to experience another kind of hair loss, central centrifugal cicatricial alopecia (CCCA), Dr. Elbuluk says. This usually causes hair loss in the center of the scalp which then expands outward. It’s thought to be caused by a combination of genetic factors and the use of certain hairstyles and hair care products, such as relaxers, hair rollers, and hot combs.

4. You may feel more comfortable seeing a dermatologist who looks like you.

Of course, any dermatologist should have the training and education to diagnose and treat any patient who walks through their doors. And, depending on where you are, you may not have many choices when it comes to dermatologists. But it’s also understandable that you might feel more comfortable (and may even get more personalized care) seeing a dermatologist who looks like you or, at the very least, has experience treating people with your skin type.

That way you can at least assume that a dermatologist of color will walk into your appointment with a certain level of cultural knowledge about you, Dr. Ogunleye says. For example, a dermatologist familiar with Black women’s hair care routines would know not to recommend washing their hair daily to reduce dandruff (the usual first-line treatment for a mild case of dandruff), because that would be harmful for Black women with hair prone to breakage, she says.

Dr. Elbuluk recommends checking on your insurance company’s website first for a board-certified dermatologist in your area. You can also check the Skin of Color Society’s directory for dermatologists who specialize in diverse skin types, she says.

If you’re not sure about a treatment that your doctor is recommending, Dr. Ogunleye says it’s totally fine to ask whether your dermatologist has prescribed that treatment to other patients of color and what their results were like.

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Above all, if you have any questions about your skin or are dealing with a new skin issue, it’s important to find a dermatologist and set up an appointment right away rather than seeking out alternative solutions first, Dr. Elbuluk says. But Dr. Ogunleye recommends patients of color be open to trying out multiple dermatologists before settling on one who is suitable for your needs.

“You should always go to whomever you feel comfortable with, whomever you feel seems to be adept in treating what you need to be treated, and whomever seems to consider you and your culturally-specific issues,” Dr. Ogunleye says. “Don’t be afraid to ask questions… If you question whether the care is specific to you, you should ask that.”

5. Unfortunately, there are some gaps in our understanding of skin of color.

Both Dr. Ogunleye and Dr. Elbuluk agree that racial and ethnic disparities exist within dermatological research. Why? Well, there are a lot of reasons. In particular, Dr. Elbuluk points to historical medical wrongdoings, such as the Tuskegee syphilis experiment in which researchers used Black men as subjects without their full consent or proper treatment, and the story of Henrietta Lacks, a Black woman whose cervical cells were taken and used for research without her consent.

Serious issues like these, she explains, have made it hard for communities of color to trust medical professionals conducting clinical trials, creating gaps in our medical knowledge about those populations. A 2014 study published in the American Journal of Respiratory and Critical Care Medicine found that researchers reported using people of color in 3 percent of non-National Institutes of Health (NIH) funded publications in 2013, a slight increase from an abysmal 1.1 percent in 1993.

But there’s more going on here beyond distrust in the medical community. For instance, researchers have also pointed out that these communities may have reduced access to medical care and insurance coverage for that care, according to a 2011 review in the American Journal of Public Health. They are also more likely to be subject to a physician’s biases against their patients, especially their Black patients.

So, we may not always know as much about how a specific treatment will affect your particular skin type. But that doesn’t mean that dermatologists can’t help you at all—and you definitely shouldn’t feel like your skin is an unsolvable puzzle. This just makes it even more crucial to find a dermatologist who knows how to treat you and who you feel comfortable being treated by.

Related:

https://www.self.com/story/taking-care-of-skin-of-color, GO TO SAUBIO DIGITAL FOR MORE ANSWERS AND INFORMATION ON ANY TOPIC

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