ForThe Melanin Edit,Allurewanted to sit down for a conversation with the dermatologists working to change this reality.
Allurecontent director Jessica Cruel:The first thing I want to talk about is perception.
I think there’s still a lot of fear among Black people of even going to the doctor.
Illustration by Herve Kwimo
I would love to hear some of your thoughts about how the Black community perceives the field of dermatology?
Dermatology was considered a luxury and Blacks simply did not have access to it.
And even to this day, there’s inappropriate treatment of skin of color.
Illustration by Herve Kwimo
And they’re like, “Well, a dermatologist isn’t really for [me].”
And I think that’s also a reason why so many concoctions and myths are so widely present.
Well, you guys do hair stuff also?"
Therefore, why would I go see a dermatologist?
Micah Brown, a medical student at Howard University College of Medicine:Cocoa butter.
The most popular dermatologists do cosmetics, but the most common dermatologist does medical dermatology.
So there’s a misconception there too.
“Dermatology was considered a luxury and Blacks simply did not have access to it.”
Valerie Callender, a dermatologist in Glenn Dale, Maryland: Most of us do both.
Do you know anything about that?"
Who’re they going to trust?
Brown:For so long Black people have had anxiety about going to the doctor.
So it definitely starts off with a culturally competent physician.
And that starts with medical school education.
Cruel:So that segues into my next question.
Brown:I’m lucky to be at Howard where that’s their goal.
And they really drive that home.
you better know what certain things look like in certain types of skin tones and things like that.
I actually just published a book chapter in the ethnic skin textbook with Dr. Kindred.
Dautriche:The majority of the patients that we serve [at my hospital] are underserved.
But there is a disconnect between the textbook and the patient population that we see.
Brown:I agree with Cula.
In 2021, this is unacceptable.
because the books are still the same.
Callender:Every picture of an ulcer or herpes was on a Black man’s penis.
Brown:That’s true.
I was just floored.
I was the only Black person in the program.
But I really never forgot it.
I’m like, it doesn’t take much to look up something.
Kindred:We have to have publishers and editors of journals and textbooks that say this is unacceptable.
As long as they’re willing to publish garbage, we’ll be teaching and learning garbage.
When those people in a decision-making capacity adjust, we’ll see change.
If you get the test-maker to make it unbiased, then people will study what’s unbiased.
Cruel:Dr. Callender and Dr. Kindred, what was it like for you all?
Kindred:Well, we were spoiled.
We trained at Howard.
How is what we’re seeing in Blacks different?
I went right into private practice in the D.C. area.
And what I found was, medications and treatment modalities were always studied in white skin.
This Retin-A just came out on the market.
But how is it going to act on Black skin?
I mean, we don’t know.
They didn’t study us.
We had to find ways to take those medications and use them safely on brown skin.
We always had to combine it with hydrocortisone cream.
That’s the way you did it.
But things are moving.
In 2021, this is unacceptable."
There’s still a fight to be the lead researchers on these trials, and things like that.
Is it just because they don’t know who to call?
Why do you think they are so hesitant?
Is it hard to find participants because there are only so many Black dermatologists?
There weren’t enough Black patients, so it’s not really recommended for Black patients.
So we still have to fight."
But that’s who’s being picked to run these clinical trials.
Black dermatologists have the built-in trust, so we need to be the principal investigators.
Callender:I finished my residency in 1990, 30 years ago.
So things are definitely different.
When I first started in private practice, everything was strictly medical.
I mean, any bang out of cosmetic procedure really wasn’t even thought about at that time.
We did a little collagen as a filler or we did large grafts for hair transplants.
We even did a little liposuction in the office.
For a Black dermatologist treating Black patients, it wasn’t what we did.
They’re like, “Why?
Why is there not one for brown skin?
What can we do instead?”
Cruel:What changes do you think we still need and what does the future look like?
What can we do to make it even better for those coming up?
I’m really encouraged by how readily people are willing to use their voice.
I think that a lot of these companies also are being forced to have these diversity and inclusion boards.
It seems like people are trying to make a sincere change.
Brown:2020 and 2021 taught me and my classmates that we do have a voice and we are powerful.
So, I’m excited.
But, like Dr. Kindred said, we really need to put ethnic skin at the forefront of research.
And it starts with us being in the room.
