Skin Equity, Complexion of Beauty?

Equitable Skincare synonymous with Skin Equity is a trending topic, and its importance cannot be diminished. ‘Flawless’ beauty gurus are prolific on Tik-Tok and social media, boosting an archetypal beauty standard and it only seems dermatologists need to step up their game. Generic prognosis comes easy to doctors, but they may miss the mark. Worse, quackery could easily run rampant in this lucrative “look driven” market.

Now, now we have nothing against being beauty driven but underlying skin issues have broader wellness implications and that is equally or even more important to address across all skin types & colors.

Have our practitioners just mastered the art of the knock? Are they only too happy to get an answer to ‘tell me why you are here’, pull out their prescription pads, and whiz away next-door? Money is brimming for skin specialists as cosmetic procedures skyrocket, but what if you truly have a skin issue? This slapdash approach could leave you both with a huge bill and a persistent or grave skin problem to contend with.

Skin (the largest organ) speaks to you in the form of allergies, deficiencies, trauma, and color change. A savvy dermatologist will ask about family history, genetics, lifestyle (sun exposure, products used, habits) and check if one has the predisposition to get a keloid, discoloration or will be able to pick out a dangerous mole or rash that has camouflaged.

A 2019 study by cancer.org reported differences in melanoma early detection associated with complexion; “One possible reason for the delay in diagnosis is that the types of melanoma most common on dark-skinned people don’t match the ABCDE (asymmetry, border, color, diameter, evolving) guidelines for examining moles,” ACS Senior Associate Scientist Culp says. “That leaves people not knowing what to look for during skin self-checks or when to see a dermatologist”.

No matter the skin color, here are the basics you should keep tabs on to keep your dermatologist accountable – Take pictures if you think it will drive for a better outcome.

Keloids, scar, bruise formation. How it happened, time to heal and what you did to treat the scar.
Allergies or unusual rashes (caused by food or a beauty product).
Rough or dry patchy skin. Eczema can go unnoticed.
An itch that is persistent
Freckles or spots
Procedures? Lasers can cause hyperpigmentation or hypopigmentation in darker skin.

Dark Skin is not a flaw! While more skin specialists are gaining experience treating darker skin there are still biases; Skin-lightening, a profitable game, is rife! Understand the procedural or ingredient risks to your skin.

OTC Skin lightening products are not a solution and need to be approached with apprehension. Skin lightening products containing mercury can still be found on US shelves; these are mostly illegal imports but common enough in some areas to prompt pointed warnings by the FDA.

Even large conglomerates like Unilever have started promoting positive beauty campaigns worldwide that deter unrealistic expectations and comparisons and to build a more equitable society. No doubt, there is concerted effort to address the skin gap – In 2019, Ellen Weiss set up Brown Skin Matters for her mixed-race son. This site is noted to have been an indispensable resource to many dermatologists.

Aptly said by Roxana Daneshjou, a dermatologist at Stanford University “Medicine seems to have been built with the same solipsism as photography. For instance, pulse oximeters – those devices health workers peg to your finger, which read your oxygen levels by pinging a red light through your skin – were calibrated using white patients, and they have been shown to consistently overestimate oxygen levels in dark-skinned people by up to 7%. If we don’t fix the biases we have in healthcare before we jump to training a computer to do it, we’re just going to actually perpetuate those biases.”

While broad slogans, campaigns, Social Media can raise the awareness and be a wow factor; the movement of equity requires a shift in our thinking, to be more thoughtful.