Dr Adeline Kikam, DO, MS, FAAD
Board Certified Dermatologist
To improve diversity and inclusion, we must make sure skin health information is available to all, regardless of skin tones.
1. What are some of the misconceptions or /assumptions around skin of colour amongst the general public?
That skin of colour does not need sunscreen.
The misconception that melanin in our skin is all protective and we don’t need sunscreen. Black and Brown people have increased melanin that offers some measure of protection from the sun’s harmful rays but it is not all protective as many would like to believe. Overexposure to UV radiation can induce DNA damage resulting in sunburns, premature ageing, worsen hyperpigmentation by overstimulating melanin production and may cause skin cancers.
2. Is there a lack of education in skin of colour diagnoses? What can be done to address this?
Education of health professionals when it comes to recognising and diagnosing skin conditions and how they present differently on darker complexioned skin could certainly be better. Textbooks and curriculums need to be updated to reflect the diversity of skin tones in our society. Many skin conditions from skin cancer to rosacea can present differently in patients of colour and failure to recognise them can delay treatment and worsen outcomes.
3. What can people do to look after their own skin?
Everyone, including people of colour, should have a professional full body skin check performed by a dermatologist at least once yearly to evaluate moles and rule out cancerous growths.
Additionally, one should perform full self-skin checks at home using a full-length mirror or handheld mirror. Check for new moles, change in the size, shape, colour and texture of moles, . a sore that does not heal or heals and returns. In skin of colour, skin cancer like squamous cell carcinoma may arise in chronic wounds.
4. How important is diversity and inclusion in the skin community? What can be done to address this?
Diversity and inclusion are very important in the skin community because they underscore the value of human dignity and respect. To improve diversity and inclusion, we must make sure skin health information is available and accessible to all regardless of skin tones or ethnic background. It’s important that public health campaigns on dermatologic health include images with people of colour. People of colour are not as visible in awareness campaigns on sunscreen use and it helps foster the narrative that they do not need them. My inspiration in starting my platform @brownskinderm was to include people of colour in conversations on skin health which I deeply felt was missing in the greater public discourse.
5. Why is it important that dermatologists be well educated in treating skin of colour?
It’s important that all physicians are trained to provide competent and culturally sensitive care for all patients regardless of race, gender and ethnic background. In dermatology, which relies heavily on visual diagnosis with emphasis on pattern recognition to readily identify lots of skin conditions, it is even more important that dermatologists have a trained eye for not just picking up unique patterns in lighter skin tones but darker skin tones as well.
Failing to be well rounded when it comes to treating skin of colour, limits access to care and fails patients of colour who already have a history and continue to experience systemic barriers in medicine.
