It’s no secret that the beauty industry has garnered negative attention due to a lack of representation and inclusiveness that does not reflect society’s diversity. But what about behind the lens of flawless beauty campaigns that are meant to sell a product? I’m talking about the medical side of beauty: dermatology. Forget the Instagram selfies that can be photoshopped or “facetuned” within minutes to portray an image of perfection. Let’s take a look at the numbers.
In the United States alone, acne is the most prevalent skin condition that affects approximately fifty million Americans per year. Rosacea, a skin condition that creates facial and bodily redness and irritation inducing bumps, affects 16 million Americans. $1.2 billion was spent on costs related to acne treatment in 2013 and $243 million on rosacea.
So, where does the disconnect lie? Within the numbers, of course. Though nearly 20% (if my math serves me correct) of the U.S. population suffers from acne/hyperpigmented skin issues, including 65.3% of African-Americans, 52.7% of Hispanics, and 47.4% of Asians. According to one 2002 study originally published in the National Library of Medicine, the ratio of practicing dermatologists and patients belonging to ethnic groups, does not align. Statistics from a more recent study acquired through resume, job proposal, and U.S. Census Bureau data, claimed that only 5.3% of active dermatologists are Black or African American, 9.8% Hispanic or Latino, and 17.3% Asian. In comparison, 64.7% “of all dermatologists,” are White. However, prominent minority populations have seen a linear surge that only continues to rise. Pew Research Center reports that now 46.8 million Americans “identify as Black,” a Hispanic population that has exceeded 60 million based on 2019 statistics, while Asian Americans have become “the fastest -growing racial or ethnic group in the U.S,” due to consistent population growth from 2000-2019.
Why do these discrepancies pose a problem? Not only is everyone’s skin different, but certain properties and characteristics also significantly vary amongst ethnic groups with a diverse range of skin tones. Avail Dermatology states that Black and Asian individuals have a denser dermis layer due to increased collagen. They also state that the likelihood of pigment disorders amongst Black, Hispanic, and Asian individuals is higher due to skin tone. Similarly, Hispanic individuals are more at risk of developing “patches of dark skin or discoloration.” Darker-skin toned individuals are also more susceptible to hyperpigmentation while Asian individuals have leading levels of overall skin sensitivities. With this information, it’s evident that representation matters within the dermatologist industry.
To gain outside input, I spoke with other College Fashionista members about their viewpoints on the lack of diversity within the dermatologist industry and any experiences with dermatologists or skincare providers that left them feeling wary.
Evette, a fashion designer and College Fashionista community member, has expressed her doubts about the skincare industry. She’s observed its lack of inclusivity in terms of her cultural values and the need for more holistic products and treatments.
“I identify as a BIPOC person, a Coahulitcean woman. I have super sensitive skin,” she tells me. “I believe we vote with the money we spend, so I’ve had a nightmare of a time trying to find what works for me. Trying to find products that align with my values, and that I don’t have allergies to takes hours of research, hours in stores reading labels, and lots of money. Though local archival and community organizations are re-teaching forgotten knowledge, trying to locate information on the native and natural plants used for skincare by my ancestors leads to many dead ends.”
Though she’s never met with a dermatologist face to face, she shared her experience with her General Healthcare Provider that left her feeling unsatisfied and untrustworthy of dermatologists in general.
“The information that’s valuable to me isn’t always considered in modern day medical research. It feels like we’re talking about apples and oranges, not like we’re on the same page about how to best take care of my health. I believe having more indigenous representation in dermatology could bridge this gap, and could encourage native medicines to be an item of consideration in dermatology.”
“I spoke with my GHC provider about allergic reactions I was having nearly every day across my skin. I was concerned it was a product I didn’t know I was allergic to. I was recommended a couple of different topical treatments and alternative soaps that would have kept me in the same cycle of not knowing what I was using. I left feeling like I was on my own to figure out what was wrong, and like the options that were right for me just weren’t reasonable.”
“I ended up switching all of my products like grapefruit microbead face scrubs, under eye serums, and primers. I replaced my skincare with natural ingredients I was used to like coconut oil, aloe vera, flax seeds, and tea tree. Come to find out, I had an allergy to the citric acid used in almost everything as a preservative!”
Overall, Evette doesn’t feel trustworthy of dermatologists because she’s felt (and experienced) the lack of access to care with people like her in mind.
Vicky, a freelance content creator who identifies as Vietnamese American and is a first generation college graduate from The University of California, Berkeley, has also communicated her doubts about certain aspects of the dermatologist industry.
“I have very sensitive skin, so I am always cautious about the products I use. Even the littlest thing can irritate my face so I try not to apply much [to my face]. If a product doesn’t work for my skin, I can see the negative effect instantly.”
Brands that she says work well with her skin are Tatcha, Shiseido, and Clinique.
“They [Tatcha] gave me their ‘Rice Wash Softening Cleanser’ and I was extremely happy when it left my skin feeling refreshed.”
However, she acknowledges that there have also been downsides to trying new skincare products.
“I have had a bad reaction to products that have been recommended to me. I do not go out of my way to purchase skincare products. Brands typically send me products and before using them, I always make sure to research them. If a product doesn’t work for me, I always express it to the brand.”
Beyond skincare brands, Vicky believes the dermatologist industry warrants diversity like any other profession. She also emphasizes that her viewpoints and experiences are based on what she knows, not speaking for all BIPOC individuals.
“When people come in looking for a service, when they see someone who looks like them or has the same experiences as themselves, it makes the interaction more comfortable. Many individuals who are first-generation college students experience imposter syndrome because they do not feel a sense of community or belonging. I think this ideology can be applied to the dermatologist industry,” she states. “If the field is highly populated with those who do not look or sound like you, then you are most likely not going to go there.”
“I’ve also heard going to a dermatologist can be pricey, which can hinder most people from actually going,” she adds.
Vicky also touches on her observations and experiences from others about dermatologists and the industry overall.
“When looking up articles and statistics, I noticed the dermatologists’ world is predominately White which could be a factor in why many POC do not seek out this service.”
“I’ve had a friend who went to a dermatologist and the doctor prescribed her medication that resulted in more breakouts. After hearing about her experience, it made me think about how everyone is different and what works for one person may not work for someone else.”
“If someone has dry skin, a product may work extremely well for someone who has dry skin, but not for someone else that has a different level of dry skin. I believe there are variations. What works for someone who has severe dry skin, may not work for someone who has mild dry skin.”
Stories like those shared by Evette and Vicky shouldn’t be the norm in today’s society. Everyone should be able to seek services without fear of complications due to a lack of knowledge rooted in unfamiliarity. Representation within industries that are meant to assist and uplift others like in the dermatologist world should be reflective of those who seek their services. Progress can be slow, but will it ever come?