INTRODUCTION
Atopic dermatitis (AD) is a chronic inflammatory disease affecting up to 15% of children and 3% of adults.1 Restoring barrier function with dermatologist-recommended gentle skin care is central to therapy. However, over-the-counter products are often expensive, exacerbating socioeconomic (SES) disparities in AD. Low SES patients are more likely to have poorer disease control and higher disease severity than their high SES counterparts.2,3 They are also more likely to live in low-income neighborhoods, raising concerns that geographic location and its impact on gentle skin care access may be an overlooked contributor to AD disparities.4
There is growing recognition of pharmacy deserts, or geographic areas where few or no pharmacies are accessible. Pharmacy desert studies, which extend findings from the food desert literature, indicate that they are most prevalent in low-income and minority neighborhoods.5 Pharmacy deserts may also limit access to gentle skin care products since this is where they are often purchased. However, the association between gentle skin care affordability, availability, and access across city zip codes has not been examined.
Here, we aimed (1) to assess the affordability of dermatologist-recommended AD skin care products compared to popularly purchased products; (2) to investigate whether pharmacy retailers that sell recommended gentle skin care were less prevalent in low-income neighborhoods in 2 cities: Chicago and New York; and (3) to examine how hours of operation, price, and stock levels vary between stores in high and low-income zip codes.6
MATERIALS AND METHODS
Data Collection
Prices of Skin Care Products
Products from the National Eczema Association (NEA) “Eczema Product Directory” were extracted as dermatologist-recommended gentle skin care products. For popularly purchased products, the top brand names were extracted from Statistica, a well-known provider of consumer data deriving from market research across industry and government.7 US surveys for 3 product types were used: moisturizing lotion,8 moisturizing cream,8 and liquid body soaps.9 Brand names with greater than 10% response rate were included. Brand names that were not descriptive, such as “Store Brand,” or brands that could not be
