The Psychosocial Burden of Skin Disease and Dermatology Care Insights Among Skin of Color Consumers

October 2023 | Volume 22 | Issue 10 | 1027 | Copyright © October 2023


Published online September 29, 2023

doi:10.36849/JDD.7713

Martina M. Cartwright PhDa, Tamar Kamen BAb, Seemal R. Desai MDc

aBeacon Science, Inc., Scottsdale, AZ; The University of Arizona, School of Nutrition and Wellness, Tucson, AZ
bTopicals Inc, New York, NY
cDepartment of Dermatology, The University of Texas Southwestern Medical Center, and Innovative Dermatology, Dallas, TX

Abstract
Background: Skin conditions are associated with psychological symptoms and may be particularly distressing for skin of color (SoC) individuals. SoC consumers' decisions to pursue dermatology care may be negatively impacted by the scarcity of skin tone diversity in dermatology. This survey explored SoC consumers' perspectives on dermatologic care to provide insight into the psychosocial burden of skin disease.
Methods: Beacon Science conducted an anonymous web-based survey in August 2022 among self-selected consumers. Demographics, bothersome skin condition effects on mental health, insights about skincare products, and dermatologists’ ability to address SoC were captured. Descriptive statistics were performed.
Results: 775 responded, 64.6% (n=501) with SoC. Among these, 94.2% (472/501) were female, 76.6% (384/501) Black/African American, and 48.9% (245/501) 18-24 years. 79.6% (399/501) reported a bothersome skin condition that was moderate to extremely bothersome (85.2%, 340/399). 57.4% (229/399) reported skin condition(s) affected mental health. Discoloration/acne-related post-inflammatory pigmentation changes (69.5%, 348/501), acne (58.5%, 293/501), and ingrown hairs (48.1%, 241/501) were most common. The face was most frequently affected (93.6%, 469/501). 40.9% (205/501) believed available skin products do not address their specific skin needs; 44.8% (179/399) have consulted a dermatologist; 46.4% (185/399) felt like the dermatologist did not know how to treat their skin; and 92.5% (369/399) did not believe most dermatologists or aestheticians are trained to treat darker skin tones. The survey was not validated and may not be generalizable.
Conclusions: SoC consumers experience skin-condition psychosocial distress and may hesitate to seek dermatology care. Dermatology products, services, and education tailored to SoC consumers is needed.

J Drugs Dermatol. 2023;22(10):1027-1033 doi:10.36849/JDD.7713

Introduction

Acute and chronic skin conditions affecting the appearance of visible skin are associated with both physical and psychological symptoms and lower quality of life.1,2 In individuals with skin of color, visible dyspigmentation may be more apparent.3 Indeed, acne-related post-inflammatory hyperpigmentation (PIH), dermatosis papulosa nigra, and pseudofolliculitis barbae may be particularly distressing for those with darker skin tones as these conditions primarily present on the face or visible areas.4-6

Today's social media platforms are a portal for information regarding dermatology treatments7,8 and a potential source of anxiety and distress for those with less than perfect skin.9 The reliance of social media on images to both communicate and engage is a double-edged sword. Posting photos can be particularly distressful to those with certain skin conditions and is associated with a negative impact on psychosocial functioning and quality of life, with higher rates of depression, anxiety, and poor self-esteem among adolescents with acne and atopic dermatitis (AD).9-12

Challenging to those with SoC is the underrepresentation of deeper skin tones within the dermatology field. Few13,14 dermatologists are Black (3.0%) or Hispanic (4.2%) and skin tone diversity depicted in dermatology textbooks, medical publications, and dermatology related social media posts is lacking.15-22 Scarcity of visual and practitioner diversity may delay SoC consumers' decisions to pursue dermatology care, thereby prolonging undue psychological hardship.23,24

It is believed SoC consumers with visible skin conditions experience psychosocial and psychological distress which may be exacerbated by concerns related to the suitability of skincare product selection and dermatological care tailored to SoC.

The purpose of this survey was to collect and evaluate SoC consumers' perspectives on dermatologic care, access, and knowledge and to provide insight into their opinions, beliefs, and attitudes about the burden of skin disease on psychosocial health.