From misdiagnosis to mistreatment, Black women aren’t receiving the care they need, and the problem starts in medical school. In order to better help Black women in the UK (and the rest of the world), we need to increase the number of Black dermatologists overall. To do so, we need to remove the barriers for entering the field. On top of this, existing dermatologists must educate themselves on how to properly treat brown skin, the cultural practices that affect the way we approach beauty and how to recognise the deep-rooted biases that make Black women feel overlooked. The time for change is now. Let’s get into it. Studies show that only 3% of dermatologists are Black, which is especially low considering that Black people make up about 13.2% of the population of London. In fact, Black physicians only comprise six percent of the entire medical profession, and of all the specialties, dermatology is one of the least diverse. As a result, among the many health disparities that Black women face, like being statistically more likely to die in childbirth and less likely to be given medicine for pain management, there are also gaps in care in dermatology. The five-year survival rate for a Black patient diagnosed with melanoma, a common form of skin cancer, is only 65%, versus 90% for white patients.
“There are few dermatologists of colour because the field of dermatology is not exempt from racism in the U.S., and more specifically, the educational system” explains Chesahna Kindred, M.D: a board-certified dermatologist based in Columbia, Maryland. Dr. Kindred’s assessment could be bolstered by the fact that data shows minority medical students receive lower grades than their white counterparts and are less likely to be granted membership into prestigious organisations. As a result, a large chunk of the population may not always receive the adequate skin, hair, and nail care that they deserve — even though all dermatologists, regardless of race, should be up to snuff on how to access and treat skin of colour.
There's a huge knowledge gap when it comes to treating darker skin across the medical field, and to remedy this, you can probably find a 'skin of colour clinic' or 'ethnic clinic' in your nearest major city. As much as this certainly alleviates the issue, it feels borderline performative, kind of like putting a plaster on a broken leg - if the problem is a lack of education when it comes to treating Black skin, then why not implement better education? When we look into the history of Black dermatology, we see textbooks and 'scholarly' articles littered with information that is not only incredibly factually incorrect, but also racist beyond belief. In 1851, Samuel Cartwright, a pro-slavery doctor, argued that Black people had thicker, less sensitive skin, as part of a disorder he called “dysaesthesia aethiopica”, which he thought made workers sluggish. He taught that the only cure was "a good whipping". “The best means to stimulate the skin,” he wrote, is “to anoint it all over in oil, and to slap the oil in with a broad leather strap; then to put the patient to some hard kind of work in the sunshine.” A 2016 study showed that a third of American medics still believe myths about black patients, such as thinking they have thicker skin, with fewer nerve endings. If this paragraph didn't make you furious, read it again.
Pop culture has had a huge impact on cultural knowledge gaps in other areas - things like food, music and fashion, and with the rise in awareness, we're being further educated on the origins of this misinformation. But we haven't seen similar advances in the medical field. Despite being one of the most popular musicians of his time, Bob Marley’s early death from skin cancer is a totemic example of the way we continue to neglect this area of knowledge. Marley's story reminds us of the extra complications that Black patients navigate when seeking healthcare, and the life-or-death significance that a lack of knowledge can have. The type of melanoma that Marley developed (Acral Lentiginous Melanoma) is the most common subtype in dark-skinned people, and yet it was still misdiagnosed. Even today, it remains the subtype of melanoma with the fewest successful treatment options.
As of February 2023, there is a change.org petition urging the UK General Medical Council to require that medical schools include a diverse representation of skin tones in their teaching. One of the youngest people campaigning for this is Malone Mukwende, a second-year medical student at St George’s Medical School in London. Mukwende has co-authored a handbook entitled 'Mind the Gap', which aims to help fill the educational blind spot when it comes to skin colour and medical practice. Also, Hutano, a new online platform has been created with the intent to empower people with knowledge about their health. But, while important, diversifying the skin tones we learn from is just the first (and easiest) step in a broader struggle to reshape the medical profession to make it inclusive to the perspectives of PoC, and eliminate the disparities that they have long suffered.