Everything You Should Be Asking Your Dermatologist as a BIPOC Woman

Hyperpigmentation

Naturally, people of color are prone to the same skin-care concerns as anyone else—it’s how our skin reacts that makes the difference. “When somebody comes in, you always have to understand the risks of scars and hyperpigmentation,” says Dr. Gohara. “Those qualifying questions aren’t usually asked of Caucasian patients, but certainly important to ask of our brown skin patients. Hyperpigmentation and scarring are extremely important to consider when putting together a treatment regimen for brown and Black skin.”

Dr. Robinson states it’s usually adverse reactions which bring BIPOC individuals into the office. “I think what brings in patients with deeper skin tones tends to be secondary skin concerns. For instance, my patients of color tend to be more concerned about post-inflammatory hyperpigmentation which accompanies acne versus acne itself. Hyperpigmentation can be far more devastating for darker pigmented skin. It can be deeper in color and longer lasting.”

As a matter of fact, often in our quest for even skin it’s the subsequent use of harsh products or aggressive techniques that make hyperpigmentation more likely and problematic. If you find that that’s the case for your skin, it’s best to speak to your dermatologist in order to prevent further damage.

Acne

When dealing with acne in melanated skin, Dr. Robinson advises speed. “Early prevention is critical, and it’s something we’re up against as a community because [patients] aren’t being treated for their acne,” she explains. “There are many access issues which prevent patients of color from seeking help for skin issues in the first place, which means by the time they see us, they present more severe acne, hyperpigmentation, and/or scarring. We also know there’s a tendency—not just with acne, but other conditions—for the severity not to be accurately recognized because redness looks different on the background of Black or brown skin.”

When it comes to addressing acne for BIPOC patients, both doctors agree a gentle cleanser paired with a targeted treatment is key, followed by moisturizer and a good sunscreen. Salicylic-acid cleansers tend to help with blackheads and whiteheads, while benzoyl-peroxide-based cleansers help clear inflammatory acne with pimples. Generally, gel washes work for oily skin, creamy formulations for dry.

As to the targeted treatments for acne, both dermatologists are fans of retinoids like Differin Gel Adapalene 0.1% (45 g), followed by a barrier-protecting moisturizer and sunscreen during the daylight hours. Just remember, don’t pick at or pop your pimples. “It’s a recipe for hyperpigmentation, and you could introduce bacteria into the lesion, both of which make everything worse,” advises Dr. Robinson.

Texture

Both experts advise that their BIPOC patients use chemical exfoliants and peels over physical scrubs when it comes to treating uneven skin texture, which provide a less abrasive skin resurfacing (and therefore less risk of causing undue damage or hyperpigmentation).

They suggest using washes with alpha hydroxy acids like Dr. Robinson’s recommended Revision Brightening Facial Cleanser, followed by retinoids or peels containing salicylic, glycolic, or lactic acids, and a barrier-repairing moisturizer like Avene Cicalaphate+ Restorative Protective Cream, and of course, sunscreen.

Sun Protection

Yes, using SPF regularly is critical in order to keep Black and brown skin safe from UVA and UVB damage, as well as high-energy visible (HEV) or blue light. This can be from your computer or phone screen, fluorescent lighting, and, of course, the sun. “Particularly with Zoom calls and all the screen exposure right now, brown skin is much more likely to get damage from visible light,” cautions Dr. Gohara. That means you need a sunscreen whether you’re spending the majority of your time outside or indoors, but even more so if you’re using a retinoid product, which can increase skin sensitivity to UV rays.

One of the most dangerous misconceptions related to the sun and skin of color is that darker skin is somehow immune to skin cancer. This is not only false, it’s perilous. “Many times there’s a misconception that BIPOC people can’t get skin cancer, so diagnosis is delayed,” cautions Dr. Gohara. According to the American Academy of Dermatology, patients of color aren’t usually diagnosed until the later stages of melanoma, when it’s more difficult to treat—not to mention they’re less likely to survive than Caucasian patients.

In addition to sunscreen and sun-protective clothing, yearly skin checks with your dermatologist are imperative, especially since people of color often get lesions in areas not commonly exposed to the sun, like the groin, between the toes, inside the mouth, and the palms of the hands.

Finding a BIPOC Dermatologist

Finally, should you look for a dermatologist of color as a BIPOC person? “I think we know when there’s some type of cultural resonance between a doctor and a patient in any specialty—usually based on ethnicity or religion—the patient outcome is better; it’s scientifically proven,” Dr. Gohara says.

Dr. Robinson agrees, but says it might be a bit challenging, but worthwhile, to do some research before reaching out to a new doctor. “The stats are staggering: Roughly 3 percent of derms are African American, and roughly 4 percent are Latinx. It’s something our profession is addressing. A lot of patients are looking for dermatologists of color or want to culturally identify with their dermatologist, and just knowing the landscape is important.”

If you’re seeking a dermatologist of color, or someone who can address the particular needs of your skin tone, The American Academy of Dermatology can be a great resource, as well as the Skin of Color Society, which is composed of dermatologists with an interest in conditions which disproportionately impact BIPOC patients. Call their offices, ask questions, pay them a visit—you deserve to live in the skin you’re in, and it deserves to look its absolute best.