The Gap Matters: Knowledge gaps in skin of colour

What is skin of colour?

Skin of colour is a term that was coined in North America. It describes people with non-Caucasian skin types so includes people with Chinese skin, Indian skin, African skin, Hispanic skin, Southern Mediterranean, Middle Eastern skin and our indigenous communities.

We are proud to say that Chroma Dermatology  is Australia’s first and only dedicated centre for those with pigment problems and for those with skin of colour. 

What is the gap?
The first research papers for skin of colour in Australia were published in 2018. Dr. Rodrigues was pivotal in both research papers. These clearly demonstrated dermatologists and dermatology trainees in Australia needed more training in the diagnosis and management of dermatology problems in those with skin of colour.

The first research paper demonstrated that 85% were not confident in managing common cosmetic issues in skin of colour and 75% were not confident performing procedures on those with skin of colour. Over 80% stated they would have liked more teaching in SOC during their training. The second research paper that evaluated dermatology trainees in Australia mirrored these findings.

It was clear from this research and anecdotal reports that dermatologists want and need more training in this area of dermatology. It was clear that bridging the knowledge gap for dermatologists, primary care doctors (general practitioners) and those working in emergency/community centres (to name a few) was critical for patient outcomes and that pairing this with understanding patient perspectives was also important.

Why does it matter?
Scientific studies have demonstrated that skin of colour is structurally and functionally different to white skin. It reacts differently to the environment and injury and treatments like creams and lasers.

One of the most important things dermatologists do is look at the skin for clues to a diagnosis – we look at the location, shape, colour and patterns that rashes and other spots create on the skin and use this information to create a diagnosis.

The first challenge is that skin of colour often lacks signs that a dermatologist is taught to look for. Redness is a good example of this. It is easily seen in white skin but very hard or even impossible to see in those with darker skin types. And, even if the skin shows a little bit of redness, the shape and pattern of the rash can be completely different in different ethnic groups. There are other examples of major structural and functional differences, but we will limit our discussion to those examples to be brief.

The final important issue is the choice of energy-based devices and settings used to achieve good outcomes in those with skin of colour. Often, laser devices come with instructions/instruction manuals that are tailored for Caucasian skin or “Fitzpatrick skin types” but these fail to recognise the nuances of genetically admixed populations.

Without adequate education and training, patients with skin of colour may not be optimally cared for.

What is being done fill this gap?
Dr. Rodrigues states, “there are giants in the field of skin of colour dermatology who started work in this area of dermatology nearly two decades ago.” These dermatologists have worked tirelessly to create dedicated textbooks and resources for those with skin of colour.

Dr. Rodrigues has spent (cumulatively) years abroad in places like the USA in dedicated skin of colour centres to research skin of colour and gain unique insights into how to best diagnose, manage and treat patients with Chinese, Indian, Hispanic, African and other skin types. It has been her vision to create a centre of excellence for those with skin of colour here in Australia. She says, “I am proud that people with skin of colour now have a home at Chroma Dermatology.”

It was also her vision to educate her dermatology and medical colleagues about how they can better diagnose and manage conditions in this patient group. She has, so far, done this through lectures, conferences, creating educational materials and medical research. Dr. Rodrigues has also worked with the Australasian College of Dermatologists to develop a skin of colour section for post-graduate training in dermatology. This was implemented about 3 years ago and she tells us she is “happy the college has embraced this area of dermatology and recognised it as a sub-specialty within dermatology” and that she is “currently working on developing the curriculum further this year.” 

Dr. Rodrigues concludes by saying, “The gap exists…the gap matters… and I am committed to working hard to change that.”

How can you learn more?
Media outlets have recently highlighted knowledge gaps in those with skin of colour. To read more check out this article by the ABC and listen to this awesome podcast from the Limbic.

The information contained in this blog post is intended as a guide only and should not substitute seeking medical attention. Please see your healthcare provider for more information on suitability of products, treatments or procedures.