If you’re a person of color, finding the right treatment for atopic dermatitis, a common form of eczema, can be challenging. Even though the disease is more prevalent in Black Americans than white Americans, dermatologists don’t always know the best way to treat atopic dermatitis in darker skin tones.
One reason for this lack of knowledge is that people of color are often underrepresented in clinical trials. One study found that almost two-thirds of atopic dermatitis clinical trial participants are white — despite the higher disease prevalence in Black Americans, as well as the number of Latino and Asian Americans who have the condition. This lack of representation can make it difficult for doctors to know how different skin tones would respond to treatment options.
Atopic dermatitis appears differently in people of color, says Caroline Opene, MD, a dermatologist at UCLA Health in Santa Monica, California. “So, when we use the knowledge acquired from predominantly white clinical trial participants, we risk utilizing ineffective and potentially harmful practices on people of color with atopic dermatitis.”
This is why it’s crucial for clinical trials to include participants who are racially and ethnically diverse. Research shows that diversity in clinical trials is essential to helping dermatologists understand the safety and efficacy of specific atopic dermatitis treatments in people of color.
The good news is, there’s a growing body of research on the differences in symptoms and treatment recommendations for atopic dermatitis in darker skin. And with proper awareness and advocacy, it’s possible to break down barriers and find the best ways to treat and manage symptoms.
Skin, Hair, and Scalp Considerations for Black People With Atopic Dermatitis
The first step in treating atopic dermatitis is working with a culturally competent dermatologist who can create a treatment plan targeted to the specific symptoms you have, says Dr. Opene.
When discussing treatment options, be sure to ask about potential side effects. For example, prolonged topical steroid use can lead to skin thinning, hypopigmentation, and hyperpigmentation. And if you don’t stop prolonged steroid use correctly, you can also develop topical steroid withdrawal, a rebound reaction that can cause your skin to become inflamed, with a burning sensation.
Don’t be afraid to advocate for yourself. “If your dermatologist prescribes a medication that doesn’t feel like a good fit, share your apprehensions,” says Opene. “Try to strike a balance between respecting their opinion as a professional while speaking up if something doesn’t feel right or if you feel like they are not creating a treatment plan specially tailored to your needs.”
You can also work with your dermatologist to come up with a daily routine to help manage symptoms and reduce the risk of flare-ups. Opene recommends the following skin- and hair-care tips:
Consider Financial Barriers to Atopic Dermatitis Care, Too
It can be expensive to manage atopic dermatitis in darker skin.
Research suggests people of color are more likely to experience poverty and unemployment due to issues such as systemic racism, which can impact access to health insurance and quality medical treatment. These factors can create barriers to receiving a timely diagnosis and effective treatment.
Additionally, Opene says the high costs of specialty skin- and hair-care products recommended for treating atopic dermatitis can create a financial burden for those who are living on a fixed income.
How to Advocate for Better Atopic Dermatitis Care
You are your own best advocate, but it’s important to keep in mind that there are various structural challenges that can make it harder to advocate for your atopic dermatitis care.
Along with systemic issues, which can create challenges such as access to care and financial barriers, research has found that negative racial bias in the healthcare system can also make it harder to advocate for yourself.
