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Time for more inclusive skincare.
By Alice Kelly — Written on Mar 19, 2021
We exist in a world that actively tries to sell the notion that lighter skin is more beautiful, whether it’s through marketing campaigns that lack diversity or branding efforts that alienate people of color from products.
But the neglect of people of color in the skincare industry runs much deeper than gloss advertising campaigns.
With the voices of people of color and the nuances of their skin’s needs being actively left out of developments in the world of dermatology, the skincare industry is inhibiting people with darker skin tones from accessing life-enhancing personal care.
Everything from acne to skin cancer in people of color is being misdiagnosed and mistreated as the industry continues to fall behind on providing basic care.
For Dr. Margareth Pierre-Louis of Twin Cities Dermatology Center, this inequality has become an overwhelming concern in her work.
Her mantra for her career is to provide “visible wellness for all” as she seeks to educate and inform people of color and fellow dermatologists of just what can happen if darker skin tones continue to be let down by modern skincare.
We spoke exclusively to Dr. Pierre-Louis about how people of color are being neglected by the skincare industry and Miiskin, the app she's using to democratize skincare accessibility.
People of color are being prescribed products that discolor their skin.
As a board-certified dermatologist who has worked with thousands of people of color, Pierre-Louis often has seen firsthand just how misinformed professionals can be when treating non-white skin.
“I have patients who are being given certain bleaching creams that are inappropriate for their skin. Or they’re coming to be with only partial treatments for their conditions,” Pierre-Louis tells us.
As Pierre-Louis points out, skin of color presents different issues from lighter skin tones but this fact is often overlooked.
“Skin of color, when injured, will present more with blemishes than it will with redness. I think we have a personal care industry that doesn’t necessarily know that so they go after the blemishes,” she says, “They throw bleaching creams at skin of color or a color corrector.”
Pierre-Louis advocates for more nuanced conversations around skincare and treatments, “The dialogue does not include that there are differences in the presentations of skin of color to other skin tones.”
The merits of skin bleaching and lightening products have been a source of debate for a number of years.
Pierre-Louis tells us that the U.S. is one of the only industrialized nations that stocks hydroquinone, a lightening product typically used for acne scars, on our shelves for prescription-free purchase.
Rep. Ilhan Omar has been lobbying Congress to investigate the multi-billion-dollar skin lightening industry since early 2020 and it has become a source of concern for people of color who feel these products push forward white beauty standards.
Pierre-Louis says dermatologists must be responsible for providing appropriate care to people of color.
Dermatologists have a duty of care to their patients and prescribing inappropriate products contributes to misinformation about the needs of people of color.
“Our personal care industry doesn’t understand skin of color so there are not good resources and products being created to address the needs of people with more melanin,” says Pierre-Louis.
She acknowledges that many dermatologists simply don’t have the experience of dealing with darker skin tones, meaning they aren’t always practiced when it comes to people of color.
But she also stresses that professionals need to start showing more interest in the needs of people of color and educating themselves around this topic, even if most of their patients are of caucasian descent.
Pierre-Louis tells us that, “It was very frustrating to have patients come in one after another having been prescribed bleaching creams or even picking it up over the counter.”
The prevalence of this concern pushed her to be more inclusive in her own practice by focusing on providing people of color with targeted treatments that won’t discolor or damage their skin.
This means no unsuitable lasers or bleaching products. Pierre-Louis also created a multi-ethnic skincare line that's safe for skin of color.
Her dermatology work is not only inclusive; it’s life-enhancing. She strives to correct some of the harmful treatments carried out on people of color for everything from acne to eczema that leaves their skin disfigured, scarred, or discolored.
A more inclusive skincare industry can also provide life-saving care for people of color.
These are not mere cosmetic issues. When it comes to skin cancer, medical professionals and skincare experts are failing to provide key information to people of color.
Melanoma often goes misdiagnosed or is diagnosed in very late stages in people of color.
“Skin of color doesn’t typically develop skin cancer because there is a natural protection from melanin,” Pierre-Louis says, “However, we know of a very rare variant of melanoma called the acral lentiginous melanoma that can start on the palms and soles which tend to have less pigment.”
She uses the example of Bob Marley who died of melanoma but went without a diagnosis during a crucial stage where treatment could have saved his life.
But Pierre-Louis stresses that you don’t have to be biracial, as Marley was, and people of color should be highly aware of their risk as should their doctors.
“I teach [people of color] the same things I teach white patients,” she says, “If you have a legion that’s new, growing, pigmented get it checked out. Take photos of it, document it, share it with your doctor but don’t just sit on it because it could be something.”
Making skincare more accessible is another vital step in providing more inclusive care.
Pierre-Louis offers virtual appointments through her telehealth platform and is licensed to provide dermatological care in 13 states. This is part of her goal to remove some of the barriers people face in accessing care, particularly during the pandemic.
“I truly believe technology can be very powerful,” she says, “It can help level the playing field of access.”
She has also begun implementing Miiskin, an AI-enabled app that allows patients to conduct skin self-exams at home. Patients can document their skin concerns by taking images and connecting with a dermatologist if they notice any unusual growths or moles.
Pierre-Louis says the app is an effective way to, “use technology to expedite intervention.”
The service creates more of a dialogue between patients and doctors, and between patients and their own health, between annual visits which can be crucial in offering effective care.
The hope is that patients can feel more at ease that they will be able to access treatment should they need to.
“We can get them in and have that early intervention,” says Pierre-Louis, “Early intervention after early detection saves lives.”
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Alice Kelly is a writer living in Brooklyn, New York. Catch her covering all things social justice, news, and entertainment.