When Black dermatologists make up one percent of all dermatologists nationwide, it’s impossible to look after every Black patient in the country. “In Ontario alone, the ratio of dermatologists is one dermatologist for every 53,000 Ontarians.” There are not enough dermatologists in Canada, period. “It’s bigger than a lack of Black dermatologists,” says Dr. Beach says there are more factors than that to look at, specifically in the educational system. Miller-Monthrope, a dermatologist at the Women’s College Hospital in Toronto, mentioned that recently one has retired, and another has moved to the U.S. Therefore, the difficulty in assessing presentation should rely on the patient and families’ reports to avoid dismissing concerns and thus undertreating.Īccording to the Royal College of Physicians and Surgeons of Canada database (RCPSC), there are seven Black dermatologists in all of Canada. In addition, postinflammatory pigment alteration can present as darker or lighter spots in darker skin. The article notes that skin issues such as psoriasis, seborrheic dermatitis, and acne vulgaris are visibly different in presentation with darker skin types. Such treatments may result in adverse effects such as post-inflammatory hyperpigmentation or keloid scarring at a higher rate than in patients with fair skin.” Yvette Miller-Monthrope, “The effect of traditional treatments for common and uncommon dermatoses is also an important consideration in managing patients with skin of colour.

According to The State of Ethnic Dermatology in Canada, a medical letter penned by Canadian dermatologists Dr. Patients with darker skin types need a careful diagnosis. I tested numerous creams, oils, balms,Īnd soaps, and they’ve either given me a reaction or did nothing. Post-inflammatory hyperpigmentation and scarring in darker skin types was not the topic of my countless dermatologist visits. My post-inflammatory skin can get extremely dry, and moisturizing is a daily sport. They look like scars, dead or burnt skin. They steal the spotlight in my photos that end up in my virtual trash can. The hot, dry summer weather doesn’t believe in moisture, and stickiness becomes itchy and uncomfortable.ĭark, bold, and blotchy spots show up in the crevices of my body inner elbows, backs of my knees, chest, neck, thighs, fingers, and more.

The cold, dry winter weather doesn’t hug in the moisture that I desperately need. Winter and summer usually tend to be the worst seasons for my eczema. My eczema flares based on the Canadian seasons. With darker skin, post-inflammatory hyperpigmentation is my reality. Melanated skin produces more stain afterwards, and additional treatment is needed to minimize this, says Dr. It undergoes post-inflammatory hyperpigmentation, and that’s what brings the patient in again, claiming they didn’t get the proper care, Dr. Renée Beach, a dermatologist in North York, Ontario, eczema can be treated, but the skin stains. Every dermatologist didn’t take the time to educate me about my eczema therefore, treatment was an outlandish concept to me.ĭermatologic care must involve educating the patient early on. The stark contrast between doctor and patient made me uneasy, even at a tender age.

There was a tang of white superiority waiting to override the patient’s concerns and prescribe their opinion. As I grew older, I noticed there was more to my eczema than meets the eye.Įvery dermatologist I was referred to had more than a white coat. As a young Black woman, I wondered why God gave me two battles to fight, both that involved my skin and neither of which I could change. Since I was six months old, my skin condition, atopic dermatitis, also known as eczema, was the topic of worry among family, the reason I would cover up with long sleeves and turtlenecks, and a constant reminder that I was different from everyone else. The idea that eczema would always be a part of my life and desperately depended on Black Canadian dermatologists, of which there are few. This time it was a spot I couldn’t reach. A scratch fest would ensue and sometimes a bloody one.Īs I closed my eyes and escaped into the fantasy I needed to believe, another tingle would run through the layers of my skin. Hotter than usual environments and oily foods would also worsen my itch tolerance. I stuck by it every time I got a glance of a triggering image, whether it was tiny holes or scaly surfaces. She would tell me to think of lush green grass, with flowers too pretty to ignore and butterflies dancing with the wind. I would repeat this phrase until I had forgotten that my skin was tingling for a scratch.

The skin deep