6 Things That Should Never Happen At The Derm If You Have Dark Skin

Design by Abbie Black.
We know, we know, if you hear the r-word (that'd be 'resolution') again this month, you're going to scream. But we're going to ask you to add one more thing to your to-do list in order to make 2017 the best skin year of your life: Make a dermatologist appointment.

Visiting the derm can be intimidating for many women, but for women of color, the thought can be especially anxiety-provoking. Questions and concerns about the doctor's experience and knowledge in treating deeper skin tones can cause most to skip the appointment all together.

And those fears aren't unfounded. A recent study conducted by doctors in the Department of Dermatology and Medicine at the University of Alabama Birmingham found that 47% of dermatologists and dermatology residents reported that “their medical training (medical school and/or residency) was inadequate in training them on skin conditions in Black [people],” with many openly admitting that they needed greater exposure to diverse patients and training materials to help them better assess potentially serious and deadly skin concerns.

But despite that alarming statistic, you should still visit the dermatologist if you’re a person of color; you just need to do your research. To help you navigate your first appointment, or shop around for the doctor you feel most comfortable entrusting your skin to, we’ve enlisted the help of several experts, all of whom have plenty of experience working with deeper skin tones, to share the six things that should never happen during your session. Ahead, the red flags to be on the lookout for.
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Design by Abbie Black.
Red Flag #1: You're Not Asked To Go Into Detail About Your Past Medical History
It would be strange if your new primary care physician went through the first appointment without asking about your medical history — and it should give you pause if your derm doesn't, either.

They should go through everything from the medications you’re currently taking to any past skin or serious health conditions you might have had. The more questions asked during your initial visit, the better.

Not only is it important to speak about your dermatologist about your medical history, it's also imperative to share the specifics of your ethnicity and heritage, such as African-American, Latina, Caribbean. This type of specificity can provide helpful insight for your doctor to better treat and examine your skin.
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Red Flag #2: Being Told All Skin Is The Same
While all skin is the same on a cellular level, those with deeper skin tones often experience a unique set of challenges, such as hyperpigmentation and overactive sebaceous glands. So if your doctor says that all skin has the same concerns or tries to downplay the differences across various skin tones, it probably means your doctor is either inexperienced in treating your skin or does not feel comfortable treating it,” says dermatologist Dina Strachan, MD. “If you don’t feel confident about your doctor’s decision, it’s time to seek a new doctor who’s better equipped to better handle your skin’s needs,” she explains.
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Red Flag #3: The Appointment Doesn't Include A Full Body Check (Especially Your Feet and Hands)
Melanoma, the most serious type of skin cancer, often manifests in different places and ways among people of color. Fran Cook-Bolden, MD, a dermatologist with extensive experience working with deeper skin tones, is adamant that a full body check is a must during the first appointment. “This type of exam​ specifically looks for abnormal and possibly precancerous moles. Although skin cancer is much more common in lighter skin tones, the incidence of skin cancer is on the rise in everyone, including those with darker skin,” she explains.

Dermatologist Carlos A. Charles, MD, founder of Derma Di Colore, a dermatology practice specializing in meeting the needs of all skin tones, says, “The doctor should examine the palms of your hands and soles of your feet during your visit, as these are the areas where melanoma, the most serious form of skin cancer, is more likely to develop in men and women with darker skin tones.”
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Red Flag #4: The Derm Skips Over Your Scars
Hyperpigmentation results when melanin is overproduced in certain areas on the skin, causing spots that look darker than your natural skin tone. It's one of the top reasons why people of color visit the dermatologist, according to physician Barbara Sturm, MD, co-founder of luxury skin-care line Dr. Barbara Sturm for Darker Skin Tones. So if the doctor doesn’t ask to see and fully evaluate your existing scars, which may be the result of acne, product irritation, sun exposure or a wound, that’s a huge red flag. Your current scars are a good indicator of your skin’s likelihood to hyperpigment and form future scars, which is exactly what you want to avoid.
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Red Flag #5: There Is No SPF Talk
One of the biggest, and most dangerous, skin misconceptions about people of color is that their darker skin is immune to skin cancer, which of course is completely false.

Wearing a daily SPF is one of the most important steps in a healthy skin-care regimen for all skin tones. If your dermatologist doesn’t bring up the importance of sunscreen, search for a new one, stat.

When Katonya Breaux launched UNSUN Cosmetics earlier this year, her goal was to educate. “Sun safety is a concern that all people should have. The melanin in our skin only determines the amount of time we are protected from the sun and the sun does not discriminate against shades or complexions,” she says. The brand’s mineral-based tinted sunscreen, which has an SPF of 30, was designed to adequately protect deeper skin tones from both potentially harmful UVA and UVB rays.

If you consider that women aged 49 and under have a higher probability of developing melanoma than any other cancer, except breast and thyroid cancers, and that the estimated five-year melanoma survival rate for those with Black skin is only 70%, versus 93% for white, you should be running to the dermatologist's office if you're a woman of color to have your skin checked out.
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Design by Abbie Black.
Red Flag #6: Your Derm's Proposed Treatment Plan Is Super-Aggressive
Dr. Charles advises patients with darker skin tones to be wary of physicians that are too aggressive during the first appointment. “It's a red flag if the physician seems to be over-promising or aiming for quick fixes to long-term issues. Deep chemical peels and lasers that result in extensive resurfacing can lead to unwanted and adverse results, such as permanent hyperpigmentation and scarring,” he warns. "The physician's approach in treating darker skin should be measured, with the goal being slow and steady long-term results.”

However, he says, people with deeper skin can certainly undergo lasers treatments and chemical peels, and in fact, he often suggests them for many of his clients. But he strongly advises that patients make sure their dermatologist is fully knowledgeable about how and when these treatments should be done to avoid scarring.
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