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Racial bias and barriers to eczema treatment

Updated: Jul 17, 2023

Eczema around the World SkinAkin

Atopic Eczema is the most common skin condition in the world, affecting adults and children globally. Whilst diagnostic and treatment protocols are mostly standardised, many people with eczema face major barriers to accessing effective care. These barriers include racial bias, misdiagnosis and societal stigma.

Unfortunately, these obstacles can often cause more pain and frustration than the eczema itself.

Let's look at some of these in more detail:

Racial Bias: Racial bias in medicine, refers to the systemic and individual biases that exist in healthcare practices and research. These biases lead to disparities in the quality of care and health outcomes for people of different races and ethnicities.

Eczema on black skin or brown skin, can often be misdiagnosed due to these biases. This is often compounded in dermatology training and education. A 2018 study analysed more than 4,000 images in four major US medical textbooks, and found that only 4.5% of images showed dark skin. Dermatology is in fact the second least diverse speciality in medicine.

This type of racial bias is not only found in the field of dermatology, but it is perhaps more amplified, given the lack of diversity. In addition, the very experts who are diagnosing and treating the condition, are being taught diagnostic techniques largely based on text book models of how it presents on white skin.

Misdiagnosis: Eczema and other skin conditions can have similar symptoms, such as redness, itching, and dryness, which can make it difficult for healthcare providers to differentiate between them. The eczema itch and rash, can often be misdiagnosed as psoriasis or a fungal infection. This is often compounded in black or brown skin because of racial bias. This can lead to incorrect treatment, sometimes making the problem worse. It also leads to great frustration for the patient, due to delays between appointments, trying to find a treatment that helps get things under control.

Stigma: Eczema can lead to social stigma and isolation due to misconceptions about the condition. The discrimination experienced can make it difficult for people to talk openly about their condition, seek treatment, and manage the physical and mental burden effectively. People can feel self-conscious and embarrassed about their appearance. This is perhaps felt even more acutely in the image led digital age, where unrealistic ideals of beauty are no longer within the confines of television, movies, and fashion magazines.

Studies have also shown, that as well as societal pressures on image, advertisements for eczema treatment are also skewed and disproportionately directed toward white people. This has led to disparities in health care access in the U.S., with fewer black people requesting and accessing effective treatment.

Atopic Eczema is a widespread condition that affects people all around the globe, but for many, access to effective healthcare is challenging due to economic and societal pressures. With 1 in 10 people affected by Eczema at some point in their lives, and cases rising globally, there is a need to focus on removing the obstacles to support.

At SkinAkin we are committed to raising awareness of the barriers people face, and widening the discussion on eczema. Every patient deserves effective treatment. We hope for a future where people with eczema are empowered to manage their condition, and can access timely diagnosis and treatment, regardless of location or background.

Have you been impacted by this topic? We'd love to hear your viewpoint, please leave your thoughts in the comments.

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