PracticalDermatology

How would you characterize the current moment regarding the treatment and research of skin of color?

“In my role as a researcher in this area of study and as the current President of the Skin of Color Society, I can say that we still have a long way to go,” says Dr. McMichael. “Skin of color has really just become a hot area in the last 10-15 years. Prior to that, there were only a few researchers looking into how to understand diseases in this population.” That said, Dr. McMichael observes that there have been great strides in some areas, such as approaching skin of color in the treatment of common diseases, like acne and eczema. Additionally, she says, “There are data that show the disease states that are of most concern in skin of color patients. There are also now a number of studies looking at cosmetic treatments in patients of color: What is safe, potential side effects, and preferences,” she explains. “We have started to lay out ways to study scalp and hair disease in patients with skin of color, as well,” Dr. McMichael adds.

What would you like to see happen (or change) in the next five years within the spectrum of skin of color?

“In the next five years, I would like to see all dermatology residency programs with a full curriculum on the topic of skin of color diseases and treatments,” Dr. McMichael says. “Currently, our residents have sporadic training in this area based on current faculty and patient mix, but I believe this topic is too important to leave training to chance. I would also like to see movement to making sure that all clinical trials for common skin disorders have a good share of skin of color patients.”

Can you discuss some of the challenges, responsibilities, and opportunities as the chair of a major dermatology department and how those project out to broader evolution of the specialty?

“Challenges in my chair role include managing access to care for all the patients wishing to see us. Access is a major problem in dermatology nationally, and we have not put enough resources into determining the work force needs for our specialty or how to work with primary care givers on protocols for minor skin conditions,” says Dr. McMichael.

In the broader dermatology spectrum, Dr. McMichael emphasizes the importance of education. “We have a responsibility to our patients to deliver quality of care and timely care, but we need to educate our patients better on what is real, scientifically sound medical care versus what is fad or pseudoscience,” she says. “So many of our patients are too frightened by potential side effects of medications to treat their skin disease appropriately, and many others are inappropriately taking unsafe over-the-counter supplements in an attempt to treat skin disease naturally.” One way to make a difference in the arenas of patient education and access may be in teledermatology, according to Dr. McMichael. “Most states do not have laws on the books yet about compensation in this area, but a few departments are leading the way in this exciting era of technology,” she says. “We also need to better utilize our Academy representatives and our governmental representatives to help us achieve all our specialty goals in government.”

Finally, she notes, “As chair, I also feel a deep obligation to get to medical students early in medical school, not only to make sure that we have quality students going into dermatology, but also to educate all young physician trainees about the basics of our specialty.” n