Close Up With Martina M. Cartwright, PhD

By 2042, more than half of the US population will have darker skin tones. People with deeply pigmented skin already comprise the majority in California, New Mexico, and Texas and will soon make up the majority in Arizona, Nevada, Georgia, New York, and Florida, according to the Skin of Color Society.

Despite these numbers, little has been known about the psychosocial burden of skin disease and experiences with dermatologists and aestheticians among people with darker skin types. Martina M. Cartwright, PhD, the director of Continuing Professional Education in the School of Nutritional Sciences and Wellness at the University of Arizona in Tucson, and colleagues set out to take a deeper dive into the lived experiences of more than 500 people with darker skin types.

Their findings appear in the October 2023 issue of the Journal of Drugs and Dermatology.¹ Dr. Cartwright spoke with Practical Dermatology^© magazine about the new findings and their potential implications for care.

Why is this topic important to study?

Few studies have addressed bothersome skin conditions in people with darker skin tones. These individuals experience common skin conditions differently than Caucasian or lighter-skinned individuals as many skin care products are designed and/or primarily tested in lighter-skinned individuals and may cause side effects in those with deeper skin tones. To our knowledge, this is the first large-scale consumer survey to seek answers about the most common skincare concerns and how they affect people with darker skin tones’ mental health and perceptions about available products/dermatologic care.

Describe your research and your findings.

We undertook an open survey to understand the most common bothersome skin conditions among people with darker skin types. Of 501 people surveyed, most respondents were women (94.2%) and African American (76.7%) and said that bothersome skin conditions were moderately to extremely bothersome. More than half said their conditions adversely affected their mental health. The degree of the impact of skin conditions on mental health was surprising. Dyspigmentation, acne, and ingrown hairs were the most common conditions. We asked additional questions of those who said acne, dark spots, or atopic dermatitis (AD) were their most bothersome skin conditions. In those with acne or dark spots, more than half edited social media pictures, and two-thirds had received negative comments from others. Fully 57.6% of people with AD said that the skin condition prevented their participation in social activities. It was noted in the survey that consumers lack confidence in dermatologists’ or aestheticians’ experience in treating darker skin types, suggesting these consumers may be hesitant to seek out care for bothersome skin conditions. Close to 93% of survey respondents did not feel that most dermatologists or aestheticians are trained to treat people with darker skin, and 83% thought Caucasian/light-skinned individuals have better skin care product options.

What is the next step?

We as dermatology professionals, whether researchers, clinicians, product developers, and/or industry professionals, need to do more to address the lack of confidence among people with darker skin tones. This means offering dermatology professionals more education about skin conditions within this demographic and learning how different products affect darker skin types. We hope these survey results will spur interest in understanding the unmet needs among consumers and bring attention to the relationship between visible skin disease, psychological burden, and beliefs about dermatologic care. Further, skincare products tailored to people with darker skin tones need to be expanded. Our plans are to publish the results from a cohort of men with darker skin types and to explore other subgroups such as age and ethnicity.

1. Cartwright MM, Kamen T, Desai SR. The psychosocial burden of skin disease and dermatology care insights among skin of color consumers. J Drugs Dermatol. 2023;22(10):1027-1033.