Dr. Adeline is the founder of Brownskinderm and a board-certified dermatologist. She shares with us her journey through medical school and the challenges she’s faced with her own skin.
“In medical school, people didn’t even believe me when I said that I wanted to do dermatology. People would just kind of dismiss me. I would go and talk to different faculty, and they didn’t take the time to explain everything to me. Someone literally sat me down and told me that being a dermatologist wasn’t going to work for me. They told me that minorities don’t make it into competitive specialties. I was told to go into another specialty if I wanted to match. I drew negative feedback just from striving towards my goals. Being doubted can be a lonely experience, but I gave myself a chance. I didn’t dare stand in my own way because everyone already was. I just went ahead and did it, and I wasn’t going to let anyone convince me otherwise.”
Dr. Adeline explains how she experienced some flaws not only within the culture of med school but in the curriculum.
“During the foundational years of medical, you don’t learn much about dermatology so I especially didn’t get training on skin of color. I really feel like this is a missed opportunity for med students. In your 3rd and 4th year, you are mostly doing clinicals. You’re going into hospitals, and you’re putting what you learned in your first two years of medical school into practice. Dermatology could be easily integrated into the diagnostic skills that we work on before we start our 3rd and 4th year. There is nothing extensive or tested on dermatology in medical school. That’s more in residency, but I really think having an introduction to dermatology as foundational knowledge would be very helpful.”
“So given the lack of teaching in dermatology in general, conditions on skin of color are not adequately taught. Likewise, dermatology is one of the least diverse specialties in medicine. Black derms are only 3% of the makeup. And if we’re only 3 percent, we can’t see all the patients of color in the country. That’s not even possible, and it’s not fair to us. The lack of diversity really affects both physicians and patients.”
“Furthermore, this type of challenge is really unnecessary because there are Caucasian colleagues that want to treat skin of color, but they’re not able to get trained. When it comes to getting trained on skin of color, the structural problems and prejudices make it hard for physicians who want to learn about skin of color too. In turn, these structural problems deepen the divide between forward-thinking colleagues like this and patients of color. For example, people will often message me about finding a black dermatologist. But, when I give them a recommendation for a Caucasian dermatologist near them who can treat skin of color, they’ll sometimes message back and say - “Thank you, but I will literally drive 3 hours to see a black derm.”
“This happens because many black patients don’t want to take the chance of having a bad experience. Due to structural inequities and individual prejudices, this has largely been the case. Patients of color are so fed up, and there’s already so much distrust with the medical community in general. Medical schools and institutions need to target this issue because it’s not unique to dermatology. There are structural issues overall with medicine and medical teaching. With that being said, there needs to be curriculum and testing that addresses how conditions present on people with different types of backgrounds and heritages. We should not only be seeing people of color when it comes to learning about sexually transmitted diseases. Things have to change. For that reason, I’m working with colleagues now to try and put an atlas together of what all skin diseases look like on all skin shades.”
Dr, Adeline continues to explain the distance between underprivileged communities and the medical community.
“In our community, we didn’t really go to the doctor for skin issues. For instance, acne wasn’t considered serious, it was just something you grew out of. And when I was growing up, there wasn’t information about acne on my skin color, and I couldn’t even find anything in magazines like Ebony and Essence. I also remember not being able to find skin products for my skin. Therefore, I started brownskinderm to speak on what skin health looks like for people with skin of color. I did this because this type of information is just not as widely accessible. From a research-based perspective, I want to build awareness, challenge stereotypes, and discuss what it means to age or have a skin condition as a black woman. I find this imperative because, once again, black health and wellness are not topics featured in the media.
Dr. Adeline believes this poses a serious risk to black patients
“When it comes to black people and skin cancer, there is a lack of access and education. Because of this, when black people get skin cancer, their prognosis is likely to be more advanced, and they are more likely to die from skin cancer. If black people aren’t getting exposure or access to this type of information, they won’t go and get checked because they are not aware of it. Plus, black people normally get skin cancers on parts of the skin that you can’t see. So, melanin is not all protected, and we still need an SPF of at least 30. Moreover, we should wear sunscreen because of hyperpigmentation. This major skin concern for black people is largely caused by UV radiation.”
She also shares how the lack of medical information for black skin has even affected her personally.
Photocred: Dr. Adeline Kikam
“Another skin concern of black people is acne, but people of color with acne are erased. We kind of suffer in silence. That’s why on Instagram, I’ll show breakouts on my chest and my back, and I’ll show everybody. People find it hard to believe that I have acne while being dermatologist, but I share this with people anyways. I know what it feels like to have nowhere to turn in the midst of a skin condition. In college, I deprived myself of opportunities, and I didn’t participate because the last thing I wanted was people turning around and looking at my face. I would be as silent as a lamb. I remember how I used to work at Forever 21, and I would sell clothes that I felt like I could never wear on my own body to people. I wouldn’t wear V necks or backless things. It’s hard to have acne when everyone is putting the best version of themselves out there. You see this especially now with Instagram. However, I’m seeing more skin positivity. On the other hand, this type of content doesn’t normally include a lot of black influencers. Because there’s a lack of treatment for skin of color, and many patients of color don’t have access to black doctors, it’s hard to be positive online when you have so much frustration and so little resources. “
Dr. Adeline “definitely understand this struggle,” but she says that we must continue to believe in ourselves and value who we are. She says, “Just remember - you cannot hide behind your acne. I’m here to help you treat it, but even if you have acne, continue to give yourself a chance.”