Why Representation in Dermatology Still Matters for Black Patients

The appointment starts with a glance in the mirror.

A patch of discoloration that wasn’t there before. A persistent scalp condition. A spot that refuses to heal. Before a patient ever enters an exam room, there is often a quiet hope that the person on the other side of the visit will recognize what they’re seeing and understand the questions that come with it.

In dermatology, that experience intersects with a longstanding conversation about representation.

Black Americans remain significantly underrepresented within the specialty. While Black people make up a much larger share of the U.S. population, workforce studies continue to place Black dermatologists at roughly 3% of practicing dermatologists nationwide. Dermatology remains one of the least racially diverse physician specialties in medicine.

The numbers have been discussed for decades. But for many patients, the conversation is less about percentages than what happens during an appointment — whether symptoms are recognized, whether concerns feel understood, and whether treatment recommendations account for the realities of different skin tones and hair textures.

A Specialty With Persistent Representation Gaps

Across the country, dermatology offices range from large academic medical centers to private practices tucked into suburban shopping centers. Yet the makeup of the specialty has changed slowly.

According to the Health Resources and Services Administration’s 2024 State of the U.S. Health Care Workforce report, the United States had 12,679 professionally active dermatologists in 2022. Applying the widely cited estimate that approximately 3% of dermatologists identify as Black suggests there are only a few hundred Black dermatologists practicing nationwide.

The contrast is notable even within medicine. The Association of American Medical Colleges reported that Black physicians represented 5.3% of active U.S. physicians in 2024. Dermatology falls below that already limited level of representation.

Researchers have documented the disparity for years. A frequently cited analysis in the Journal of the American Academy of Dermatology reported that Black dermatologists accounted for about 3% of the specialty, while Black Americans represented approximately 12.8% of the U.S. population at the time of publication.

More recent studies suggest progress has been slow. A 2023 analysis of dermatology resident training trends found that Black trainee representation remained largely unchanged across a 15-year period and continued to lag behind many other medical specialties.

Beyond the Numbers

In classrooms and training programs, conversations about representation often begin with educational materials.

Skin conditions can present differently across skin tones, yet researchers have found that darker skin tones have historically appeared less frequently in the images used to train future physicians. A 2021 analysis published in the International Journal of Women’s Dermatology found that images of skin of color were underrepresented in commonly used educational resources for medical students.

For physicians, experience and training remain essential regardless of background. Dermatologists emphasize that expertise in treating patients with darker skin tones is developed through education, clinical exposure, and continued learning.

Still, educators and researchers point to a connection between workforce diversity and educational diversity. A wider range of perspectives can influence research priorities, clinical discussions, and the populations that receive attention within the field.

Patient Experience and Trust

For patients, those conversations often become tangible in the exam room.

Research does not suggest that shared racial identity alone determines the quality of care. But studies have found that many patients value feeling understood by their healthcare providers and having confidence that their concerns will be taken seriously.

A 2019 study examining Black patients’ perceptions of dermatology care found that participants reported greater satisfaction in a skin-of-color clinic than in previous dermatology experiences. While some preferred physicians who shared their racial background, many identified cultural understanding and clinical expertise as equally important.

The concerns discussed in those visits can vary widely. Hair and scalp disorders, pigmentary conditions, inflammatory skin diseases, and skin cancer awareness all require careful evaluation, often with consideration for how symptoms present across different skin tones.

“The skin is a window to the rest of your health,” dermatologist and educator Dr. Ginette Okoye told the Associated Press in 2023.

Access Remains Uneven

Access remains another layer of the conversation.

Research has found that Black and Hispanic patients are less likely than non-Hispanic White patients to receive outpatient dermatology care. The reasons extend beyond any single explanation and can include insurance coverage, specialist availability, geography, referral patterns, transportation, and broader healthcare utilization trends.

Workforce studies have also identified differences in where physicians practice. A 2023 analysis found that self-identified Black dermatologists were more likely to practice in the South than their non-Black counterparts.

For many patients, geography can shape available choices long before an appointment is scheduled. In some communities, finding a Black dermatologist may be possible. In others, the nearest option may be hours away.

Building the Pipeline

Efforts to expand representation increasingly focus on mentorship and exposure.

Many students do not encounter dermatology until later in their medical training, and some have limited access to mentors working in the specialty. Organizations across the field have developed programs designed to address that gap.

The American Academy of Dermatology’s Pathways programs connect students with practicing dermatologists through mentorship opportunities and educational experiences. The Skin of Color Society and the National Medical Association’s dermatology section have also developed initiatives aimed at supporting students, residents, and early-career physicians interested in the specialty.

Leaders within dermatology often describe mentorship as one part of a larger effort that includes recruitment, educational reform, research opportunities, and institutional support.

Looking Ahead

The conversation around representation in dermatology has expanded beyond workforce demographics alone.

Questions about education, access, patient experience, and clinical preparation now sit alongside discussions about who enters the specialty. The statistics remain striking, but their impact is often felt in quieter ways.

A patient searching for answers. A medical student looking for a mentor. A physician learning to recognize how a condition appears across a broader range of skin tones.

Those moments unfold every day in clinics, classrooms, and community health settings across the country. Long after workforce reports are published, they continue to shape how care is experienced and who feels reflected within it.

RELATED SOURCES & FURTHER READING

• Health Resources and Services Administration (HRSA), State of the U.S. Health Care Workforce 2024
https://bhw.hrsa.gov/data-research/projecting-health-workforce-supply-demand

• Association of American Medical Colleges (AAMC), U.S. Physician Workforce Data Dashboard
https://www.aamc.org/data-reports/report/us-physician-workforce-data-dashboard

• Perlman KL et al., “Skin of Color Lacks Representation in Medical Student Resources: A Cross-Sectional Study,” International Journal of Women’s Dermatology (2021)
https://pubmed.ncbi.nlm.nih.gov/33937492/

• Skin of Color Society
https://skinofcolorsociety.org

• American Academy of Dermatology Pathways Programs
https://www.aad.org/member/career/pathways

• National Medical Association – Dermatology Section
https://www.nmanet.org

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