The Black Medical Students Fighting Racism in Skincare

Finding a skincare routine that works for you is often a matter of trial and error. Whether you battle with dryness, acne or inflammation, all manner of products promise to provide the perfect Instagram glow in no time. But when it comes to treating skin conditions like hyperpigmentation – a common complaint that causes skin to darken and is often found in those with dark skin – most skincare blogs and high street pharmacies are notably lacking in solutions.

London beauty influencer and aesthetician-in-training Alicia Lartey created her own numbered system for categorising post-inflammatory hyperpigmentation (PIH) after being dissatisfied with the information she found online. Her system, which categorises PIH from zero to one that turns skin six shades darker than its usual tone, is specifically designed for people with darker skin.

“The [beauty] industry is really big on pushing vitamin C and glycolic acid [for hyperpigmentation],” Lartey says. “Those two won’t do too much for darker skin, unless you’re a professional because it has to be the correct PH, so you can control how deeply it will penetrate the skin. If you’re at home, you’re more likely to burn yourself.”

But even skincare professionals can be unaware of how to treat hyperpigmentation in dark skin, Lartey notes.

“I think the industry has fed into the idea that using vitamin C for brightness is enough to shift hyperpigmentation, but it isn’t,” she says. “Maybe on white or lighter skin tones, yes, it will help and make quite a big difference. For darker skin, I would say that it shouldn’t be the main focus of your hyperpigmentation treatment.”

The beauty and skincare worlds suffer from a serious lack of diversity. In 2016, 78 percent of adverts for skincare and make-up featured white models, while Black models featured only 8.3 percent of the time. This explains why beauty brands that do focus on people of colour, such as Fenty Beauty, are praised as outliers. In a recent piece for Vogue, Fenmi Futto wrote that Rihanna’s celebrated make-up and skincare range had “changed the state of play in the industry”, due to its commitment to products for every skin colour.

As a third-year biomedical student, Lartey wants to use her knowledge to make the skincare industry easier to navigate for people of all skin tones and types. “My whole skincare journey came with me wanting to just be in control of my skin because I didn't feel confident and I didn’t feel like I was being taken seriously when I was going to the doctors,” she says. “I went out of my way to find what works for my skin tone, or my mum’s skin tone, who is darker than me.”

Hyperpigmentation isn’t the only skincare issue ignored by the beauty industry. In fact, the erasure of darker skin is common in both amateur skincare and professional dermatology – it’s also a form of medical racism. Like Lartey, many other young medical students and professionals are fighting to combat the issue, and ensure that skincare conditions are correctly treated in those with dark skin. Hani Hassan, a 25-year-old doctor based in London, posts YouTube videos that discuss racial bias in medical journals and offers practical skincare tips to those with darker skin. Malone Mukwende, a second-year medical student at St. George’s, University of London, recently published a book on diagnosing skincare conditions in dark skin. He says that medical racism in dermatology can cost lives.

“The case that resonates with me a lot is Victoria Climbié’s because when I look at the case, of course there were loads of different factors involved, however when she presented to hospital, it was a prime opportunity to know that they were signs of abuse,” Mukwende says. “Instead doctors just diagnosed it as scabies and sent her home. It’s so scary to think that something like that can even happen because if doctors had identified it earlier, maybe she would be living today.”

Racism in dermatology impacts patients in other ways, too.

“One thing that’s a common running theme in medicine is that it’s always assumed that white skin is the norm or the reference point and then from there, we work out the abnormalities by going backwards,” Mukwende says. “There are loads of doctors who have the scope to get things wrong because we’re just not taught it altogether. It’s left down to a case of interpretation and experience.”

Lartey agrees, and notes that this can leave Black patients without a proper diagnosis. “When doctors and derms put you through that excess trauma, they’re forgetting the emotional side of it as well,” she says. “Forget the skin damage, there’s a deeper emotional side because you feel very lost and you feel left there to do things by yourself. I feel like that’s why DIY skincare is really big within the Black community.”

Although Mukwende’s work has received praise and recognition from figures including Lupita Nyong’o and @theshaderoom, he says that his research is only the start.

“There’s still a way to go, I definitely don’t feel like I’ve solved everyone’s problems,” Mukwende says. “I am a student and I’m still finding answers myself.”

@nanasbaah