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Baby Cologne Raises Concerns in Pediatric Atopic Dermatitis
At SDPA 2025, Candrice Heath, MD, said many clinicians remain unaware of baby perfume traditions that may contribute to persistent symptoms in patients of color.
Numerous studies have shown that Black and Hispanic children have greater odds of persistent atopic dermatitis (AD). At the Society of Dermatology Physician Association (SDPA) summer 2025 meeting on Thursday, June 26th, in Washington, DC, Candrice Heath, MD, an associate professor at Howard University, discussed how darker skin tones itself are not what increases the odds of AD but rather racial systemic issues.
Heath also discussed the concern of baby cologne, products that are rarely tested on people of color. When she asked the crowd how many did not know baby perfume existed before the session, several hands raised. Heath, too, did not know about baby perfume until very recently.
Not long ago, Heath talked to a colleague about cultural practices and pediatric atopic dermatitis. The conversation turned to Hispanic babies receiving routine cologne. Her colleague said something like, “Have you ever counseled your pediatric atopic dermatitis visits about not using baby perfumes?”
“I'm like, no, because I never knew it existed,” Heath said. “Of course, my mind goes to the literature, and it's like, oh my goodness, populations of color are less likely to receive patch testing.”
It dawned on her that some babies in her clinic have been receiving fragrances, substances that may not even be safe due to the limited patch testing in minority groups, and she had not been counseling about that.
“There's always room to learn,” she said. “That's why I really enjoyed learning about people and where they were raised—just find it interesting to layer those things onto what we're seeing, learning, studying, and understanding about skin disease.”
Heath also touched upon dark spot concerns, seen more often in patients with darker skin tones and atopic dermatitis. She highlighted the importance of acknowledging these darker skin pigments are a part of atopic dermatitis and the treatment plan for it.
“Even though the prescription can be the exact same, the patient may leave thinking they were not heard if you did not acknowledge that what you were treating was going to also help with the dark spots,” Heath said. “Now, we know that topical medicines for AD or injectables are not…treating pigmentation. We know we're reducing inflammation—we're reducing the secondary causes of that. But if we don't verbalize that, then that patient may go off, never use the medicine, and they're just out there with untreated AD.”
She also added that hyperpigmentation can occur not only on specific spots but the whole body.
“Some people may actually have what looks like their normal skin tone, or areas that just look a little bit darker than they should, but it's actually active atopic dermatitis,” Heath explained.
She discussed a survey that found 63% of Asians, 50% of Black individuals, and 33.6% of White individuals reported hyperpigmentation. As seen with these statistics, many patients did not discuss their pigmentation changes with their clinicians. Among Black respondents, 53.3% discussed their pigmentation concerns with their doctors, but still about half did not speak up about their worries.
“Pigment concerns really go unspoken, but not unnoticed,” Heath said. “Now we have a data point for that. When they did speak up about pigmentation changes, 1 in 3 [among the] groups felt that their pigmentation concerns were dismissed or unresolved.”
When a patient says something like, “I don’t like these [dark] spots,” Heath told her fellow peers to think to themselves, “This is not dark spots.”
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