In the latest episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, produced by HCPLive and hosted by Skin of Color Savvy (SOCS) leaders, host Elizabeth A. Kiracofe, MD, a board-certified dermatologist and founder of Airia Comprehensive Dermatology, led a discussion on patient empowerment, shared decision-making, and advancing equitable dermatologic care for patients with skin of color.
Joining her were Avery LaChance, MD, MPH, a dermatologist at Brigham and Women’s Hospital and director of multiple specialty clinics focused on autoimmune and inflammatory skin disease, and Barry Gardner, a biologic coordinator and medical assistant with LARK Dermatology who is currently completing his path toward becoming a physician assistant.
The conversation centered on the growing influence of patients in shaping their own care and how clinicians can better partner with them to improve outcomes. Kiracofe framed patient power as a shift away from a physician-directed model of care toward one in which patients actively participate in treatment decisions. Throughout the episode, the speakers emphasized that successful dermatologic care depends not only on clinical expertise but also on trust, education, and meaningful communication.
LaChance noted that today’s patients have unprecedented access to medical information, making treatment discussions more collaborative than ever before. She described patient power as the combination of personal beliefs, cultural values, education, and conversations with healthcare professionals that ultimately shape healthcare decisions. However, she stressed that these conversations are particularly important for patients with skin of color, many of whom may carry a historical mistrust of the healthcare system stemming from past inequities, biases, and underrepresentation in research.1
Gardner echoed the importance of trust and education, drawing from his experience working directly with patients. He explained that many patients with darker skin tones arrive at specialty dermatology clinics after multiple misdiagnoses or unsuccessful treatment experiences. For him, empowering patients begins with ensuring they understand their diagnosis, available treatment options, and the evidence supporting those therapies. He highlighted the value of accessible educational materials, clear communication, and creating opportunities for patients to ask questions even after appointments have ended.
A major theme throughout the episode was shared decision-making. LaChance described the process as presenting patients with appropriate treatment options while allowing their goals, concerns, and preferences to guide the ultimate plan. Rather than directing patients toward a single choice, she advocated for helping patients understand the spectrum of available therapies and tailoring recommendations based on individual priorities, whether that involves speed of improvement, convenience, safety considerations, or treatment experience.
The discussion also addressed the importance of representation in dermatology education, clinical practice, and research. LaChance emphasized that clinicians must be trained to recognize how skin diseases present across a wide range of skin tones and avoid relying solely on textbook descriptions that often focus on lighter skin. She also discussed the need for more diverse participation in clinical trials and the importance of thoughtfully addressing concerns that patients with skin of color may have about research participation.
Another key topic was setting realistic expectations for treatment outcomes. Both Kiracofe and LaChance highlighted the significance of post-inflammatory hyperpigmentation in patients with skin of color, noting that lingering discoloration can often be more distressing to patients than active disease itself.2 They stressed the importance of discussing these concerns openly and helping patients understand the timeline for improvement.
In closing, the speakers encouraged clinicians to prioritize listening, self-education, and humility when caring for diverse patient populations. They emphasized that improving equity in dermatology requires effort from the entire healthcare team, from physicians and advanced practice providers to medical assistants and biologic coordinators, and that meaningful progress begins with ensuring every patient feels heard, respected, and empowered to participate in their care.
To learn more about SOCS’s programs and initiatives, visit Skin of Color Society.
Editor’s note: This episode was summarized with the help of AI tools.
Disclosures: Kiracofe, LaChance, and Gardner had no relevant disclosures of note.
References
Narla S, Heath CR, Alexis A, et al. Racial disparities in dermatology. Arch Dermatol Res. 2023 Jul;315(5):1215-1223. doi: 10.1007/s00403-022-02507-z. Epub 2022 Dec 12. PMID: 36508020; PMCID: PMC9743121.
Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010 Jul;3(7):20-31. PMID: 20725554; PMCID: PMC2921758.
