Why People of Color Have Greater Odds of Atopic Dermatitis and What to Do About It

Epidemic studies show that Black and Hispanic children have greater odds of persistent atopic dermatitis (AD) than non-Hispanic White children. Not only that, but a 1997 – 2017 US population-based household survey found the hospitalization of AD was linked to non-White children and those receiving Medicaid.

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, presented the session, “Bridging Gaps: Pediatric Atopic Dermatitis in Diverse Skin Tones.” During her talk, she explained that darker skin tones itself does not increase the odds of AD—it is more so race/ethnicity leads to racism, which leads to socioeconomic status, environment, and access to healthcare.

“All of those things can impact atopic dermatitis risk from the prevalence, incidence, severity, persistence,” Heath said.

For instance, she said that if a parent cannot take off work to take their child to the doctor’s office and get their allergies under control, this can impact AD.

“You get stuck in the cycle of just having your atopic [dermatitis] and not being able close the gap, bridge the gap on being able to get the medication,” she added.

Although no pill or injection exists to address social drivers of health, dermatologists can take several actions to close this treatment gap, such as increased access to telehealth support, education, and community clinics. Other areas that can be improved to bridge this gap include economic stability, health care and quality, social and community context, neighborhood and built environment, access to healthy foods, neighborhood safety, housing stability, income level, education quality, and transportation availability.

Heath suggested ways to bridge the gap in your office actively, such as incorporating come anytime hours, validating the mother’s struggle, connecting with extended family, giving a direct office number, and make a note on the calendar of when they should be coming back, and if they do not show, call. She also advised dermatologists to encourage families to bring all children, even if they booked 1 appointment, and to mingle with other departments and discover new resources such as transportation.

Heath also recommends starting with milder treatments, telling patients to return in a month and continuing with more advanced treatments. Dermatologists should also do the heavy lifting in educating patients about medication health literacy. If they hear “my medicine ran out” or my medicine “didn’t work,” they should ask follow-up questions.

Dermatologists could recommend that patients bring the medicine to the appointment or ask for the estimated size of the medication tube to see if their patient might need a refill. They should also count the number of expected strips and tell their patient something like, “If you don’t get 3, please let me know.”

Also, Heath added that dermatologists should be aware that medications may come from a different pharmacy. They should advise their patients to answer unknown calls for about 4 -5 days, and an unknown pharmacy will call about a prescription.

“How many times have people come back for a follow up visit after you did all the counseling about the medication you got them to buy, you're going to put them on about logic…and then [when] they come back, they're like, ‘Oh, I didn't get it,’” Heath said.

Often, when Heath investigates this, the medication was approved, but the specialty pharmacy could not get the medication to the patient since they never confirmed their address.

“That has happened a number of times,” she said.

References

Heath, C. Bridging Gaps: Pediatric Atopic Dermatitis in Diverse Skin Tones. Presented at Society of Dermatology Physician Assistants on Thursday, June 26, 2025.