Investigating demographic differences in women's dermatologic concerns: a large urban cohort study

Few studies have comprehensively assessed dermatologic conditions in women, particularly among different racial and ethnic groups.

This study characterizes common dermatologic diagnoses in adult women (acne), emphasizing conditions disproportionately affecting women of color (WOC) (hidradenitis suppurativa [HS], hypertrophic scars, and scarring and nonscarring alopecia).

This retrospective cohort study analyzed data from Northwestern Medicine's Enterprise Data Warehouse, covering 637,124 patient visits from 2018 to 2021. The dataset included 212,223 unique patients, with 398,431 visits by women. Patient demographics (age, race, and ethnicity) and clinical data (diagnoses, treatments) were analyzed using logistic and linear regression.

Women accounted for 62.5% of dermatologic visits. Women were significantly more likely than men to present with acne, HS, and scarring and nonscarring alopecia. White women represented 77.4% of women, while WOC (Black, Asian, and Hispanic) comprised 16.3%. Acne was the most common diagnosis among women under 30. WOC were younger on average (44.6 years) compared with white patients (50.9 years) and had higher odds of alopecia, hypertrophic scars, acne, and HS. Cosmetic procedures were less frequent among WOC.

Findings may have limited generalizability due to being conducted within a single medical system.

Women, and specifically WOC, are disproportionately impacted by many common dermatologic conditions. These conditions have significant morbidity, which is heightened by complications like hyperpigmentation and scarring in the skin of the color population. Accurate and timely diagnosis is necessary to improve women's dermatology outcomes.