International Expert Consensus on Knowledge Gaps in Care for Dermatologic Disorders in Skin of Color

Patients with skin of color (SOC) face unique dermatologic challenges that are often underrepresented in research and in dermatological education, creating critical gaps in care. We aimed to identify and explore key gaps in research and clinical management for SOC across four domains: skin diseases, hair disorders, photoprotection, and aesthetic procedures. An international panel reviewed articles retrieved from PubMed using the search terms "skin of color" or "skin of colour" in titles and abstracts from September 2019 to September 2024. Inflammatory skin diseases, including acne, atopic dermatitis, psoriasis, and rosacea, are common in SOC subjects, necessitating tailored diagnostic and therapeutic approaches due to unique clinical presentations and specific challenges such as post-inflammatory hyperpigmentation and erythema detection. Pigmentary disorders such as melasma and acne-induced hyperpigmentation significantly impact quality of life in SOC, requiring cautious treatment to avoid exacerbation, while the unregulated use of skin bleaching agents containing high-potency corticosteroids can pose serious health risks. Skin cancer in SOC often presents at advanced stages with poorer outcomes due to lower awareness and unique clinical manifestations, resulting in delayed diagnosis. Hair disorders in SOC populations require tailored diagnostic and therapeutic approaches due to unique hair properties. Gaps in photoprotection education on SOC exacerbate pigmentary disorders and other dermatologic conditions, with limited research on effective sunscreens for this population. In aesthetic dermatology, misconceptions and knowledge gaps regarding the prevention of complications hinder access to safe and effective procedures for SOC subjects, compounded by inadequate diversity in clinical trials. Inclusive research, improved diagnostic accuracy, and customized procedures are needed to ensure equitable dermatologic care.