Alisha M. Bridges still vividly remembers a doctor appointment when she was in her early 20s. "I was so frustrated with nothing working for my psoriasis that I broke down and started crying."
Her provider's response? "She did not give me much compassion or empathy. … That definitely was a moment where I did not feel understood," says Bridges, who is now 35 and a vocal advocate for other people with psoriasis.
Going to a doctor who treats psoriasis isn't always enough to get the outcome you want. Someone who's a different race or ethnicity from you may not know the right way to diagnose and treat your psoriasis.
Bridges discovered this early in her treatment journey. "People in the medical industry weren't familiar with how psoriasis presented in people of color," she says. "In the textbook, they would say that psoriasis is pink to reddish. But for those of us who are brown or Black, our psoriasis can present as purple or pink, a deep dark red, or even brown."
That kind of misunderstanding may be why it often takes longer for Black and Hispanic people with psoriasis to get the right diagnosis and find a treatment that works for them.
The Benefits of Culturally Competent Care
Your doctor shouldn't just be able to recognize psoriasis on your skin. They also need to understand your beliefs and values, and to honor them when treating you. This is called culturally competent care or cultural humility. It helps to create a more immediate connection between you and your doctor.
"One of the main advantages of seeing a dermatologist of the same race or ethnicity is an inherent degree of trust in the patient-doctor relationship," says Tiffany Mayo, MD, an associate professor of dermatology at the University of Alabama at Birmingham.
A doctor of the same race or ethnicity as you already has a sense of your concerns and treatment goals, and can address them when managing your psoriasis, says Mayo, who is also the department vice chair of diversity, equity, and inclusion at the university. Research finds that people have a better experience when they see a doctor who looks more like them.
How to Find a Doctor Who Gets You
While you may want to see a dermatologist of the same race or ethnicity, it may take some searching to find one. Only 3% of practicing dermatologists in the United States are Black and 4% are Hispanic, even though these two groups make up nearly 30% of the population.
One place to look is the Skin of Color Society website. This organization includes not only dermatologists of color, but also those who are interested in treating patients of different racial and ethnic groups. The American Academy of Dermatology is another good resource. You can search its directory for dermatologists in your area by entering your ZIP code.
Even with a doctor who looks like you, getting culturally competent care isn't a given. "I remember a couple of years ago going to a Black female doctor thinking that I would find solutions," Bridges says. "Even she wasn't necessarily knowledgeable in how psoriasis presented in people of color."
More important is the doctor's training and experience. Have they learned how to diagnose psoriasis in different skin tones? Do they treat other patients who look like you? A dermatologist who does research and is involved in clinical trials on psoriasis may have more experience than someone who devotes much of their practice to cosmetic treatments, Bridges says.
Other Ways to Find Support
Your doctor isn't the only person who can help you manage psoriasis. You can also turn to other people with this condition for advice. A good way to connect with them is through a psoriasis support group.
These groups are an accepting place to talk about your feelings. You can also learn how others who have psoriasis manage their condition and how different treatments have worked for them. They may be able to point you to other resources as well, including doctors and therapists.
Joining a group also helps to prevent the isolation that can come with a visible disease like psoriasis. "That really helped give me the confidence to live with this condition instead of suffering from it, because it let me know that there were other people going through the same thing," Bridges says.
To find a support group, ask your doctor if they can recommend any in your area. You may also be able to find listings for in-person groups on social media.
The National Psoriasis Foundation website is a good resource for finding online support groups. The foundation also offers a matching service that connects you with someone who has psoriasis for one-on-one contact through phone calls, emails, or text messages.
Advocacy events are other places to find your psoriasis community. The Psoriasis Foundation hosts conferences, walks, runs, and cycling fundraisers all over the country. These events are a great way to connect with people in your area, according to Bridges.
Become a Self-Advocate
Remember that no one is a more important member of your psoriasis treatment team than you. Only you can push to get the care you want – and deserve. "I always tell patients, especially those of color, to learn how to advocate for yourself," Bridges says.
Speaking up will ensure that you get access to the treatments that work for you: the ones that clear your skin and give you back your quality of life. If your doctor doesn't listen to you or understand your concerns, look for someone else who will.
Photo Credit: gahsoon / Getty Images
Alisha M. Bridges, Atlanta.
Tiffany Mayo, MD, associate professor of dermatology, University of Alabama, Birmingham.
American Academy of Dermatology: "Find a Dermatologist."
Dermatology: "Barriers to Diversity and Academic Promotion in Dermatology: Recommendations Moving Forward."
Dermatology and Therapy: "Unmet Need in People with Psoriasis and Skin of Color in Canada and the United States."
JAMA Network Open: "Association of Racial/Ethnic and Gender Concordance Between Patients and Physicians with Patient Experience Ratings."
National Psoriasis Foundation: "Life with Psoriasis."