Advancing Dermatology and Health Equity: Insights from the Founders of the Skin of Color Community

Dive into the inspiring journeys of Dr. Eb Henebeng and Dr. Uzo Okoro, dermatologists and co-founders of the Skin of Color Community. Interviewed by VisualDx Student Advisory Board member Idowu Olugbade, Dr. Henebeng and Dr. Okoro share their personal paths to dermatology, their motivations for creating the Skin of Color Community, and their vision for advancing healthcare equity. Their stories highlight the profound impact of personal experiences on professional commitment and offer valuable insights into fostering diversity and inclusion in dermatology.

Tell us a little about yourselves: Where are you from, what is your educational background, and what led you to pursue a career in dermatology?

Dr. Henebeng: My name is EB Henebeng, and I am originally from Providence, RI. I attended Northeastern University in Boston for college. After graduating, I spent two years conducting clinical research on adolescence, preventing risky behaviors, and promoting sexual health. Initially, I intended to pursue child psychiatry in medical school. However, in my third year, I realized that field wasn’t for me.

During the summer between my first and second year of medical school, I researched the quality of life among adolescents living with HIV. Many of them spoke about how skin conditions felt like a scarlet letter. They didn’t want family or friends to know, but rashes made them self-conscious. That experience opened my eyes to the impact dermatology can have, particularly among adolescents, in building their self-esteem and self-worth.

These experiences led to my interest in dermatology. What sustains my interest is the field’s diversity.

As medical providers, we diagnose more than just STIs and skin cancers and have the surgical skills to treat various conditions. The breadth of the field is exciting, and the continuous learning aspect is crucial.

While there are common cases, we must be knowledgeable about rare conditions, like Melkersson-Rosenthal syndrome, because patients come to us seeking that expertise.

Dr. Okoro: I’m Uzo. I think my interested in dermatology began in high school. I had just moved from Kentucky to the Chicago suburbs and developed a rash on my lip. The doctors couldn’t figure out what it was. After the third or fourth visit to different dermatologists, one suggested I see a Black dermatologist, noting he might be better at treating my skin type.

I remember being excited because I had never had a Black doctor before.

When I went to the office, I saw that the front desk staff, the PA, and the dermatologist were all Black. The dermatologist treated me, and the rash eventually went away. The experience motivated me because I started to think about why I had to go to someone else.

In high school, I applied to Brown University’s Program in Liberal Medical Education (PLME), a combined BS/MD program and was accepted. I completed both my undergraduate and medical education at Brown. While I was always interested in dermatology, I had various interests during medical school. Dermatology was always in the back of my mind, but given its competitiveness, I didn’t think I would match. So, I planned to do internal medicine and possibly specialize in gastroenterology. While I was doing my sub-internship in IM, despite enjoying the rotation, I realized that it wasn’t what I wanted to do. I ended up switching my focus to dermatology at the beginning of my fourth year.

Can you share the inspiration behind founding the Skin of Color Community organization? What motivated you to start this non-profit?

Dr. Okoro: One of the things that intrigued me about dermatology was the ability to empower patients and help them recognize when they need to see a specialist. Our specialty involves a lot of patient education. However, I noticed that many patients were not receiving the level of care I would want if I were in their situation.

It wasn’t that they weren’t being treated well, but there were delays in diagnosis, feelings of being misunderstood, or a lack of understanding regarding their hair type, skin type, and other factors. These issues potentially prevented them from making appointments or finding the right dermatologist in their area.

I began to realize there are numerous barriers for patients, especially people of color, particularly Black patients, in accessing dermatologic care. We set out to provide community-centered education, meeting people where they were and considering their level of knowledge. Instead of simply presenting a seminar with slides, we wanted to create a learning environment in a safe, open community space where we could share our knowledge as medical students and the expertise of dermatologists interested in helping underserved communities.

We partnered with a local Black hair salon in Providence, Rhode Island, and held our first event there in December 2019. This in-person event featured music, food, and an environment that wasn’t an academic space or classroom but a familiar and comfortable setting for attendees. Our panel included a YouTube hair guru, the salon owner, and dermatologists from Brown University. Our first event demonstrated the impact we could have, and as we continued to host more events, we noticed people spreading the word to others. This demonstrated the potential impact we could have and how much dermatologists could contribute to these community-centered efforts.

It was a learning experience for all of us involved, and I felt it should continue. We wanted to extend it beyond local in-person events and connect with others through an online virtual platform. We have reached people from many different states in the United States and even internationally, in Europe and South Africa. It’s amazing how many people we have been able to reach with this initiative.

Looking ahead, what are your long-term goals or aspirations for the Skin of Color Community? How do you envision the organization growing or evolving in the coming years?

Dr. Henebeng: Some of our initial long-term goals have come to fruition in ways we didn’t anticipate happening so quickly. We currently have a self-sufficient team. Initially, we thought it would be more like a student group where leaders could take over and keep the programming alive. However, we found that when many people focus on a goal, our timelines might not align. Some people have more time to dedicate, while others have less. This led to a situation where we had many people in their fourth year who were on their way to graduating. Now, we have a more even spread among classes, so first and second years can take on more leadership roles and possibly dedicate more time than busier third and fourth years. Both groups are showing up in the best way they can because they find the work really meaningful and exciting.

One of the things Uzo mentioned is that it can be tough during residency to see the big picture of your impact. Having people in the classes below us, knowing they want to achieve the same things, helps put it into perspective. We’ve learned so much, and we are indebted not only to our community but also to the students who are part of our organization. It’s great to be a source of inspiration for them.

Dr. Okoro: One thing we’re focusing on is developing our website. We have many ideas for making it an educational space where we can share stories and perspectives. We want to recreate that communal feeling we had during in-person events, even though it’s challenging to do so over the screen. We have some great stories that people are excited to share, and I hope this builds more of an online community.

We also want to increase the frequency of our online events and are working on developing chapters in different cities. Our student Skin of Color Community ambassadors can advocate for their local communities and be spokespersons. For example, if there are many questions about a particular topic, they could host an event focused on that. We support the development of local events and programming because we recognize that creating effective community outreach programs is challenging and sustaining them requires even more effort. However, many people are interested in creating these types of community spaces for patient education.

We aim to lower the barriers for community programs, viewing them as vital as research and basic science in medicine. Without these community efforts, we won’t achieve our goals. Moving forward, we’re focusing on securing more funding and collaborating with like-minded individuals and organizations. This includes exploring partnerships with groups already engaged in similar initiatives.

How can individuals and other organizations support the efforts of the Skin of Color Community? Are there specific ways people can get involved or contribute to your mission?

Dr. Henebeng: Individuals and organizations can support us in various ways. They can donate directly through our website, provide suggestions for event topics via surveys, or recommend speakers. We also run an ambassador program with diverse membership, including medical students and other stakeholders, who help spread the word about our events through their networks.

Dr. Okoro: There are many collaboration opportunities with other organizations focused on research and skin of color. By working together, we can create inclusive community spaces, either within their organizations or in partnership with them. This collaborative approach ensures our efforts are aligned and impactful across different sectors of healthcare. We are looking for ways to partner not just with medical schools, but also with physician assistant programs and nursing schools, to broaden our impact and outreach effectively. We are just scratching the surface of what we can do and how we can impact our community.

During the COVID-19 pandemic, we saw a lot of mistrust in the medical system. This mistrust often stems from historical and systemic factors that have disproportionately affected people of color. In dermatology, where visual differences are pronounced, rebuilding trust is paramount.

By recognizing past injustices and actively striving for equitable care, we can work toward restoring and reinforcing trust between healthcare providers and communities of color.

It is all of our responsibilities as physicians to rebuild trust between people of color and the medical institution. This is a cornerstone of efforts within the Skin of Color Community, aimed at fostering understanding and re-establishing trust.

As we consider the future of dermatology, what changes or improvements do you believe are needed to enhance access and advance the field towards achieving health equity, especially for underserved populations?

Dr. Henebeng: Dermatology ranks as the second least diverse specialty. Recent debates within the AAD have highlighted issues related to diversity, equity, and inclusion. Although some resolutions were not adopted, the fact that they were proposed indicates that some people believe underrepresented in medicine (URM) candidates are less eligible than others. Many leaders in the field countered these perceptions, asserting that URM candidates are equally qualified and dedicated. In addition, URM students often work twice as hard and are just as capable, if not more so, than their colleagues.

Some patients avoid seeking care because they don’t see providers who look like them or who they believe will understand them, leading to mistrust. Having Black and Brown dermatologists who resemble marginalized patients is crucial.

Enhancing diversity in dermatology and improving access to care can include reforming medical school admissions to prioritize diversity, starting exposure to medicine earlier in education (such as in high school), and implementing mentorship programs. Community involvement and allyship are also vital.

Dr. Okoro: Systemic changes in healthcare policies and individual efforts by healthcare providers are necessary to achieve health equity. At every level—in your hospital, office, or state—you need to recognize where changes can be made or where we are falling short. We must strive for better outcomes for all patients, as data shows outcomes improve when treated by a diverse physician population.

Health equity means additional care for the underserved without taking anything away from others. It means providing more support to patients who should have received it long ago.

At Skin of Color Community, we aim to educate our patients to become knowledgeable and confident self-advocates. There’s still so much inequity they face, such as seeing doctors who don’t understand their hair or skin type or traveling long distances to see a doctor who looks like them. We need to give our patients more tools, which means stepping out of the office and into the community. If you don’t have the energy for that, you can partner with us and donate to our community.

Early exposure is also essential. I never saw a Black doctor until high school, and it made me realize, “That could actually be me.” Never underestimate the power of someone seeing themselves in a position they aspire to be in.

Lastly, advocating for better policies is crucial. The number of dermatologists accepting Medicaid is very low due to various factors. We need to advocate for increased Medicaid reimbursement. These small factors create significant barriers for people of color. Addressing these barriers requires different people at different levels. The most important thing is being vigilant about how you and your community can help address these issues because we can’t do it individually.

What advice would you give to medical students and residents interested in dermatology, particularly those passionate about addressing healthcare disparities and serving diverse communities?

Dr. Henebeng: Figuring out your “why” is important. Understand what your community needs and ask them how best to address it. Often, people see a problem and just put a band-aid on it without understanding the root cause. Finding mentors is crucial. I wouldn’t be where I am today without mentors in the field and peers a few years ahead of me. Remind yourself that even small changes matter. If you make a difference for one or two patients, it can fuel your passion to keep going despite the challenges.

Dr. Okoro: I agree completely. There are many distractions and people who may doubt your capabilities or the need for initiatives for URM students. Don’t get caught up in these distractions—stay focused on your goals. There’s often an overemphasis on research, but community outreach is equally important. Even as a medical student or resident, you can make a significant impact through community programs. Don’t underestimate the importance of inspiring others and sharing your knowledge. Mentorship is key. If you don’t have mentors locally, consider signing up as a community ambassador with organizations like ours, which offer mentoring and group discussions.

It’s also important for medical programs to reframe how community outreach fits into the role of being a physician. Early exposure to seeing doctors who look like you can be incredibly powerful and inspirational. Advocate for better policies, such as increasing Medicaid reimbursement, as these systemic changes are necessary to reduce health disparities. Being vigilant about how you can help, both personally and as part of a community, is crucial.

Dr. Henebeng: To elaborate on Uzo’s point, sometimes as medical students, we might feel like we don’t have the same impact as seasoned professionals. However, as students, we are often closer to the patients and more aware of their knowledge gaps. For example, I once met a mother whose daughter had severe eczema. Previous providers hadn’t taken the time to explain the condition or empathize with her struggles. As a student, I was able to build a relationship and educate her, which helped bridge the trust gap.

Don’t underestimate your worth and value within the healthcare team. Your ability to empathize and educate can significantly impact patient care and trust.

To learn more about Skin of Color Community and support the organization, please visit www.skinofcolorcommunity.org.