Racialization of a Skin and Diseases: A case of Atopic Dermatitis

• In Event: Science, Knowledge & Technology Section Roundtables
  In Refereed Roundtable (60 minute): Table 2: Distinguishing difference: classification, standardization, and racialization

Abstract

How do dermatologists account for race in their treatment and conceptualization of skin? Skin color has been the primary means by which racial categories have been constructed and maintained. Within dermatology, skin color has been central in shaping diagnosis and treatment. Yet pigment captures only one aspect of how dermatologists see skin. They also encounter other properties of skin, such as the rate at which it loses water, its lipid and ceramide content, its pH, its microbiome, and its susceptibility to disease and allergens. I examine how dermatologists negotiate structural factors such as housing, neighborhood, and environment, along with the physical properties of skin, immune pathways, and genetics in their treatment of skin conditions. My analysis draws on interviews with medical professionals and skin researchers, observations of medical conferences, and analysis of conference presentations and academic papers.
I focus on how dermatologists and skin researchers conceptualize race and ethnicity as a risk factor for atopic dermatitis, a chronic disease that causes inflammation, itchy skin, and redness. According to the National Eczema Foundation, atopic dermatitis impacts 9.6 million children and 16.5 million adults in the United States. There are racial disparities in the occurrence of AD; Black populations have higher prevalence of AD than White or Asian populations. Dermatologists and skin researchers racialize the properties of skin through their construction of this condition. I show how scientific research and a desire to understand the differences between White and Black skin serve to essentialize racial categories and link disparities to supposed innate differences, beyond melanin. While dermatologists are aware of the social construction of race, they rely on race as a biological given and resort to what I term an essentialist reflex. In contrast, research shows that exposure to environmental pollutants like BTEX compounds and (di)isocyanate is correlated with AD.

Author

• Durgesh Solanki, Johns Hopkins University