Cultural Practices and Atopic Dermatitis: Insights from SDPA 2025

At the Society of Dermatology Physician Assistants (SDPA) summer meeting held on June 26, 2025, in Washington, D.C., Dr. Candrice Heath, an associate professor at Howard University, presented concerning findings regarding the impact of cultural practices on pediatric atopic dermatitis (AD) in minority populations. Dr. Heath's presentation spotlighted the use of baby cologne among Hispanic families, a tradition that many clinicians may not recognize as a potential aggravator of persistent AD symptoms, particularly in Black and Hispanic children.

The significance of this issue is underscored by extensive research indicating that Black and Hispanic children are statistically more likely to experience persistent AD compared to their White counterparts. According to a study published in the Journal of the American Academy of Dermatology in 2020, Black children are 1.5 times more likely to have persistent AD than White children (Huang et al., 2020).

Dr. Heath emphasized that the increased prevalence of AD in these populations is not merely a consequence of skin tone but is rooted in systemic racial issues. She remarked, “It’s not about the skin itself; it’s about the systemic barriers that limit access to care and knowledge.”

One of the major concerns raised during her presentation was the lack of awareness among dermatologists regarding baby perfumes and their potential effects on the skin. During the session, Dr. Heath queried attendees about their familiarity with baby cologne, revealing that many clinicians were unaware of its existence. This gap in knowledge highlights a critical area for improving patient care and education.

Dr. Heath noted that these baby fragrances are often not subjected to patch testing, particularly in minority groups, which raises concerns about their safety. “Many of the products used in these cultural practices may not be safe, but we lack the data to confirm this,” she stated. “It’s a reminder that there’s always more to learn about our patients’ backgrounds and the products they use.”

Additionally, the issue of hyperpigmentation, which affects many individuals with darker skin tones, was a focal point of Dr. Heath's discussion. She presented a survey indicating that 63% of Asian respondents, 50% of Black respondents, and 33.6% of White respondents reported concerns regarding pigmentation changes due to AD. Alarmingly, among Black respondents, 53.3% discussed their pigmentation concerns with their healthcare providers, yet many still felt their concerns were dismissed or unresolved.

Dr. Heath articulated the importance of acknowledging these pigmentation issues in treatment discussions, as failing to address them may lead to misunderstandings and non-adherence to treatment plans. “Patients need to feel heard,” she asserted. “If we don’t acknowledge their concerns about pigmentation, they may leave with the impression that their issues are not being taken seriously.”

The implications of Dr. Heath’s findings are profound. They highlight the necessity for dermatologists to understand cultural practices and their potential effects on skin health, especially in minority populations. As healthcare providers, it is imperative to engage in effective communication about treatment options and patient concerns, particularly regarding the intersections of cultural practices and dermatological health.

In conclusion, the discussions at SDPA 2025 serve as a call to action for clinicians to broaden their understanding of atopic dermatitis in diverse populations. By doing so, they can ensure more equitable healthcare outcomes for all children suffering from this condition. The integration of cultural competence into healthcare practice may not only improve adherence to treatment but also enhance the overall patient experience, fostering a more inclusive and informed healthcare environment.