~20 minute read

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Dermatology Nursing Education

I have spoken extensively about the lack of diversity in dermatology when it comes to data on nurse practitioners, medical education, faculty, medical images, pocket guides, point-of-care resources, clinical research, medical language, technology, and hands-on training models. While we still have lots of room for improvement, a significant amount of work has already been started. The incoming president of the American Academy of Dermatology, Dr. Susan Taylor, Founded the Skin of Color Society over twenty years ago. There are several dermatology organizations offering education, more to nurse practitioners (requiring an NPI to participate) than to nurses, but none are in existence, with initiatives solely focused on improving the lack of diversity in nursing education.

My entire platform is dedicated to improving access to dermatology education for nurses and nurse practitioners because of the job requirements. On average, employers are requiring nurse practitioners to have 2+ years of dermatology experience at the time of hire. There is a percentage of NPs who receive a job offer despite their lack of experience, but the learning curve remains steep, skin of color education is still absent, and the lack of mentorship and professional development remains insufficient. Nurses (registered nurses, licensed practical nurses, and licensed vocational nurses) traditionally gain experience in settings where the most common dermatologic diseases are not prioritized, and even less attention is given in nursing curricula where the focus is on the integumentary system and pressure injury prevention. Nurse Practitioner programs permit, on average, 40-60 hours of extracurricular clinical hours, of which dermatology is viewed as being – extracurricular. Furthermore, the hair and scalp are practically neglected unless there is a wound or surgical incision, which is why the Hair For You Advisory Board is in existence today.

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One Solution to the Physician Shortage: Nurse Practitioners

Despite the work being done by some dermatology organizations and researchers on groups under represented in medicine (URMs), only 5% of dermatologists are black or Hispanic and less than 1% are American Indian, Alaska Natives, Native Hawaiian, and other Pacific Islander. The statistics in nursing are unknown. Patients still lack adequate access to timely dermatology care, with some waiting up to 35 days for an appointment in densely populated areas (where many dermatologists are attracted to live and practice) and up to 75 days or more in rural areas where there is a significant shortage of providers and dermatology conferences. On average, it takes 12 years to become a dermatologist. Solely depending on physicians to decrease patient wait times and improve outcomes is not a timely solution. Further, when it comes to patient outcomes, it behooves all of us to seek out and demand education and inclusive clinical trials as there are simply not enough skin of color providers to meet the needs of all skin of color patients and ensure we're providing the most appropriate treatment. According to the 2021 Physician Workforce Data report, there were 940,254 active physicians and 328,239,523 people in the United States. This means, there were only 286 physicians for every 100,000 persons. When we look at the table, we see physicians of color barely comprise 30% of the physician supply. When you look at individual races/ethnicities there is even less representation compared to the general physician supply.

Nurse Practitioners were created to reduce the burden in primary care due to the shortage of physicians. NPs can address these gaps in dermatology the same way we’ve addressed them in primary care. Nothing delights me more than to see an increase in the number of nurses, nurse practitioners, and doctoral students who desire to practice dermatology and conduct nursing research. But this can only be done with increased access to dermatology education for nurses and nurse practitioners.

Mahogany Dermatology

In response to the demand for NPs to have 2+ years of experience, I have dedicated my time to creating strategies and resources to help NPs begin their education and exposure while they are still practicing as a nurse or wherever they may practice at the time they fall in love with dermatology.

In this article, I’ve listed over ten medical textbooks. Notably, there are more textbooks, but many of them were published over ten years ago, and even still, there remains a paucity of medical textbooks dedicated to skin of color in wound care, and pediatric and cosmetic dermatology. At the time of this writing, there is only one book written for dermatology nursing education and the last edition was published in 2016 (see below). We don’t need separate books for every race and ethnicity. I would be the first to agree that skin of color education should be standardized in nursing curricula and training. But until those books are written, we have the ones listed here. Please email me additional resources that should be added to the list.

Call to Action to Nursing Schools and Certification Boards

The skin is the largest organ and a window to internal health and external threats to the body. One could argue that prioritizing dermatology nursing education is a form of prevention – our foundation and primary practice. Therefore, I ask that you join me in giving a call to action to your Nursing Schools and Certification Boards to add skin of color resources to their required reading and continuing education requirements, respectively. You may use this article to support your argument. Stay tuned, there is more to come.

The Value of Continuous Learning

Nurse Practitioners must be aware of the many variations in skin of color, including differences in pigmentation patterns, vascular structures, and response to inflammation or injury. Without this knowledge, diagnostic errors and delays can occur, leading to disparities in treatment outcomes. As the patient population becomes increasingly diverse, it is essential for practicing and aspiring nurse practitioners to expand our educational resources. The textbooks presented here are invaluable for fostering a deeper understanding of the nuances of diagnosing and treating conditions across a spectrum of skin tones. They have the potential to not only bridge knowledge gaps but also serve as a step toward reducing disparities in dermatologic care. Equipping nurses and NPs with the tools and knowledge to serve all patients effectively contributes to a more inclusive and equitable healthcare system. I thank you all for sharing with me how much you too desire access to this information.

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Taylor and Elbuluk's Color Atlas and Synopsis for Skin of Color (2023). Accessible here.

Taylor and Elbuluk's Color Atlas and Synopsis for Skin of Color, 1st Edition by Dr. Susan C. Taylor and Dr. Nada Elbuluk, is an indispensable guide for recognizing dermatologic conditions across diverse skin tones. Designed to enhance diagnostic precision, the book highlights differences in disease presentation between lighter (Fitzpatrick Skin Types I–III) and darker skin types (IV–VI). With over 350 high-quality images, this atlas equips healthcare providers, from students to clinicians, with the tools to improve dermatologic care for patients of all skin types.

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Dermatology for Skin of Color (2016). Accessible here.

The second edition of Dermatology for Skin of Color by Dr. Susan C. Taylor, Dr. A. Paul Kelly, Dr. Henry Lim, and Dr. Ana Maria Anido Serrano is a pivotal resource for understanding dermatologic science and treatment for patients with pigmented skin. This edition features 21 new chapters and over 900 clinical images, covering a broad spectrum of medical, surgical, and cosmetic dermatology.

Dr. Susan C. Taylor, a renowned dermatologist and the founder of the Skin of Color Society is a leader in advancing diversity and equity in dermatology. She is the Bernett L. Johnson, Jr., M.D. Professor and Vice Chair of Diversity, Equity, and Inclusion at the Perelman School of Medicine, University of Pennsylvania. Dr. Taylor will serve as the 84th President of the American Academy of Dermatology (2025–2026), making history as the first African American in this role. A Harvard Medical School graduate and expert in alopecia and pigmentary disorders, Dr. Taylor has authored over 100 peer-reviewed articles and is passionate about mentorship and improving care for populations with skin color.

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Dermatology Atlas for Skin of Color (2014). Accessible here.

Dermatology Atlas for Skin of Color, 2014th Edition by Dr. Diane Jackson-Richards and Dr. Amit G. Pandya is an essential resource for understanding dermatologic conditions in ethnic skin. Featuring over 300 color photos, the atlas highlights disorders prevalent in skin of color, including pigmentary and follicular disorders, eczemas, granulomatous diseases, and more. Each chapter provides concise explanations, diagnostic criteria, and treatment insights. Its global relevance makes it an invaluable reference for dermatologists and healthcare providers dedicated to equitable care for diverse populations.

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Pediatric Dermatology in Skin of Color: A Practical Guide (2021). Accessible here.

Written by dermatology experts Dr. Manish K. Shah and Dr. Preeti K. Sheth, Pediatric Dermatology in Skin of Color: A Practical Guide emphasizes the clinical management of pediatric skin disorders prevalent in darker skin types. Drawing on their extensive experience, the authors provide a comprehensive manual blending evidence-based practices with hands-on insights. The book features detailed clinical descriptions, differential diagnosis techniques, and innovative treatment approaches, particularly in resource-limited settings. High-quality, original images throughout the text ensure clear visual references, making this guide an essential resource for clinicians navigating pediatric dermatology in diverse populations.

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Pediatric Skin of Color (2015). Accessible here.

Edited by Nanette B. Silverberg, Carola Durán-McKinster, and Yong-Kwang Tay, Pediatric Skin of Color is the first textbook dedicated to the unique dermatological needs of pediatric patients with skin of color. This comprehensive resource covers the biology of skin, common skin conditions, and systemic diseases that manifest with skin involvement, with a focus on populations such as African American, Asian, Hispanic/Latino, Middle Eastern, and Indigenous communities. The text serves as a crucial reference for Dermatology nurses and NPs and pediatric clinicians treating diverse patient groups.

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Clinical Cases in Skin of Color: Adnexal, Inflammation, Infections, and Pigmentary Disorders (2016). Accessible here.

Edited by Dr. Porcia B. Love and Dr. Roopal V. Kundu, Clinical Cases in Skin of Color: Adnexal, Inflammation, Infections, and Pigmentary Disorders focuses on the top dermatological conditions encountered in patients with skin of color. Through real-world clinical cases, it highlights distinctive presentations of diseases in darker skin tones, providing critical diagnostic and management strategies. The text integrates cultural considerations and clinical pearls, empowering clinicians to deliver patient-centered care. With the growing population of individuals with skin of color, this book addresses essential educational needs in dermatology training and practice.

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Pigmentary Skin Disorders (2018). Accessible here.

Pigmentary Skin Disorders, edited by Prasad Kumarasinghe, MD, is a specialized volume in the Updates in Clinical Dermatology series, focusing on diagnosing and managing pigmentary disorders, particularly in skin of color. This text bridges the gap in standard dermatology resources by addressing evolving research and innovative treatments. Key topics include post-inflammatory hyperpigmentation, drug-induced pigmentation, and laser treatments. Written by international experts, the book combines practical insights with summaries of the latest advancements, offering clinicians a structured guide for improving patient outcomes in pigmentary dermatology.

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Pigmented Ethnic Skin and Imported Dermatoses: A Text-Atlas (2018). Accessible here.

Edited by Constantin E. Orfanos, Christos C. Zouboulis, and Chalid Assaf, Pigmented Ethnic Skin and Imported Dermatoses: A Text-Atlas offers a comprehensive examination of skin diseases in dark-skinned populations, focusing on those common in tropical and subtropical regions. It addresses conditions emerging globally due to migration and travel, with expert insights on the pathogenesis, diagnosis, and management of these disorders. Featuring high-quality images, this book is a vital resource for practicing and aspiring nurses and NPs treating patients with diverse skin types across varying clinical contexts.

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Clinical Dermatology in Skin of Colour: Infections (2022). Accessible here.

Dr. Ranthilaka R. Gammanpila's Clinical Dermatology in Skin of Colour: Infections delves into the unique presentations of over 30 common skin diseases in tropical regions and darker skin tones. This essential resource emphasizes conditions such as psoriasis, lichen planus, and erythrasma, highlighting their distinctive features in Fitzpatrick types V and VI. With 125 high-quality illustrations, the book equips dermatology trainees and practitioners with insights into tropical diseases like cutaneous tuberculosis and leishmaniasis, offering practical knowledge for diagnosing and managing infections in diverse clinical settings.

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Asian Skin: A Reference Colour Atlas of Dermatology and Venereology (2020). Accessible here.

Asian Skin: A Reference Colour Atlas of Dermatology and Venereology (2nd Edition), edited by A/Prof Chua Sze Hon, Prof Goh Chee Leok, Dr. Ng See Ket, and A/Prof Tan Suat Hoon, is a vital resource for understanding dermatoses in Asian populations. This edition updates over 95% of its original images and introduces eight new chapters, expanding on unique conditions such as the nevus of Ota/Ito and Hori’s nevus. With over 1,400 clinical and histological images, it is an indispensable tool for dermatology nurses and NPs treating patients of Asian descent.

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Atlas of Pediatric Dermatology in Asian Skin (2024). Accessible here.

Atlas of Pediatric Dermatology in Asian Skin by Mark Jean Aan Koh, Emily Yiping Gan, and Lynette Wie Yi Wee is an essential guide exploring pediatric dermatology with a focus on Asian skin. It delves into the physiological differences between Asian skin and other skin types and addresses a wide range of conditions, from neonatal dermatoses and atopic dermatitis to pigment disorders, vascular anomalies, and systemic disease indicators. The book also highlights dermatological procedures tailored for children, making it an invaluable resource for clinicians managing pediatric skin conditions in Asian populations.

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Dermoscopy in General Dermatology for Skin of Color (2021). Accessible here.

Dermoscopy is a critical tool for evaluating dermatologic conditions, allowing for non-invasive, magnified visualization of the skin’s surface. While it has been extensively studied and utilized for patients with lighter skin tones, its application to skin of color presents unique challenges and considerations. In Dermoscopy in General Dermatology for Skin of Color, editors Enzo Errichetti and Aimilios Lallas bring together a wealth of knowledge from international experts. This highly illustrated text focuses on phototypes IV to VI, covering a diverse range of skin types, including subcontinental Asian, North African, South American, and African skin. The book offers practical insights and visual examples to enhance diagnostic accuracy for practitioners working with these populations.

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Dermatoanthropology of Ethnic Skin and Hair (2017). Accessible here.

Dermatoanthropology of Ethnic Skin and Hair, edited by Neelam A. Vashi, MD, and Howard I. Maibach, MD, is a comprehensive guide dedicated to understanding skin and hair conditions in persons of color. Featuring 26 chapters, it integrates medical, surgical, and cosmetic dermatology with anthropological insights and basic science. Topics include skin structure, pigmentation, common disorders like acne and keloids, and cultural considerations in treatment. This resource equips clinicians with tools to diagnose and manage diverse dermatologic conditions effectively, emphasizing the nuances of ethnic skin and hair.

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Procedures in Cosmetic Dermatology: Cosmetic Procedures in Skin of Color (2024). Accessible here.

Procedures in Cosmetic Dermatology: Cosmetic Procedures in Skin of Color by Dr. Andrew F. Alexis is a practical guide for mastering safe and effective cosmetic techniques tailored to skin of color. With step-by-step instructions, high-quality visuals, and procedural videos, the book covers popular treatments such as chemical peels, laser therapies, fillers, and hair transplantation. It addresses specific concerns like melasma, hyperpigmentation, and keloids, offering evidence-based approaches for diverse skin types. A must-read for dermatology nurses and NPs committed to enhancing aesthetic care for all skin tones.

Dr. Andrew F. Alexis, MD, MPH, is a renowned leader in dermatology, specializing in skin of color and advancing diversity in patient care, research, and education. He serves as Vice-Chair for Diversity and Inclusion and Professor of Clinical Dermatology at Weill Cornell Medicine. Formerly, he chaired dermatology at Mount Sinai Morningside and West, directing the groundbreaking Skin of Color Center for over 15 years. Currently, he serves on the Board of Directors of the American Dermatological Association and Cicatricial Alopecia Research Foundation, as well as Co-Chair of the Skin of Color Society’s Scientific Committee.

Dr. Alexis holds an MD from Columbia University Vagelos College of Physicians & Surgeons and an MPH from Columbia’s Mailman School of Public Health. His dermatology training includes a residency at Weill Cornell Medicine and a dermatopharmacology fellowship at NYU Langone. He has authored over 90 peer-reviewed articles in journals like JAMA Dermatology and co-edited two textbooks, making significant contributions to dermatologic literature. His expertise spans pigmentary disorders, acne, alopecia, and cosmetic dermatology in patients of diverse backgrounds. As a sought-after speaker, he has delivered lectures globally and at prestigious academic institutions.

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Multicultural Skin Treatments: Learn How to Effectively Treat Skin of Color by Combining Chemical Peels and Laser Treatments (2020). Accessible here.

JoElle Lee's Multicultural Skin Treatments: Learn How to Effectively Treat Skin of Color by Combining Chemical Peels and Laser Treatments is a practical guide for skincare professionals navigating the complexities of treating multicultural skin. Drawing from her extensive industry experience, Lee addresses the rising demand for cosmetic procedures among people of color—80% of the global population.

JoElle Lee, L.E., is a highly respected esthetician and educator with over 20 years of experience in skincare, specializing in treatments for multicultural skin. Formerly the personal esthetician to First Lady Michelle Obama, JoElle is the author of Multicultural Skin Treatments and Esthetician on a Mission. She is renowned for her expertise in chemical peels, corrective facials, and laser treatments for skin of color. JoElle also provides training and business coaching for estheticians, emphasizing effective marketing and innovative approaches to skincare. Her philosophy, “Beautiful Skin Begins Within,” drives her integrative methods.

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Dermatologic Nursing Essentials: A Core Curriculum (2016). Accessible here.

Dermatologic Nursing Essentials: A Core Curriculum, Third Edition by Dr. Noreen Nicol offers a comprehensive guide for nurses in dermatology, blending clinical care expertise with certification preparation. This official publication of the Dermatology Nurses’ Association highlights core concepts like anatomy, physiology, and patient-centered care. It covers a broad range of skin conditions, effective treatments, and patient education strategies. Featuring nearly 400 color images, outlines, and review materials, this resource is an essential reference for dermatology nurses and allied health professionals aiming to provide top-tier skin care.

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Conclusion

As dermatology continues to evolve, so must our perspectives and approaches. With resources like these, we can take another step forward in honoring the diversity of our patients and the unique challenges they face. Let us expand our perspectives, enrich our practice, and embrace the opportunity to provide truly comprehensive care for all patients.

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Kimberly Madison, DNP, AGPCNP-BC

I am a nurse practitioner entrepreneur who specializes in dermatology nursing education and research with an emphasis on skin of color. I created this blog to share my journey as a source of motivation and as a blueprint, as you embark on your journey. Most importantly, I’m looking forward to increasing access to dermatology education and clinical training for aspiring and practicing nurse practitioners. I invite you to view the mission and vision statement on the homepage to see how we can best partner to make our dreams align.

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