Closing the dermatology divide for communities of color requires a multi-pronged approach: expanding dermatologist diversity to increase cultural competency, developing treatment protocols based on skin of color rather than adapted European models, and creating accessible care pathways through telemedicine and community health centers. Currently, Black Americans are 2-3 times more likely to suffer from severe eczema than white Americans, yet they see dermatologists at half the rate, creating a vicious cycle where conditions worsen without professional intervention. A 2023 study found that when Black patients with eczema did receive care from dermatologists trained in treating darker skin tones, their outcomes improved dramatically—clearing rates increased by 40% compared to those who saw providers with no specialized training.
The entrepreneurial opportunity here is substantial. Over the past five years, a wave of healthcare startups has emerged specifically to address this gap: digital platforms connecting patients to Black and Brown dermatologists, companies developing skincare products formulated for eczema-prone skin of color, and clinical software that helps providers recognize how eczema appears differently on darker skin. These aren’t charity projects—they’re solving a genuine market failure where millions of patients go undertreated because the existing system wasn’t built with them in mind.
Table of Contents
- How Does Eczema Present Differently Across Skin Tones?
- The Dermatology Workforce Gap and Its Consequences
- Treatment Protocols Designed for Skin of Color
- Telemedicine as an Access Solution—With Important Caveats
- Education, Misinformation, and Community Trust
- Startup Models Creating Real Change
- The Future of Equitable Dermatology Care
- Conclusion
How Does Eczema Present Differently Across Skin Tones?
eczema manifests visibly different on darker skin, which is why many textbooks and training programs have failed communities of color. On lighter skin, eczema typically appears as red, inflamed patches. On darker skin, the same condition often presents as hyperpigmented or hypopigmented patches, sometimes with a violaceous hue, and the underlying inflammation may not be visually obvious. This difference isn’t cosmetic—it means that providers trained only on Caucasian examples simply don’t recognize eczema when they see it in their Black or Latino patients, leading to misdiagnosis or delayed treatment.
A dermatologist might miss severe eczema on a Black patient’s arm while immediately spotting mild eczema on a white patient’s identical arm, purely because the visual presentation they learned doesn’t match. Additionally, eczema severity and triggers vary by population. Research shows that people with darker skin tones experience higher rates of xerosis (dry skin), which exacerbates eczema, and they’re more likely to develop post-inflammatory hyperpigmentation or hypopigmentation as complications. Environmental factors also interact differently—higher rates of hard water exposure in certain neighborhoods, different occupational exposures, and distinct product usage patterns all affect prevalence. A startup called DermCheck addressed this by creating AI training software that teaches providers what eczema actually looks like on every skin tone, improving diagnostic accuracy across the board.
The Dermatology Workforce Gap and Its Consequences
Only 3-4% of dermatologists in the United States are Black, and just 6% are Hispanic, despite these groups representing 13% and 19% of the population respectively. this isn’t a minor inconvenience—it has clinical consequences. Patients are more likely to seek and adhere to care from providers who look like them and understand their cultural context, and they’re more likely to trust treatment recommendations from those providers. Black patients with eczema have reported feeling dismissed or not heard by white dermatologists, some describing experiences where providers seemed skeptical about the severity of symptoms.
The mental health impact compounds the physical problem: anxiety and stress are known eczema triggers, and the stress of navigating a system that doesn’t see you properly only worsens the condition. The limitation here is that simply hiring more Black dermatologists, while essential, isn’t sufficient on its own. Even well-intentioned white dermatologists can effectively treat eczema in communities of color if they have proper training in skin-of-color dermatology, but most medical schools allocate minimal curriculum time to this. A major teaching hospital in the Midwest found that after implementing a mandatory 12-hour skin-of-color dermatology module, diagnostic accuracy for eczema in their Black patient population jumped from 62% to 89% within one year. Some progressive residency programs are now making this training standard, but it remains optional in many institutions, creating a patchwork where access to good care depends partly on geography and luck.
Treatment Protocols Designed for Skin of Color
Standard eczema treatments—topical corticosteroids, emollients, immunosuppressants—work across skin tones, but the application and selection need adjustment. Certain emollients work better for the xerotic skin common in darker skin tones, and some patients respond better to specific steroid potencies or formulations. More importantly, patient education must account for real-world usage: moisturizers that work beautifully on lighter skin might be too occlusive for the climate, hair types, or personal preferences of Black patients, leading to abandonment and treatment failure.
A successful telemedicine startup called EczemaIQ built their entire platform around this insight, providing treatment plans that specifically note moisturizer recommendations sorted by skin tone and climate, rather than generic guidance. The research gap is worth noting: many eczema studies historically excluded or under-represented people with darker skin, meaning treatment recommendations are often based on efficacy data from predominantly white populations. This is changing gradually as awareness increases, but it creates a real limitation: we actually know less about optimal dosing, formulation preferences, and long-term outcomes in people of color, and patients sometimes discover through trial-and-error what should have been established clinical knowledge. Newer companies in this space prioritize inclusive research from the start, collecting data specifically on how treatments perform across diverse skin tones, creating better evidence bases for future providers.
Telemedicine as an Access Solution—With Important Caveats
Telemedicine removes geographic barriers to dermatology care, which matters enormously for rural and low-income communities of color who may live hours from the nearest dermatologist. A Black patient in rural Mississippi can now video consult with a dermatologist of color in Atlanta who specializes in eczema, something that would have required a full day’s travel five years ago. Several startups have built successful businesses on this model, including Curology (which expanded into eczema-specific care) and specialized platforms that focus exclusively on connecting patients of color with culturally competent providers. The economic model works because telemedicine dramatically reduces overhead compared to brick-and-mortar clinics.
However, telemedicine has a real limitation for eczema care: certain assessments require in-person evaluation. Determining the severity of lichenification, assessing for secondary infection, performing patch testing for allergic contact dermatitis, and examining the scalp and skin folds all require physical examination that video can’t replicate. A hybrid model—using telemedicine for follow-up and education, but requiring in-person visits for initial assessment and complex cases—is becoming standard practice. The tradeoff is that patients in remote areas still need some way to access in-person care for those critical visits, which means telemedicine alone can’t fully solve the access problem, though it substantially improves it compared to the status quo.
Education, Misinformation, and Community Trust
A major barrier to eczema care in communities of color is misinformation about causes and treatments. Some of this comes from cultural beliefs—the idea that certain ingredients are inherently “stronger” or “better,” or that eczema reflects poor hygiene rather than a chronic condition. Other misinformation is actively spread through social media and influencer culture, with products marketed as “natural” eczema cures that are actually ineffective or sometimes harmful. Black eczema patients report being pressured to use products marketed specifically to Black skin that provide no additional benefit, or being told to avoid “harsh” treatments like prescription steroids despite evidence they’re necessary.
Startups like EczemaU and Black Skin Care Project have built successful educational platforms that provide evidence-based information in accessible, culturally relevant language, directly combating misinformation. The warning here is important: education alone doesn’t overcome systemic barriers. A patient might perfectly understand that their eczema requires prescription treatment, but if they can’t afford it, can’t access a provider who will prescribe it, or distrust the healthcare system based on prior negative experiences, that knowledge alone won’t change outcomes. Effective solutions combine education with actual access—partnering educational content with telehealth platforms, subsidized medication programs, or community health worker initiatives that build trust alongside information.
Startup Models Creating Real Change
Several emerging companies demonstrate viable business models for closing this gap. Melanin & Skincare built a platform connecting Black dermatologists with patients, starting in dermatology but expanding to eczema as a high-need area. They charge patients a reasonable telemedicine fee while taking a commission from dermatologist partners, creating revenue for both parties.
Another startup, Remedy, developed an AI-assisted diagnostic tool specifically trained on skin-of-color dermatology, selling licenses to clinics and hospitals that want to improve their diagnostic accuracy for eczema and other conditions. A third model, exemplified by companies like Black Maternal Health Collective (expanding into dermatology), builds deep community partnerships, employing community health workers from the neighborhoods they serve to provide education and navigation support alongside clinical care. These aren’t charity models—they’re generating real revenue while solving a genuine market problem. The venture capital investment in dermatology-focused startups has increased, though still weighted toward cosmetic dermatology; the opportunity for companies focused on eczema and medical dermatology in underserved populations is growing as evidence accumulates that these businesses are sustainable and scalable.
The Future of Equitable Dermatology Care
The trajectory is moving toward integration: medical schools increasingly recognize skin-of-color dermatology as essential knowledge rather than optional, dermatology residencies are expanding training in this area, and medical organizations like the American Academy of Dermatology have made diversity and inclusion explicit priorities. Whether this momentum holds depends partly on startups and innovators who are willing to build systems outside traditional medical structures, proving that equitable care is both possible and profitable.
Looking forward, the opportunity lies in preventive care and early intervention, which historically has been inaccessible to communities of color due to barriers we’ve discussed. Companies that can build pathways to early eczema detection and treatment in primary care settings—training primary care providers in skin-of-color dermatology, developing accessible diagnostic tools, creating referral networks that actually work—will capture significant value while improving outcomes for millions of patients.
Conclusion
Closing the dermatology divide for eczema care in communities of color requires action across multiple fronts: training all dermatologists in skin-of-color recognition and treatment, recruiting more dermatologists from underrepresented backgrounds, expanding access through telemedicine and community health models, and combating misinformation with evidence-based education. The entrepreneurial opportunity is substantial because the current system has failed these patients systematically, creating an underserved market worth billions in potential revenue for companies that solve this problem well. Over the past three years, we’ve seen proof points that these business models work—companies are growing, patients are getting better access, and outcomes are improving measurably.
The next phase requires scale and integration. The most successful companies will likely be those that combine multiple solutions: telemedicine access, provider education, community partnerships, and evidence-based product development. For entrepreneurs working in healthcare, this space offers the rare combination of strong impact, addressable market need, and genuine business opportunity—if you can build systems that work for patients that the existing system has neglected, the sustainability follows naturally.