Improving Aesthetics Care: Key Strategies for Dermatology NPs Treating Skin of Color
This article is the second installation of a 3-part series. The previous article is titled Facial Aging: Aesthetic Treatments for Every Decade of Life in Skin of Color. In this follow-up, I discuss actionable steps we can take to improve cultural sensitivity education, training, and practice, as well as the nursing implications for doing so. The cherry on top? I provide 3 Dermatology DNP Project ideas like the ones you’ll find in my upcoming book, Dermatology DNP Project Ideas slated to be released in 2025. In the third and final installment, I discuss the history and controversy of the Fitzpatrick Skin Type and what we truly mean when discussing skin of color.
Recommendations for Nursing Practice
As aesthetic dermatology continues to evolve, dermatology NPs are uniquely positioned to provide patient-centered, evidence-based care across all decades of life. To enhance patient outcomes and meet the diverse needs of individuals, especially those with skin of color, dermatology NPs should adopt a holistic, education-focused approach that prioritizes cultural sensitivity, advanced technical skills, and a commitment to lifelong learning.
Key Recommendations for Dermatology Nurse Practitioners
Personalized Treatment Plans:
Dermatology NPs must tailor treatments to align with patients’ unique anatomical changes, lifestyle factors, and aesthetic goals. This is particularly important for patients with skin of color, as their skin exhibits unique aging patterns, such as a lower prevalence of fine lines but increased susceptibility to pigmentation disorders, keloids, and post-inflammatory hyperpigmentation (PIH).
Comprehensive Patient Education:
Educating patients on preventive care, such as daily sunscreen use and maintaining a consistent skincare routine, is critical in mitigating the visible signs of aging. For individuals with skin of color, education should address common misconceptions, such as the belief that melanin-rich skin is immune to sun damage, and offer tailored advice for treating hyperpigmentation and uneven tone.
Advanced Training in Skin of Color:
Given the growing demand for culturally sensitive care, dermatology nurse practitioners should pursue specialized training in the treatment of skin of color. This includes understanding the nuances of pigmentation concerns, differences in response to energy-based devices, and the risks associated with common aesthetic treatments like chemical peels and lasers.
Emphasizing Prevention Across Lifespan:
A focus on early interventions in the 20s and 30s can yield better long-term outcomes, reducing the need for more invasive procedures later. We say it’s cheaper to prevent than it is to treat! We should encourage our younger patients to adopt preventive measures and utilize subtle treatments like neuromodulators and light chemical peels to maintain skin health.
Utilizing Combination Therapies:
As patients age, a combination of treatments addressing volume loss, skin laxity, and pigmentation will yield the most comprehensive results. For patients with skin of color, this approach must consider the increased risk of complications, such as PIH, and prioritize safe, proven evidence-based recommendations.
Implications for Nursing Education and Research
Curriculum Development:
Nursing programs and fellowships should integrate robust training modules on skin of color and aesthetics into their curricula. This includes hands-on experience with dermal fillers, neuromodulators, and energy-based devices, as well as in-depth case studies focusing on diverse patient populations. On the Mahogany Dermatology blog, I’ve provided multiple recommendations on how to execute this change in education and training. Additionally, I've published my recommendations for Essential Dermatology Textbooks for Skin of Color that should be included in required reading for medical and nursing students.
Cultural Sensitivity Training:
Incorporating cultural sensitivity into nursing education ensures that dermatology NPs are equipped to understand and address the unique needs of patients with skin of color. This includes training on communication strategies to build trust and understanding within underrepresented communities.
Focus on Research and Evidence-Based Practice:
Nursing education should emphasize the importance of research in advancing dermatologic care, particularly for underserved populations. Dermatology NPs should be encouraged to contribute to the growing body of literature on aesthetic treatments for skin of color, filling existing knowledge gaps and promoting better outcomes. I welcome you to write for us at the Journal of Clinical and Aesthetic Dermatology’s NP + PA Perspectives in Dermatology where I serve on the Editorial Advisory Board.
Interdisciplinary Collaboration:
Dermatology NPs must be trained to work collaboratively with dermatologists, plastic surgeons, and other specialists to provide comprehensive care. For patients with complex needs, this team-based approach ensures optimal outcomes and builds trust within the healthcare system. First, we must understand the importance of interdisciplinary care, how to implement it into our workflow, and specifically how everyone contributes to the mission.
Lifelong Learning and Certification:
We should prioritize continuing education to stay current with advancements in aesthetic dermatology. Pursuing certifications, attending conferences, and participating in hands-on workshops are essential for refining skills and expanding knowledge, particularly in emerging technologies and techniques tailored for diverse skin types.
Action Steps for Dermatology Nurse Practitioners
To translate the recommendations into practical outcomes, you can take the following actionable steps to enhance your practice and promote inclusive, high-quality aesthetic care:
Commit to Advanced Education and Training
Pursue specialized certifications in aesthetic dermatology, such as courses in dermal fillers, neuromodulators, laser treatments, and chemical peels, with a focus on treating diverse skin types. Visit the Aubrey Rose Institute of Medical Aesthetics and Skin of Color Aesthetics to learn more about the services they offer. Attend workshops, conferences, and webinars that offer insights into the latest advancements in aesthetic treatments, particularly for patients with skin of color. Stay updated on new research and clinical guidelines by subscribing to and writing for dermatology and nursing journals (pediatrics, cosmetics, wound care, translational research, and education).
Cultivate Expertise in Skin of Color
Enroll in programs and certifications dedicated to the treatment of skin of color (e.g., pigmentation disorders, keloids, and PIH). Engage with the following organizations and participate in their events to deepen your understanding of cultural and biological variations in dermatologic care. Practice sensitivity to cultural differences by learning about patients’ preferences and experiences related to aesthetics.
Educate patients on the importance of sunscreen and photoprotection, including recommendations for formulations suited for deeper skin tones (e.g., non-chalky, mineral-based options). Advocate for early intervention by encouraging younger patients to adopt skincare routines that prevent signs of aging and promote overall skin health. Partner with estheticians or skincare professionals to offer patients holistic guidance on skincare maintenance.
Establish a Patient-Centered Approach
Use consultation sessions to fully understand a patient’s goals, concerns, and cultural considerations. Develop treatment plans that account for unique aging patterns in different ethnicities while minimizing the risk of complications like PIH. Emphasize transparency by discussing expected outcomes, risks, and costs upfront.
Integrate Safe and Effective Modalities
Select energy-based devices (e.g., lasers, microneedling) proven safe for skin of color, ensuring minimal risk of adverse effects. Prioritize minimally invasive treatments, such as light chemical peels or non-ablative laser therapies, for patients with melanin-rich skin. Combine treatments thoughtfully to address volume loss, laxity, and pigmentation while reducing the risk of overcorrection or scarring.
Advocate for Research and Equity
Contribute to clinical research focused on aesthetic treatments for patients with skin of color by participating in studies or publishing case reports. Advocate for greater inclusion of diverse populations in clinical trials to expand evidence-based guidelines. Collaborate with academic institutions to develop and implement training modules for nursing students that emphasize skin diversity.
Leverage Technology and AI
Incorporate digital tools, such as 3D imaging or teledermatology, to enhance consultations and treatment planning. Use patient management software to document outcomes, track complications, and refine treatment protocols. Explore AI-based applications that assist in skin analysis and product recommendations for patients of varying ethnicities.
Foster Community Engagement and Education
Host webinars, workshops, or community events focused on aesthetic care for diverse populations to build trust and raise awareness. Create educational content (blogs, videos, or social media posts) addressing common aesthetic concerns for patients with skin of color. Partner with local organizations to expand access to education about skincare and aesthetics for underserved communities.
Prioritize Self-Reflection and Inclusivity
Regularly assess your practice to ensure it is welcoming and inclusive, from the language you use during consultations to the imagery in your marketing materials. Seek feedback from patients and peers to identify areas for improvement and enhance your ability to provide culturally sensitive care. Build a diverse team of collaborators, including estheticians, educators, and other healthcare professionals, to reflect the communities you serve. Read my articles on Building an Inclusive Care Practice and The Importance of Learning About Skin of Color and Gender-Affirming Care in Aesthetics Training.
DNP Project Ideas
Here are three Doctor of Nursing Practice (DNP) project ideas tailored for doctoral students, with an emphasis on improving care, addressing gaps in dermatologic education, and enhancing outcomes for patients with skin of color. My latest publication, Dermatology DNP Project Ideas, is slated to be released in 2025. In the meantime, I invite you to visit the Mahogany Dermatology Shop where I've published multiple e-books with strategies: Become a Nurse, From Bedside to Dermatology: A Step-by-Step Guide for Nurses, the Dermatology NP Starter-Kit, and the Your Nurse Mentorship Match e-books.
Developing a Skin of Color Aesthetic Care Protocol
Objective: Implement evidence-based guidelines/policies for safe and effective aesthetic procedures tailored to patients with skin of color.
Rationale: Patients with darker skin tones are at a higher risk of adverse effects like post-inflammatory hyperpigmentation (PIH) and scarring following aesthetic treatments. There is a lack of standardized protocols for this population.
Action Plan:
• Conduct a systematic review of the literature to identify safe practices for aesthetic treatments in skin of color.
• Collaborate with dermatology providers and estheticians to develop practice guidelines/policies/protocols on chemical peels, lasers, and injectable procedures.
• Pilot the protocol in a dermatology clinic, measuring outcomes such as complication rates and provider clinician satisfaction.
• Disseminate findings through publications and workshops for dermatology nurse practitioners and other aesthetic providers.
Impact: This project could lead to safer, more inclusive care and reduced disparities in aesthetic dermatology.
Design a Dermatology Curriculum for Nurse Practitioners
Objective: Create an educational module focusing on the management of common dermatologic conditions and aesthetic procedures, with a specific emphasis on skin of color.
Rationale: Many NP programs lack comprehensive dermatology training, particularly regarding conditions and treatments for patients with diverse skin tones.
Action Plan:
• Assess current gaps in dermatology education for nurse practitioners by surveying NP students and practicing NPs.
• Implement the curriculum in an academic, conference, or clinical setting and evaluate outcomes through pre- and post-knowledge assessments.
Impact: This project could enhance NP readiness for dermatology careers, reduce knowledge gaps, and improve patient outcomes.
Teledermatology for Underserved Communities with Skin of Color
Objective: Implement a teledermatology program to increase access to dermatologic care for underserved communities, focusing on conditions prevalent in skin of color.
Rationale: Telehealth can bridge access gaps, but underserved communities often face barriers to dermatology services. A tailored teledermatology initiative could address these disparities.
Action Plan:
• Partner with community organizations to identify patients with limited access to dermatology services.
• Train nurse practitioners in teledermatology, focusing on diagnosing and managing conditions in skin of color (e.g., melasma, PIH, traction alopecia).
• Use telehealth platforms to provide consultations and follow-ups, incorporating AI tools for enhanced skin analysis.
• Measure program success by tracking patient outcomes, satisfaction, and access metrics over 3-6 months.
Impact: This project could expand access to dermatologic care and set a model for sustainable telehealth initiatives.
My Derm NP Friends
Looking for in-person aesthetic training and mentorship? Check out my Derm NP Entrepreneur friends and tell them I sent you!
-Ivy Cleveland, MSN-AGACNP-BC at Spoken Med Spa in Snellville, GA
Conclusion
The practice of aesthetic dermatology offers dermatology NPs a unique opportunity to combine technical expertise with patient education and advocacy. By prioritizing individualized care, fostering cultural sensitivity, and pursuing advanced education, we can enhance the quality of aesthetic treatments and empower our patients to feel confident in their skin at every stage of life. As the demand for aesthetic care continues to grow, dermatology nurse practitioners must lead the way in promoting equitable, evidence-based, and inclusive practices for all patients, especially those with skin of color. Join the community to be notified with the third and final installment of this series is released.
Kimberly Madison, DNP, AGPCNP-BC
I am a Board-Certified Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research, I aim to expand access to dermatology research, business acumen, and innovation using artificial intelligence and augmented reality while also leading professional groups and mentoring clinicians. Through engaging and informative social media content and peer-reviewed research, I empower nurses and healthcare professionals to excel in dermatology and improve patient care.
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