Addressing needs of Muslim patients in dermatology

Key takeaways:

• Muslim patients exhibited a lack of familiarity with dermatology care.
• Muslim patients tended to avoid medications that break a halal diet and reported changing their medication regimen for Ramadan.

Researchers recommend incorporating religion into cultural humility training for dermatologists to better serve Muslim patients, according to a study.

“The impact of religious identity on dermatologic care is an understudied topic,” Ghida El-Banna, MD, MPP, of the department of dermatology at Stanford University School of Medicine, and colleagues wrote. “To explore the impact of the cultural, social and political lived experiences of Muslim patients seeking dermatologic care, we conducted a mixed-methods study.”

In the study, researchers surveyed 21 Muslim patients (mean age, 36.4 years) in the U.S. Of the 16 women, 10 wore hijab. Most participants (n = 11) identified as Middle Eastern followed by South Asian (n = 8), North African (n = 1) and Pacific Islander (n = 1).

Results showed that Muslim participants had a general lack of familiarity with dermatology care in the U.S. For example, many participants believed that they were protected against skin cancer because of their darker skin tones and modest coverings. In fact, some perceived sunscreen as simply a cosmetic tool to avoid getting darker.

According to the survey, some participants believed cosmetic care was more accepted among higher socioeconomic classes, whereas others described cosmetic care as “haram,” which means “religiously impermissible” because it alters God’s creation and is considered unnatural or unnecessary.

“Participants sometimes had barriers to dermatology care, especially when skin disease was not life threatening or when skin treatments were costly,” the authors explained.

Participants also expressed stigma surrounding cutaneous manifestations of sexually transmitted diseases and any conditions affecting private body parts. As a result, most participants felt more comfortable with a clinician of the same sex.

According to the study, past experiences with Islamophobia and colorism made Muslim participants feel as though they could not disclose necessary information to their dermatologist. However, when asked if they ever felt unfairly treated or discriminated against in a dermatology clinic, all but one patient said they did not.

Nevertheless, some participants expressed a preference for Muslim dermatologists or dermatologists with skin of color on the grounds of higher relatability of culture and religious practices. For example, participants expressed avoiding medications that contain gelatin, such as isotretinoin, because gelatin is not in accordance with a halal diet. Further, they expressed altering their oral medication schedules to accommodate fasting during Ramadan.

“This qualitative mixed-methods study highlights the importance of integrating religion into existing cultural humility training because it may improve dermatologists’ knowledge of the unique needs of Muslim patients,” the authors concluded.