The LGBTQ+ community faces significant disparities in healthcare access and dispensation at practically every level and in every area of specialization, including dermatology. The specialized individual and public health issues to which this population has been found to be particularly vulnerable often include immediate and long-term dermatological impact; however, access to proper skin care is just one of many aspects of healthcare that eludes them. These disparities exist at the both the juvenile and adult levels, and it’s important to understand how they emerge, why their treatment is often hindered and what you or your loved one can do to independently manage them.
Common Skin Issues among the LGBTQ+ Community
There are multiple health conditions that specifically affect the LGBTQ+ community more than the heterosexual cisgender population. Many of these conditions come with associated dermatological symptoms, among others. Below are some of the conditions to which LGBTQ+ patients are vulnerable and the skin conditions that often accompany them.
The United States Department of Health and Human Services indicates that LGBTQ+ community members, specifically lesbian women, struggle with higher rates of heart disease, which can lead to skin issues, including but not limited to:
- Yellowish-Orange Waxy Growths
- Clusters of Waxy Bumps
- Painful Lumps on the Fingers and Toes
- Brownish-Red Discoloration on the Palms
- Persistent Non-Itchy Rash
These skin conditions are emblematic of poor heart health and will, thus, require a proper cardiac care plan. To treat them immediately, keep the area clean and dry. Your doctor may also recommend topical ointments and antibiotics if the issue is related to bacteria.
Different Types of Cancer
LGBTQ+ are also prone to higher rates of cancer, according to data from Department of Health and Human Services Office on Women’s Health. Cancer leads to a variety of dermatological conditions, including but not limited to:
Dry Skin – Often manifested through red, flaky patches; cracks; and even slight bleeding at areas of skin covering the joints. To treat these issues, apply moisturizing alcohol-free lotions twice daily; wash with cool or warm water; avoid harsh scrubbing as well as colognes and aftershaves that contain alcohol; and use an electric razor. You should also protect your skin from harsh or extreme weather and stay hydrated. Drink as much fluid as your care provider says is OK. You should also work with your oncologist and dermatologist to address these issues as they continue to emerge.
Severe Itchiness and Rash – Identified through discoloration, cracks, bumps, scratch-marks and more. To treat itchiness, you can do things like applying alcohol-free creams twice per day; bathe in warm water; add baking soda, oatmeal (in a cloth or mesh bag), or bath oil to your bath water; wear loose clothes; pat your skin dry instead of harsh rubbing; stay hydrated and keep your room at 60-70 degrees Fahrenheit. You can reduce the desire to scratch, keep your nails short, apply cold packs to the skin and asking your doctor for anti-itching creams.
If you’re caring for someone with cancer, monitor what kind of detergent, soaps and other skin-contact agents they’re using for skin side effects.
Discoloration – Different events in the cancer treatment journey, including tumor growth can lead to yellowing, reddening and paleness of the skin. To treat these issues, ask your doctor about medications; carefully rinse and pat the affected area dry; protect yourself from extreme weather and temperature; protect your skin from the sun; use sunscreen with an SPF of 30 or higher on any skin that is exposed to the sun. If you’re caring for someone with cancer, you should keep them from bathing in hot water.
Pressure Sores – Also known as “bed sores”, pressure sores occur when the affected area of the skin doesn’t get enough blood flow because of pressure on the area. They often appear as cracked, blistered, scaly, or broken skin, but can leak yellowish puss-like fluid when they’re more severe. To treat or manage pressure sores, try to move around as much as possible in your bed or chair and aerate the area. Try to change position at least every two hours. You should also stay hydrated and start eating more high-protein foods.
If you’re caring for someone with cancer, rinse the affected area thoroughly and carefully apply bandages. Use ointments and creams as directed and only use bandages that have been approved by your loved one’s cancer care team. Generally speaking, it’s best to work with your oncologist to develop a stage-appropriate dermatological care plan to address your continuing pressure sores.
For cis and trans women who are struggling with cancer-related skin conditions, the American Cancer Society offers a variety of helpful makeup and cosmetic tips. Scarring and wounds are also not uncommon during the oncology journey and can be managed by proper bathing with warm water, thoroughly drying and dressing and physician-approved topical ointments and medications. If you’re caring for someone with cancer, make sure you wash your hands thoroughly before dressing any wounds to prevent further bacteria and infection.
Obesity, Weight and Fitness Issues
Certain subsets of the LGBTQ+ population are more prone to weight and obesity issues that can lead to associated skin conditions. Data from the Strayer University indicates that lesbian and bisexual women, specifically, struggle with weight and obesity, as does research from Boston University and the American Psychological Association. Fitness issues can, and do, also affect gay and bisexual men.
Obesity and dermatological issues are linked on multiple fronts, including skin conditions caused by eating foods high in sugar and trans fats, as well as everyday issues like skin-fold irritation. Some of the many skin issues tied to weight issues and obesity include:
- Skin Ulcers
- Atopic Eczema
- Plantar Hyperkeratosis
Skin-fold issues can be managed by keeping the area clean and dry, as well as through antifungal topical ointments and medications. For more serious issues, you will have to speak with your primary care physician or dermatologist. Obesity also creates higher risk of skin infections such as folliculitis, candidiasis, furunculosis, erythrasma, and tinea cruris, as a result of obesity and comorbid conditions such as diabetes and impaired circulation. It can also increase the risk of melanoma.
Sexually Transmitted Diseases
Gay and bisexual men, specifically, are at considerably higher risk of sexually transmitted diseases, including but not limited to HIV/AIDS, hepatitis A, B, or C virus; human papillomavirus (HPV), etc. These conditions can cause a variety of skin issues, including but not limited to:
- Skin Tags
- Dry Skin
Skin issues are actually one of the first and most immediate signs of some types of STDs, like syphilis, herpes, genital warts and gonorrhea and more. While flare-ups may be managed by everyday interventions, such as keeping the area clean and applying topical and antibiotic ointments, it’s best to work with your healthcare provider to form a comprehensive care plan. Be sure to always use protection and the appropriate contraception to mitigate the possibility of unwanted pregnancy and sexually transmitted infection.
Substance Use Disorder
Like other types of mental health issues, substance use disorder (SUD) is particularly common in the LGBTQ+ population:
- 26% of transgender or gender non-conforming adults reported misusing drugs or alcohol to cope with transgender-related discrimination. 42% attempt suicide.
- LGBTQ+ people are twice as likely to abuse substances than heterosexual patients.
- Past year opioid use (including misuse of prescription opioids or heroin use) was also higher with 9% of sexual minority adults aged 18 or older reporting use compared to 3.8% among the overall adult population.
Substance use can lead to a variety of skin issues. These can include track marks from repeated needle use, breakouts from prescription and meth abuse, yellowing and discoloration of skin and more. While certain everyday cosmetic and clinical interventions may help, you or your loved one need quality and effective substance use disorder treatment.
Skin Scars from Self-Harm
The LGBTQ+ population is also at increased risk of self-harm. Alongside comprehensive mental health treatment for the underlying causes and immediate impact of these conditions, there are ways to treat the scars from the period in your life when you were engaging in self-harm. Consult a dermatologist to identify what treatment is available, based on what types of scars you have. Some of the more common ways to treat scars from past self-harm include grafting and laser surgery.
Developing a Proper Skin Care Plan Based on Your Clinical Needs and Conditions
There is a deep and intricate correlation between LGBTQ+ health disparities and proper skin care; however, this correlation manifests in multiple ways, sometimes more superficial and sometimes more serious. One element of this relationship that is universally apparent is the toll these issues can take on emotional health and self-confidence, which are issues felt more and more by the LGBTQ+ community.
Always remember that you don’t have to be afraid or ashamed of these conditions, and you can empower yourself by working with your care team and an experienced dermatologist to address these issues as they emerge. Talk to your doctor today about moving forward with a proper care plan.