Eczema, Acne, and Skin Cancer Screening: Why Every Bronx Family Needs a Dermatologist

Dermatology has an access problem in the Bronx. The borough has one of the lowest ratios of dermatologists to residents in all of New York City. Wait times at hospital-based clinics can stretch to months. And for patients with darker skin tones — who make up the majority of the Bronx population — there is an additional challenge: many dermatologists were trained primarily on presentations in light skin, which means conditions are missed, misdiagnosed, or undertreated.

This guide explains common skin concerns by age group, what dermatology visits can include, and why skin of color deserves careful evaluation. Moses Medical sees children, teens, adults, and older patients for concerns ranging from eczema and acne to skin cancer screening.

Skin Conditions by Life Stage

Your skin changes throughout your life, and different conditions emerge at different stages. Here are common concerns that bring patients to a dermatology visit, organized by age group.

Infants and Young Children (0-5)

Eczema (atopic dermatitis) is one of the most common skin concerns in young children. It affects up to 20% of children in the U.S., and prevalence is higher in Black and Latino children. Eczema presents as dry, itchy patches that can appear anywhere but are especially common on the cheeks, elbows, and behind the knees.

In darker skin, eczema does not always look red. It may appear as dark brown, purple, or ashy-gray patches — a presentation that is frequently overlooked by providers unfamiliar with skin of color. Parents often describe their child as “just having dry skin” when what they are looking at is active eczema that needs treatment.

What the visit may include: a skin care plan with appropriate moisturizers, topical medications when needed, and trigger identification. Common triggers include certain detergents, fabrics, and foods. For moderate to severe cases, the clinician may discuss newer therapies, including non-steroidal topicals and, in select cases, biologics.

School-Age Children and Teens (6-17)

Acne dominates this age group. What many families do not realize is that acne is not a cosmetic issue — it is a medical condition that, left untreated, can cause permanent scarring and significant psychological distress. Adolescent acne affects self-esteem during a critical developmental period, and the earlier it is treated properly, the better the outcomes. If your teen is struggling emotionally, our behavioral health team can help — they understand the unique pressures facing young people in the Bronx.

Post-inflammatory hyperpigmentation (PIH) is another major concern in young patients with darker skin. Even after acne clears, it can leave dark marks that persist for months or years. Treating the underlying acne early can help reduce the risk of lingering marks.

Scalp conditions including tinea capitis (ringworm of the scalp) are more common in Black children and require oral antifungal treatment. Topical creams alone are not effective for scalp infections. Traction alopecia can also affect teenagers who wear tight braids, weaves, or ponytails. Early intervention can prevent permanent hair loss.

What the visit may include: evidence-based acne treatment such as topical retinoids, benzoyl peroxide, antibiotics when needed, and isotretinoin for severe cystic acne. For PIH, treatment may include brightening agents and sun protection strategies tailored to the patient’s skin type.

Adults (18-64)

Adult dermatology in the Bronx is heavily driven by chronic conditions:

• Psoriasis — an autoimmune condition causing thick, scaly plaques that can be painful and socially isolating. In darker skin, psoriasis plaques may appear purple or dark brown rather than the classic pink-red shown in textbooks.
• Hidradenitis suppurativa — a chronic inflammatory condition causing painful lumps under the skin, typically in the armpits, groin, and under the breasts. It disproportionately affects Black women and is severely underdiagnosed.
• Fungal infections — including toenail fungus and skin fungal infections, which are common in patients with diabetes or compromised immune systems.
• Dermatitis — contact dermatitis, seborrheic dermatitis, and other chronic skin irritations that affect quality of life.
• Skin cancer screening — yes, even in patients with darker skin. While melanoma is less common in darker-skinned individuals, it is more deadly because it tends to be diagnosed later. Acral melanoma — melanoma of the palms, soles, and nail beds — actually occurs at similar rates across all skin types and is frequently missed.

What the visit may include: an individualized plan. For chronic conditions like psoriasis and hidradenitis, treatment may include topical therapies, systemic medications, and biologic agents when appropriate. For skin cancer screening, the exam should pay attention to areas that are commonly missed in patients with darker skin.

Older Adults (65+)

Skin becomes thinner, drier, and more fragile with age. Common concerns include:

• Pre-cancerous lesions (actinic keratoses) that require monitoring or treatment
• Skin tears and chronic wounds — which may overlap with our wound care program. Patients with diabetes should pay particular attention here, as diabetic wounds require specialized care to prevent serious complications.
• Severe dry skin (xerosis) leading to itching and secondary infections
• Shingles-related skin complications
• Medication-related skin reactions — older adults take more medications, and drug rashes are common

Why Skin of Color Expertise Matters

Medical education is changing, but slowly. The majority of dermatology textbooks and training programs historically featured images almost exclusively from light-skinned patients. This means that many providers — even well-intentioned ones — have less experience recognizing how conditions present in Black, Latino, South Asian, Middle Eastern, and East Asian skin.

At Moses Medical, skin of color is not an add-on topic. It is part of how dermatology concerns should be evaluated, documented, and treated.

Some practical differences:

• Eczema may look gray or violet, not red
• Psoriasis plaques may be darker and harder to distinguish from surrounding skin
• Keloids (raised, overgrown scars) are more common in patients of African descent and require specialized treatment approaches
• Melanoma on darker skin often appears on the palms, soles, or under nails — areas that are easy to overlook
• Post-inflammatory changes (both dark and light marks) are more pronounced and require specific management

What a Dermatology Visit Looks Like

If you have never seen a dermatologist, here is what to expect at Moses Medical:

1. Check-in and intake. Like any other appointment. You will fill out a brief questionnaire about your skin concerns, medical history, and current medications.

2. Skin examination. Depending on your reason for the visit, the clinician may examine just the affected area or perform a more comprehensive skin check. For a full-body skin cancer screening, you will be provided a gown. A dermatoscope, a magnifying instrument with built-in lighting, may be used to evaluate suspicious spots.

3. Discussion and plan. Your clinician explains what they see, what it may mean, and what the treatment options are. If a biopsy is needed, it is a quick, in-office procedure done under local anesthesia. Results usually come back within a week.

4. Follow-up. Many skin conditions are chronic and benefit from regular follow-up. We schedule visits at intervals that make sense for your specific condition — monthly for active acne treatment, quarterly for chronic conditions, annually for skin cancer screening.

Insurance and Access

Dermatology visits at Moses Medical are covered by MetroPlus, Fidelis Care, Amerigroup, and all other Medicaid managed care plans we accept, as well as Medicare and most commercial plans. For a detailed look at what your specific plan covers and whether you need a referral, see our Medicaid coverage guide. Most managed care plans require a PCP referral for dermatology; if your PCP is at Moses Medical, we can handle the referral internally and often see you the same week.

Book a dermatology visit or call (646) 741-2111. Moses Medical is at 871B Westchester Ave, Bronx, NY 10459.