Immigrants and refugees receive special treatment at unique skin clinic

By Gita Abraham
Local Journalism Initiative Reporter
New Canadian Media

Ottawa’s general hospital has opened a clinic that focuses exclusively on immigrants and refugees who often have different skin problems than people who were born in Canada.

The Skin of Colour Dermatology Specialty Clinic at The Ottawa Hospital Civic Campus is the first of its kind in Canada.

Dr. Reetesh Bose, a dermatologist and founder of the clinic, said several skin conditions, including psoriasis and eczema, are increasingly diagnosed in immigrants and refugees. He said patients may have suffered with these issues before they immigrated to the country, but the condition flared up because of the dry, cool climate in Canada.

Bose said white-skinned people are prone to skin cancer because they have less melanin in their skins compared to those who are Black, Asian or mixed-race. Melanin provides protection against ultraviolet rays from the sun and pigmentation to skin, hair and eyes.

Skin cancer has been on the rise in Canada for the past 30 years. Based on current statistics, one in 73 women and one in 59 men develop melanoma, a serious skin cancer that mostly affects people with lighter skin.

In 2019, the Canadian Cancer Society estimated 7,800 Canadians would be diagnosed with melanoma and 1,300 Canadians would die from it that year.

The Skin of Colour clinic focuses on providing care and the latest treatments for patients with non-white skin, which includes people who are of South Asian, Chinese, Black, Filipino, Latin American, Arab, Southeast Asian, West Asian, Korean and Japanese origin.

So far, about 150 patients have been treated at the clinic, which officially opened in December 2022.

“Throughout my training, I found hardly any focus on diverse skin types in dermatology, with very few images in textbooks showing conditions in dark skin types,” said Bose, who studied and practised in the U.S. He said this lack of information led him to delve deeper into the subject.

Bose said immigrants might have been given mixed diagnoses and not found answers as to why they have scarring and other skin and scalp conditions. He said their skin cancer symptoms may have been misread as fungal infections.

“When patients finally approach a dermatologist, the delays in diagnosis could affect the outcomes of treatment,” Bose said. “Melanoma is the most serious type of skin cancer.

“When skin is exposed to UV light, melanocytes produce more melanin and melanoma of the skin is most common.” Melanocytes are found in the lowest layer of the skin’s epidermis.

Bose said using tanning equipment, as well as applying henna can increase the risk of skin cancer. Henna can cause side effects such as redness, itching, burning, swelling, blisters and scarring of the skin. The temporary dye is applied on the skin by South Asians, as well by people from African and Middle Eastern countries. Henna is also added to hair dyes.

Psoriasis and eczema are common skin conditions seen in immigrant populations in Canada, Bose said. According to the Canadian Dermatology Association, psoriasis affects one million Canadians and 125 million people worldwide.

The National Eczema Association states people of all skin colours, races and ethnicities can be affected by eczema. Those from Asian and South Pacific Islands are slightly more affected by the disorder.

Dr. Reetesh Bose is a dermatologist with the Ottawa Hospital who has founded a clinic, the Skin of Colour Dermatology Specialty CLinic, in order to better assist immigrants and refugees to Canada who could experience skin conditions that are different from those experienced by people who were born in Canada. – The Ottawa Hospital photo

People with darker skin tones are also more likely to be diagnosed with alopecia areata (hair loss), keloids (thick raised scars), lupus (immune system disorder) and vitiligo, a chronic autoimmune disorder that causes patches of skin to lose pigment. Alopecia is more likely to affect African Americans than White or Asian Americans. If it is diagnosed at an early stage, Bose said alopecia can be treated and permanent hair loss prevented.