In 2023, the American Society of Plastic Surgeons reported that approximately 15 percent of all cosmetic procedures in the United States were performed on patients who identified as Black, Hispanic, or Asian. The industry generates over $16 billion annually. The math is not difficult.

The medical aesthetics industry has, for most of its modern history, been built around a single aesthetic standard — one that is white, thin, and largely Northern European in its idealized proportions. The marketing reflects it. The clinical training reflects it. The before-and-after photography that populates the websites of most aesthetic practices reflects it. And the patients who do not fit that standard have, for decades, been treated as edge cases — accommodated when necessary, but rarely centered.

Representation in medicine is not a diversity initiative. It is a clinical imperative. When patients do not see themselves reflected in a practice — in its imagery, its staff, its understanding of their skin — they do not come back. And the gap in their care widens.

I know this not only as a physician but as a patient. As an African American woman who has navigated the medical aesthetics space from both sides of the treatment table, I have experienced firsthand what it feels like to walk into a clinic and sense, immediately, that the space was not designed with you in mind. Not because anyone said so. Because no one had to.

What the Data Actually Shows

The underrepresentation of people of color in medical aesthetics is not a perception problem. It is a structural one, documented across multiple dimensions of the industry.

Clinical training in aesthetic medicine has historically centered lighter skin tones. The Fitzpatrick scale — the most widely used classification system for skin phototype in aesthetic and dermatological practice — was developed in 1975 by a white Swiss dermatologist studying tanning response to ultraviolet radiation. It remains the dominant framework for laser and light-based treatment protocols. Its limitations for darker skin tones are well-established in the literature, yet many practitioners receive minimal training in how to adapt their approach for Fitzpatrick Types IV through VI. The consequences are not theoretical. They include post-inflammatory hyperpigmentation, burns, and scarring — outcomes that occur at disproportionate rates in patients with melanin-rich skin when treated by providers who lack the appropriate training.

The research literature compounds this picture. A 2021 analysis published in the Journal of the American Academy of Dermatology found that Black patients were significantly less likely than white patients to receive cosmetic dermatology services, even after controlling for income and insurance status. A 2020 study in JAMA Dermatology found that clinical trials for dermatological treatments enrolled Black participants at rates far below their representation in the general population — meaning that the evidence base for many treatments has been generated almost entirely in white skin. The treatments are then applied broadly, without adequate data on how they perform across the full spectrum of human skin.

When the evidence base excludes you, the standard of care was never fully built for you. That is not a grievance. It is a fact — and facts can be changed.

The marketing dimension is equally well-documented. A 2019 analysis of the top fifty medical aesthetics practices in the United States found that fewer than eight percent of the patient photography featured on their websites depicted patients of color. The industry's visual language has communicated, consistently and at scale, that aesthetic wellness is a white space. The effect on patient behavior is measurable: studies on healthcare-seeking behavior consistently show that patients are more likely to pursue care in environments where they see themselves represented.

What It Means to Build Differently

When I began designing The Skin Parlor™, I made a series of deliberate decisions that I want to name clearly — not because they are exceptional, but because they should be standard, and they are not.

First: equipment selection. The GentleYAG Nd:YAG laser system we use for permanent hair reduction was chosen specifically for its safety and efficacy profile across all Fitzpatrick skin types, including the deepest skin tones. The 1064nm wavelength penetrates deeper into the skin with less absorption by melanin in the epidermis — which is precisely what makes it safer for darker skin. This was not a secondary consideration in our equipment selection. It was the primary one. A practice that cannot safely treat every patient who walks through its doors has made a choice about who it is willing to serve.

Second: provider training. Every treatment protocol at The Skin Parlor™ is developed with melanin-rich skin as the baseline, not the exception. Our approach to injectables accounts for the anatomical and aesthetic differences in facial structure across ethnicities — differences that are real, clinically significant, and frequently ignored in standardized training curricula. The goal of aesthetic medicine is never to impose a single standard of beauty. It is to enhance what is already present. That requires understanding what is present.

Enhancement is not homogenization. The most skilled aesthetic practice honors the particular — the specific face, the specific skin, the specific person — rather than moving every patient toward the same idealized result.

Third: the visual language of the practice. The imagery at The Skin Parlor™ — in our marketing, on our walls, across every patient-facing surface — reflects the full range of people we serve. Men and women. Multiple ethnicities. Multiple body types. Multiple ages. This is not a diversity statement. It is an accurate representation of our patient population and of the community we are embedded in. Mississippi is one of the most racially diverse states in the country. A practice that does not reflect that diversity in its visual identity has made a choice, whether consciously or not.

Fourth: pricing and access. The underrepresentation of people of color in medical aesthetics is not only a cultural or clinical problem. It is an economic one. Aesthetic medicine has historically positioned itself as a luxury category — and luxury, in the American context, has a racial dimension that is impossible to separate from its history. We have structured our pricing deliberately to make physician-guided aesthetic care accessible to patients across income levels. That decision is inseparable from our commitment to representation. You cannot claim to serve a community while pricing them out of your doors.

The Longer Conversation

I want to be precise about what I am and am not claiming here.

I am not claiming that The Skin Parlor™ has solved the representation problem in medical aesthetics. No single practice can. The structural issues I have described — in clinical training, in research methodology, in industry marketing, in pricing — require industry-wide responses that are slow in coming and uneven in their progress.

What I am claiming is that the choices a practice makes — about equipment, about training, about imagery, about pricing, about who it centers in its design — are not neutral. They are decisions. And decisions can be made differently.

Every practice in this industry makes choices about who it is built for. We made ours deliberately, with full awareness of what the industry has historically chosen — and with a clear intention to choose otherwise.

There is also a clinical argument to be made here that I think is underappreciated. Diverse patient populations present with diverse clinical needs. A practice that has developed genuine expertise in treating melanin-rich skin — in understanding its particular vulnerabilities, its particular strengths, its particular response to treatment — is a more skilled practice across the board. The clinical knowledge required to treat Fitzpatrick Type VI safely makes you a better clinician for every patient you see. Representation is not only an equity issue. It is a quality issue.

I have watched the medical aesthetics industry change over the past decade — slowly, unevenly, but perceptibly. More practices are investing in training for diverse skin tones. More brands are expanding their visual representation. More conversations are happening at the clinical and educational level about the gaps in the evidence base. The direction is correct. The pace is insufficient.

The standard should not be that a Black woman can find one practice in her city that knows how to treat her skin safely. The standard should be that she cannot find one that does not.

Until that standard is met, practices like The Skin Parlor™ will continue to exist not as exceptions but as demonstrations of what is possible — and as quiet, persistent arguments for what the industry should become.

We built this place to be different. We intend to stay that way.