Double Standards and Inconsistencies in Access to Care—What Constitutes a Cosmetic Treatment?

Barbieri, John S.; LaChance, Avery; Albrecht, Joerg

doi:10.1001/jamadermatol.2022.6322

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…While some payers are no longer covering acne care based on the rationale that it is merely cosmetic, only 26.4% of participants believed that acne is a cosmetic issue . Our findings expand on understanding of the quality-of-life impairment associated with acne, suggesting that stigmatizing attitudes might result in negative effects on relationships, education, and employment opportunities.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Stigma Toward Individuals With Acne

Shields,

Nock,

et al. 2024

JAMA Dermatol

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ImportanceLittle is known about the prevalence and magnitude of stigmatizing attitudes of the general public toward individuals with acne.ObjectiveTo explore the degree of stigma toward individuals with acne and whether these attitudes vary based on characteristics of the individuals with acne or of the survey participants.Design, Setting, and ParticipantsIn this cross-sectional internet survey study, 4 stock portraits of adults that varied in sex (male/female) and skin tone (light/dark) were digitally enhanced to have acne (mild/severe). One of these 12 images was randomly presented to survey participants, who subsequently answered questions regarding stigmatizing attitudes with respect to the pictured individual, such as desire for social distance and stereotype endorsement. The survey was administered to a convenience sample of adult respondents in the US who were volunteers on the ResearchMatch platform.Main Outcomes and MeasuresPrevalence and magnitude of stigma toward individuals with acne.ResultsThe survey was completed by 1357 respondents (65.7% completion rate) (mean [SD] age, 42.4 [14.3] years; 918 [67.7%] female, 439 [32.4%] male). Compared to those with no acne, for those with severe acne, participants reported less comfort being friends (adjusted coefficient [95% CI], −0.28 [−0.47 to −0.10]; P = .003), hiring (−0.33 [−0.51 to −0.15]; P &lt; .001), having physical contact (−0.26 [−0.45 to −0.08]; P = .006), dating (−0.44 [−0.74 to −0.14]; P = .004), and posting a photograph together on social media (−0.50 [−0.70 to −0.30]; P &lt; .001). Compared to those with no acne, participants were more likely to rate individuals with severe acne as having poor hygiene (adjusted coefficient [95% CI], −1.04 [−1.46 to −0.82]; P &lt; .001) and being unattractive (−0.89 [−1.12 to −0.67]; P &lt; .001), unintelligent (−0.42 [−0.63 to −0.22]; P &lt; .001), unlikable (−0.36 [−0.56 to −0.15]; P &lt; .001), immature (−0.52 [−0.74 to −0.30]; P &lt; .001), and untrustworthy (−0.40 [−0.61 to −0.18]; P &lt; .001). There was evidence that the effect size of the association of acne with desire to social distance was greater for individuals with dark skin.Conclusions and RelevanceThis survey study demonstrates that stigmatizing attitudes toward patients with acne existed across a variety of social and professional scenarios, with severe acne and acne in darker skin tone being associated with a greater degree of stigma. These findings highlight the need to identify approaches to reduce stigmatizing attitudes in the community and for adequate access to care, which might prevent negative downstream effects related to these stigmatizing attitudes.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Stigma Toward Individuals With Acne

Shields,

Nock,

et al. 2024

JAMA Dermatol

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“…Dear Editor, Acne vulgaris is a common, chronic skin disorder that fulfils the WHO criteria of common chronic disease 1 (Table 1) and which can be associated with substantial psychosocial effects as well as dyspigmentation and permanent scarring. 2 Acne is responsible for 4.96 million disability-adjusted life years (DALYs), the second largest contributor of combined skin age-standardized DALYs 3 and is responsible for a greater global burden of disease than psoriasis, cellulitis, and melanoma. 4 However, despite these impacts, acne is often considered a cosmetic disorder.…”

Section: E T T E R T O T H E E D I T O R a Call For Action To Tackle ...mentioning

confidence: 99%

A call for action to tackle the increasing global burden and challenges of acne

Oon

Lim

Barbieri

et al. 2023

Acad Dermatol Venereol

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“…34 This additional silo of subcertification at the genus level of taxonomy has the potential to flank its own membership undoubtedly complicating an already crowded field. Also within the ABMS, some members of the American Board of Dermatology not only receive training in the use of Botox and/or fillers within the face 35 but also in tumescent liposuction. Similarly, members of the American Board of Family Medicine or Internal Medicine receive training in certain surgical procedures.…”

Section: Nutritionally Rich Renumeration: Aesthetic/cosmetic Surgerymentioning

confidence: 99%

Applying Principles of Evolutionary Biology to Plastic Surgery at an Organizational Level Predicts an Extinction Event

Zbar

Taylor²,

Canady³

2023

Aesthetic Surgery Journal Open Forum

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As an organized profession, plastic surgery struggles delivering a clear message regarding scope of practice to patients given the diversity of procedures performed. Whereas granting licensure to practice medicine resides in governmental bodies, certification rests within organizations. However, certification is not required to practice plastic surgery. Since plastic surgery operationalizes techniques rather than working within a defined body organ, competition for patients is intense. Mapping territorial interactions between healthcare providers while parsing taxonomy elucidates individual, community, organizational, and governmental levels creating various selection pressures. Applying evolutionary biology as a framework predicts the termination of plastic surgery over time as a unique specialty. An entirely new domain, Restorative Healthcare, is proposed which circumvents an extinction outcome.

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Double Standards and Inconsistencies in Access to Care—What Constitutes a Cosmetic Treatment?

Abstract: This Viewpoint examines the inconsistencies in classification of cosmetic vs medical care and offers potential solutions to the issue of payers not providing coverage for skin conditions that have psychosocial effects.

Cited by 6 publications

References 8 publications

Evaluation of Stigma Toward Individuals With Acne

Evaluation of Stigma Toward Individuals With Acne

A call for action to tackle the increasing global burden and challenges of acne

Applying Principles of Evolutionary Biology to Plastic Surgery at an Organizational Level Predicts an Extinction Event

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