(WHS-L4.03) RACIAL DISPARITIES IN INCIDENCE OF AND ACCESS TO HYPERTROPHIC AND KELOID SCAR MANAGEMENT
Thursday, May 16, 2024
10:30 AM – 11:30 AM East Coast USA Time
Background: Incidence of hypertrophic and keloid scars is influenced by inherent skin attributes such as skin color. Both are clinically challenging to forecast and manage. This study aims to understand differences in occurrence and access to treatment to normalize skin color as consideration of scar management following surgery or trauma in order to achieve optimal results.
Methods: Using the All of Us Research Program's Data and Research Center (DRC), the incidence of hypertrophic and keloids scars segmented by race was retrospectively analyzed. Proportions of scars for Black and White self-identifying patients were compared to the rates of access to treatment, defined as either topical or revision protocol to address scars by race. Chi-squared test and Mann–Whitney U test were used to determine statistical significance between groups.
Results: 10,910 total scars were included. Hypertrophic and keloid scars represented 16.0% and 12.6% of these scars across all races. Scars in Black patients represented 31.9% of hypertrophic scars and 34.5% of keloids while overall scars from Black patients only represented 17.4% of the total (p < 0.05). Black patients only represented 20.2% of all scars treated topically and 20.0% of scars treated with a revision protocol. There was a statistically significant difference between the proportion of hypertrophic and keloid scars represented by Black patients and the proportion of scars treated (p < 0.05).
Conclusion: Black patients have a disproportionately lower rate of access to treatment as compared to the rate of incidence of hypertrophic and keloid scars. As Black patients are more likely to have worse perceptions and lower probability of improvement for these scar types, it is important to increase access to treatment options. This study highlights the need to address patient race when considering the healing process of wounds.