The Epidemic You Didn’t See Coming: Cüties and the Battle for Skin Health in Communities of Color

It started innocuously enough. In playground whispers and childhood taunts, “Cüties” were the stuff of elementary school myth—a make-believe contagion exchanged with a touch, a teasing jab between friends. But beyond the jest, the metaphor of Cüties has carried into adulthood, symbolizing something much deeper: a real-life epidemic, particularly in marginalized communities, where misinformation, lack of access to quality care, and cultural stigmas around skin health persist.

As whimsical as the term may seem, the real-world equivalent—acne vulgaris, eczema, hyperpigmentation, and various other skin conditions from the contributing Cutibacterium Acnes—has disproportionately impacted people of color, with Black communities facing unique hurdles in diagnosis, treatment, and access to proper skin care. For decades, the dermatological world has been dominated by white-centric research, clinical trials, and education. And while strides have been made, the representation gap in dermatology is glaring. A recent study revealed that out of all dermatologists practicing in the U.S., only 3% identify as Black.

The Unseen Epidemic

At the heart of this issue is how skin conditions manifest differently in Black and Brown communities. Hyperpigmentation, keloids, and other visible scars can often result from improper care, leading to both physical and emotional scars. For those like me, who grew up in a household where well-intentioned advice from family members on how to treat acne and skin cuts often led to worsened conditions, the long-term effects are deeply personal. Many of us bear the lasting evidence of misinformed remedies, with scars that reflect not just skin damage but a system that has left us behind.

This is not just anecdotal. The data backs it up. According to a comprehensive review published in The Journal of Clinical and Aesthetic Dermatology, acne is the most common skin disorder in the U.S., affecting 50 million people annually. However, the representation of patients of color in acne studies is consistently low, with research often failing to account for the unique manifestations of acne in darker skin tones.

What exacerbates this is the misinformation that circulates in communities of color. According to the British Journal of Dermatology, Black patients are often misdiagnosed when presenting with conditions that look different in melanated skin, such as psoriasis or eczema. These disparities reflect a broader issue: the lack of diversity in medical research and dermatological education.

In Nimbus and the Cütie Catchers, my latest work of fiction, I sought to address this very issue, using a whimsical narrative to delve into serious themes around skin health. The metaphor of Cüties, which in the story manifests as various skin ailments, represents the misinformation and barriers to proper care that many in our communities face. It’s not just about defeating monsters; it’s about confronting deeply ingrained social and medical inequities.

A Deeper Look into Skin Conditions

The very real science behind skin infections is alarming, particularly when it comes to underrepresented populations. For example, Cutibacterium acnes (formerly Propionibacterium acnes), the bacteria linked to acne, behaves differently based on environmental and genetic factors, including skin type and tone. Studies have shown that people with darker skin are more prone to certain forms of acne and post-inflammatory hyperpigmentation, a condition where dark spots appear after a breakout.

According to a study in Nature Scientific Reports, bacteria like C. acnes can become more virulent when exposed to certain stressors, such as pollution or hormonal changes, which are more prevalent in dense urban environments. These stressors disproportionately affect communities of color, who are more likely to live in areas with higher pollution levels and environmental degradation, further aggravating skin conditions.

Moreover, as C. acnes evolves, its resistance to antibiotics—traditionally the go-to treatment for acne—has become a pressing issue. Research published in Trends in Microbiology highlights the alarming rate at which antibiotic resistance is spreading, especially in overexposed populations. This raises serious questions about the sustainability of current treatments and the need for innovative solutions tailored to underrepresented groups.

The Power of Representation in Dermatology

The intersection of race, skin health, and equity in care is where my passion for creating Nimbus and the Cütie Catchers lies. As the only Foundational Black American medical student in my school, I’ve seen firsthand how the healthcare system often neglects the unique needs of Black patients. When I created Nimbus, the quirky protagonist of my story, I wanted him to be more than a hero. I wanted him to represent the resilience required to not only overcome external monsters but the internal battles of self-worth and insecurity that arise from being “othered” in both the healthcare and societal systems.

Much like how Nimbus fights off “Cüties” that infect his world, the Black community faces an ongoing battle with misinformation, lack of access, and an underrepresentation of culturally competent care. A 2019 study from The Journal of the American Academy of Dermatology concluded that medical students and residents receive little to no training on diagnosing skin conditions in patients with darker skin. This contributes to the disparities in care and outcomes, as Black and Brown patients are less likely to receive proper treatment for conditions like acne, eczema, and other skin ailments.

In Nimbus and the Cütie Catchers, we are reminded of the power of teamwork, knowledge, and self-confidence. Nimbus’ battle is not just against physical monsters but the internal struggles of believing in one’s worth, a theme deeply resonant with many in marginalized communities. At its core, the story is about saving Blackness through skin care—both literally and metaphorically.

A Call for Change

It is imperative that we, as a society, begin to address these inequities. Black and Brown communities deserve dermatological care that reflects their needs, rooted in research and cultural competence. More Black dermatologists, more studies focused on melanated skin, and more representation in health and beauty industries are critical to shifting the tide. As I continue to tell stories that shine a light on these disparities, I hope Nimbus and the Cütie Catchers inspires not only readers but healthcare professionals to question the systems that perpetuate inequality.

Because, in the end, the battle against “Cüties” isn’t just a fantasy—it’s an ongoing struggle for equity, representation, and self-worth.

Preorder the book: https://shop.iltopia.com/products/cutiecatchers

Read the story: https://www.wattpad.com/story/377000770-the-quirky-misadventures-of-nimbus-and-the-c%C3%BCtie