6 ms·

I get the impression that a lot of gynecological care is in the same realm, but I don't have the equipment to have first hand anecdotal evidence. Heard many a

by Spoom 4y ago

I get the impression that a lot of gynecological care is in the same realm, but I don't have the equipment to have first hand anecdotal evidence. Heard many a horror story about IUD placement / removal, where folks were told that a Tylenol would be enough.

bad416f1f5a2 4y ago
Medical racism and sexism are very real. One in four residents believe blacks have thicker skin than whites: https://www.pnas.org/doi/abs/10.1073/pnas.1516047113 https://www.pnas.org/doi/abs/10.1073/pnas.1516047113
- 9991 4y ago
  And? Is it true?
  - jacobolus 4y ago
    From a brief skim of the literature, the main difference seems to be that darker skin is better protected against aging effects from sun exposure, and better maintains its elasticity (etc.) when exposed to ultraviolet radiation over decades. But less research than might be expected has been done about other differences between the skin of different groups. * * * > There exists substantial evidence to support that Black skin has a higher transepidermal water loss, variable blood vessel reactivity, decreased skin surface pH, and larger mast cell granules compared with White skin. Although some deductions have been made about Asian and Hispanic skin, further evaluation needs to be done. Differences in water content, corneocyte desquamation, elastic recovery/extensibility, lipid content and skin microflora, although statistically significant, are inconclusive. https://link.springer.com/article/10.2165/00128071-200304120-00004 https://link.springer.com/article/10.2165/00128071-200304120... > The thickness of the skin is higher on the cheek compared with the dorsal and ventral forearm, with no ethnic or age-related specificity. We confirm that the sub-epidermal non-echogenic band is a sensitive marker of skin aging, and reveal for the first time that it is less pronounced in African Americans. From OCT images, we bring out evidence that the thickness of the dermal–epidermal junction (DEJ) decreased with age, and was higher in African Americans than in Caucasians. Finally, by comparing US images at 150 MHz with OCT images, we show that papillary dermis thickness can be measured and appears to be quite constant irrespective of age or ethnic group. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0846.2009.00365.x https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0846... > Skin roughness, scaliness and stratum corneum hydration varied significantly in different anatomic areas and age groups. There was no racial variation in skin hydration between any anatomic site, nor significant differences in roughness and scaliness between races, except for the preauricular area. Skin roughness was significantly increased in the aged, compared to the young at the preauricle, volar forearm, lower back, thigh and lower leg. Older women demonstrated significantly more scaling at the preauricle than younger women. Stratum corneum hydration correlated with scaliness. No significant correlation between stratum corneum hydration and skin roughness was observed. https://www.karger.com/Article/Abstract/17932 https://www.karger.com/Article/Abstract/17932
    - 9991 4y ago
      I believe the paper the parent comment linked used 'thick skin' as a metaphor for pain resistance, not literally deeper epidermis.
      - jacobolus 4y ago
        I am pretty sure this is literally about skin thickness. Here is the list of false beliefs polled: Blacks age more slowly than whites; Blacks’ nerve endings are less sensitive than whites’; Black people’s blood coagulates more quickly than whites’; Whites have larger brains than blacks; Whites are less susceptible to heart disease than blacks; Blacks are less likely to contract spinal cord diseases; Whites have a better sense of hearing compared with blacks; Blacks’ skin is thicker than whites’; Blacks have denser, stronger bones than whites; Blacks have a more sensitive sense of smell than whites; Whites have a more efficient respiratory system than blacks; Black couples are significantly more fertile than white couples; Whites are less likely to have a stroke than blacks; Blacks are better at detecting movement than whites; Blacks have stronger immune systems than whites Apparently a majority of white laypeople think that black people literally have thicker skin. Among white first-year medical students, 40% believe this, dropping to 25% of white residents. Though in the narrow context of skin condition, it is true that people with darker skin “age more slowly”, i.e. have less age-related deterioration in skin quality because they are less susceptible to UV radiation. Minority groups in the USA are also more susceptible to cardiovascular disease, though that’s largely if not entirely attributable to environmental factors.
        Auracle 4y ago
        I mean, as you hinted there are at least a few things on that list that are true. We’re in a weird period of time where people are desperate to ignore any differences between races but they absolutely exist as one would expect due to different evolutionary pressures. I don’t know how you’d go about testing some of those and many shouldn’t matter to doctors, but I personally think the differences between us are fascinating.
        4y ago
- deleted 4y ago
  [deleted]
- rscho 4y ago
  Common layman prejudice aside, it's more likely experience from people placing iv lines regularly. Black skin is more difficult for many reasons, and I can easily believe that many get the impression of thicker skin because of other associated factors. Black people really do have black skin, you know? It's not all racism...
jnovek 4y ago
Oh my goodness, yes. I’ve traded chronic pain stories with women who have endometriosis and I am convinced that it would just be beyond my capacity to cope. Many women (I’m not sure how many because, of course, it’s not well studied) with endometriosis are ignored for years because it’s assumed that they are experiencing period pain and period pain doesn’t “count” for some reason. Gynecology sounds like torture.

by Spoom 4y ago

bad416f1f5a2 4y ago

Medical racism and sexism are very real. One in four residents believe blacks have thicker skin than whites: https://www.pnas.org/doi/abs/10.1073/pnas.1516047113 https://www.pnas.org/doi/abs/10.1073/pnas.1516047113

9991 4y ago
And? Is it true?
- jacobolus 4y ago
  From a brief skim of the literature, the main difference seems to be that darker skin is better protected against aging effects from sun exposure, and better maintains its elasticity (etc.) when exposed to ultraviolet radiation over decades. But less research than might be expected has been done about other differences between the skin of different groups. * * * > There exists substantial evidence to support that Black skin has a higher transepidermal water loss, variable blood vessel reactivity, decreased skin surface pH, and larger mast cell granules compared with White skin. Although some deductions have been made about Asian and Hispanic skin, further evaluation needs to be done. Differences in water content, corneocyte desquamation, elastic recovery/extensibility, lipid content and skin microflora, although statistically significant, are inconclusive. https://link.springer.com/article/10.2165/00128071-200304120-00004 https://link.springer.com/article/10.2165/00128071-200304120... > The thickness of the skin is higher on the cheek compared with the dorsal and ventral forearm, with no ethnic or age-related specificity. We confirm that the sub-epidermal non-echogenic band is a sensitive marker of skin aging, and reveal for the first time that it is less pronounced in African Americans. From OCT images, we bring out evidence that the thickness of the dermal–epidermal junction (DEJ) decreased with age, and was higher in African Americans than in Caucasians. Finally, by comparing US images at 150 MHz with OCT images, we show that papillary dermis thickness can be measured and appears to be quite constant irrespective of age or ethnic group. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0846.2009.00365.x https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0846... > Skin roughness, scaliness and stratum corneum hydration varied significantly in different anatomic areas and age groups. There was no racial variation in skin hydration between any anatomic site, nor significant differences in roughness and scaliness between races, except for the preauricular area. Skin roughness was significantly increased in the aged, compared to the young at the preauricle, volar forearm, lower back, thigh and lower leg. Older women demonstrated significantly more scaling at the preauricle than younger women. Stratum corneum hydration correlated with scaliness. No significant correlation between stratum corneum hydration and skin roughness was observed. https://www.karger.com/Article/Abstract/17932 https://www.karger.com/Article/Abstract/17932
  - 9991 4y ago
    I believe the paper the parent comment linked used 'thick skin' as a metaphor for pain resistance, not literally deeper epidermis.
    - jacobolus 4y ago
      I am pretty sure this is literally about skin thickness. Here is the list of false beliefs polled: Blacks age more slowly than whites; Blacks’ nerve endings are less sensitive than whites’; Black people’s blood coagulates more quickly than whites’; Whites have larger brains than blacks; Whites are less susceptible to heart disease than blacks; Blacks are less likely to contract spinal cord diseases; Whites have a better sense of hearing compared with blacks; Blacks’ skin is thicker than whites’; Blacks have denser, stronger bones than whites; Blacks have a more sensitive sense of smell than whites; Whites have a more efficient respiratory system than blacks; Black couples are significantly more fertile than white couples; Whites are less likely to have a stroke than blacks; Blacks are better at detecting movement than whites; Blacks have stronger immune systems than whites Apparently a majority of white laypeople think that black people literally have thicker skin. Among white first-year medical students, 40% believe this, dropping to 25% of white residents. Though in the narrow context of skin condition, it is true that people with darker skin “age more slowly”, i.e. have less age-related deterioration in skin quality because they are less susceptible to UV radiation. Minority groups in the USA are also more susceptible to cardiovascular disease, though that’s largely if not entirely attributable to environmental factors.
      - Auracle 4y ago
        I mean, as you hinted there are at least a few things on that list that are true. We’re in a weird period of time where people are desperate to ignore any differences between races but they absolutely exist as one would expect due to different evolutionary pressures. I don’t know how you’d go about testing some of those and many shouldn’t matter to doctors, but I personally think the differences between us are fascinating.
        4y ago
deleted 4y ago
[deleted]
rscho 4y ago
Common layman prejudice aside, it's more likely experience from people placing iv lines regularly. Black skin is more difficult for many reasons, and I can easily believe that many get the impression of thicker skin because of other associated factors. Black people really do have black skin, you know? It's not all racism...

jnovek 4y ago

Oh my goodness, yes. I’ve traded chronic pain stories with women who have endometriosis and I am convinced that it would just be beyond my capacity to cope. Many women (I’m not sure how many because, of course, it’s not well studied) with endometriosis are ignored for years because it’s assumed that they are experiencing period pain and period pain doesn’t “count” for some reason. Gynecology sounds like torture.