As Black History Month invites reflection and renewed dialogue around representation, we brought professionals across the aesthetics field together to examine how far the industry has come, and how far it still needs to go.
Four leading voices – Dr Ifeoma Ejikeme, Dr Catherine Fairris, Dr Zara Nortley, and Dija Ayodele – offer their perspectives on diversity, inclusion, and the evolving meaning of equity in aesthetic medicine today.
From Invisibility to Visibility, but Not Yet Equity
Across the board, our experts agree that progress has been made, but that it remains uneven.
For Dija Ayodele, aesthetician and founder of the Black Skin Directory, “the industry has definitely made progress in terms of diversity and inclusion, but a lot of it has been at a surface level.” Marketing campaigns and social media imagery have diversified, but this Ayodele refers to as “low-hanging fruit” with deeper systems such as education, research, product formulation and leadership, “still catching up.”
We are moving from invisibility to visibility, but it's definitely not what would be described as true equity.”
Dr Ifeoma Ejikeme, founder of Adonia Medical Clinic, also recognises genuine momentum. “When I first entered aesthetics, it was uncommon to see women take the stage at aesthetic conferences and even rarer to see women of colour,” she says. “It is encouraging now to see the UK’s diversity increasingly reflected among the brilliant doctors contributing to our field.” For her, this progress is not about token visibility, but “recognising excellence and hard work across all backgrounds.”
Dr Zara Nortley, who has been practising since 2013, has seen a shift too – from formulaic training and narrow ideals of beauty to a more holistic focus on skin health, which has helped open up the patient demographic. “Those who may not have traditionally looked at treatment are now interested in how we can help them,” she says. Beyond race, she also highlights progress in inclusivity for non-binary and trans patients, describing the expansion of beauty’s definition as “not a trend, but a responsibility.”
For Dr Catherine Fairris, the picture is mixed but hopeful. She views aesthetic medicine as “quite a diverse clinical field with practitioners from a wide range of professional and racial backgrounds.” Yet, she concedes, “we don’t often see many women in senior leadership positions, nor many racially diverse doctors or dentists in positions of leadership.”
Representation and the Gaps That Remain
When it comes to representation in practice, all four experts agree there is still work to be done – both in how Black patients are seen and how they are served.
Dr Ejikeme says that while there has been progress, we still have a way to go... "There remains a real gap in high-quality training focused on treating Black skin. As a result, some practitioners feel confident treating all skin tones, while others choose not to, leaving patients to do their own research to find suitable clinics. The outcome is inconsistency in care. Standardised education and training should be accessible to all practitioners so that every patient, now and in the future, can be treated safely and effectively."
Dr Fairris echoes that education and product testing remain insufficient: “There is a growing acknowledgement of the need to tailor more treatments to skin of colour. Even in mainstream medicine, there is a lack of knowledge around it and its response to treatments,” she says pointing to the fact that Dermatology textbooks have only just started being updated to include skin of colour and how different conditions show up in deeper tones.
When you look at treatments like laser or chemical peels, we often find that there is limited testing, protocols and guidance on skin of colour with only a few specialists offering treatment to this growing cohort of patients,” she adds.
Dr Nortley describes representation as “still often superficial.” “We might see more diversity in imagery than before, but it’s rarely inclusive of the full spectrum of Black skin, and often groups Black and Asian people together, when treatment needs and motivations may differ greatly,” she says. “This lack of visibility matters both symbolically and clinically. Black skin has different anatomical and physiological characteristics, and if education and training materials don’t reflect that, it directly affects patient safety and outcomes."
Similarly, a lot of clinicians aren’t confident treating darker skin tones because their training simply didn’t prepare them, or worse, scared them. That gap puts the burden on patients to self-treat, or worse, avoid treatment altogether."
For Ayodele, that lack of depth perpetuates inequity: “Not all brands are willing to actually put their hands in their pocket and pay what it costs to get products clinically tested or protocols validated across all skin tones.” True inclusion, she insists, “costs money,” and until the industry is willing to invest, Black patients will continue to feel inadequately catered to.
Training, Knowledge and the Need for Structural Change
Each contributor points to education as the foundation for real progress.
Dr Ejikeme recounts how she had to seek additional training internationally (the US, Asia and Europe) to gain expertise in treating darker skin tones and diverse facial anatomy. “That required time and resources,” she explains, “and not everyone has that opportunity.”
"Early in my career, I attended talks by people I admired, but I did not hear my experiences or my patients reflected in their words," she adds. At the time, it was not uncommon to hear language that would now be considered inappropriate when describing facial features or skin tones. Some described Black skin as “hard skin”, which really reflected a lack of understanding. My experiences abroad, listening to experts who deeply understood Black skin and beauty, shaped my ethos and ultimately inspired the creation of Adonia Medical Clinic, a space for evidence-based treatments for all skin types."
Dr Nortley similarly highlights how foundational training often lacks nuance. “We famously learnt about ratios associated with beauty,” she recalls, “but many of us weren’t told about the ‘norms’ for other ethnic groups.” Now, as an educator herself, she ensures her students understand those variations in facial morphology so they can deliver natural results for all.
Ayodele emphasises that even as awareness improves, much of the new education is “optional or an add-on.” Unless diversity is “embedded in the syllabus as standard,” she warns, “there will always be gaps.”
Dr Fairris agrees that change must start early and be built into scientific validation itself: “Teaching at junior levels needs to improve, and this will start with improving diverse recruitment into clinical trials. Darker skin types need to be tested along with fairer skin types when new innovations are introduced into the market. Inclusive studies should be expected as standard, but there is still a long way to go.”
Barriers, Bias and the Emotional Toll of Representation
For many practitioners of colour, the journey into aesthetics has required navigating unseen hurdles.
Dija Ayodele identifies the financial barriers that often stand in the way of Black entrepreneurs: difficulty accessing business loans, lack of generational wealth, and limited networks or sponsorships. “Aesthetics is an expensive industry to enter,” she says. Beyond finances, she highlights “the emotional toll of feeling like you represent an entire community in spaces that weren’t built for you.”
Dr Nortley pinpoints the same issue of visibility – or rather, invisibility. “We’re underrepresented in leadership roles, training faculties and brand partnerships,” she says. “That can make it harder to access the same opportunities, networks and recognition that others might take for granted.”
While Dr Fairris argues that overt barriers are fewer now, she acknowledges that practitioners can still be “pigeonholed into specific roles.” Dr Ejikeme agrees that some “doors feel harder to open than others,” but points to the empowering aspects of running your own clinic as a professional of colour… “You can truly run your own race. You can shape a clinic that reflects your values and vision. However, a key challenge remains ensuring all practitioners, regardless of background, are equipped with the knowledge to safely and confidently treat patients of every ethnicity.”
Cultural Competency and Patient Trust
All four women stress that inclusion in aesthetics is not just an ethical goal, but it is a matter of safety, trust and excellence.
“Cultural competency is absolutely critical in all areas of aesthetics,” says Dija Ayodele. “It’s not just about understanding the physiology of skin, but appreciating identity, language and lived experience, because those are the things that foster trust.”
Dr Ejikeme sees cultural awareness as integral to clinical success: “I see patients with specific cultural or genetic characteristics, for example, tribal marks or differing patterns of facial ageing across ethnicities. We also encounter sensitive topics such as colourism. The more a practitioner understands these contexts, the higher the quality of communication, trust and ultimately treatment outcomes for patients."
Dr Nortley frames it as “true holistic care. seeing the whole person in front of you, not just their skin, but their story.” Without it, she warns, the consequences can be serious - “from skin damage due to lack of knowledge about melanin-rich skin to patients feeling dismissed, stereotyped or misunderstood. This can be intensified by past experiences of bias or neglect within the wider healthcare system which is unfortunately, very common.”
Patient trust, they agree, must be earned. Dija Ayodele describes the “trepidation and stigma” that still exists among Black clients, often rooted in mistrust or fear of poor outcomes, “but there's also a lot of curiosity and interest.”
Dr Ejikeme adds that building trust “through education, visible representation and consistently excellent results” is the key to changing perception.
Representation and Leadership – Moving Beyond Tokenism
Visibility at senior and public levels remains a sticking point.
Dr Ejikeme observes that, “while there are many outstanding Black doctors and dentists in aesthetics who are knowledgeable and engaging speakers, they still remain underrepresented on major platforms… Those who are visible have earned their place through excellence and dedication, but I would like to see more diversity on these stages, not as a token gesture, but as a true reflection of the talent within our industry.”
Dr Nortley has noticed the same pattern: more Black clinicians are being invited to speak, but often limited to topics about Black skin or diversity. “It’s essential that our expertise and perspectives are valued across all areas of practice, not only in culturally specific contexts,” she insists.
Dija Ayodele has experienced this tokenism first hand being repeatedly invited to speak only on hyperpigmentation or diversity. “Even though I would suggest alternative topics,” she says, “it would still be, ‘this is what we want you to cover.’” She eventually started to step back from public speaking, instead using her platform to promote new voices: “As senior Black practitioners, we need to open the door for younger ones to come through.”
Industry Responsibility – Beyond Campaigns and Calendar Moments
Our experts stress that inclusion must become an everyday practice, not a seasonal slogan.
“Diversity is everyone’s issue,” says Ayodele. “It’s not a Black History Month issue. It’s a twelve-months-a-year issue.” She believes leadership teams must view diversity as “part of professional and moral duty, embedded into hiring, training, and brand partnerships, regardless of what is going on politically or what is cool and trendy."
Dr Ejikeme echoes this sentiment: “They need to live it - Clinics, brands and training providers alike. Diversity is not only the right thing to do, it is also good business. A thriving organisation relies on diverse perspectives, because that is where innovation and genuine connection come from.”
Dr Fairris adds that inclusivity should be pursued “meaningfully and not in a tokenistic way.” This means Including patients of all skin types into clinical trials or case studies, testing new innovations on all skin types, showing patients with darker skin tones and different ethnic backgrounds in campaigns and including doctors from a broad ethnic and cultural backgrounds on faculties.
For Dr Nortley, “real inclusion means embedding diversity into how we recruit, train and treat both patients and team members. It HAS to go beyond just marketing… Authentic representation must be a daily practice reaching from the consultation room to the boardroom, not just a seasonal campaign.”
A Shared Vision for the Future
Each expert envisions a future where diversity is so ingrained that it no longer requires discussion.
For Dija Ayodele, a truly inclusive industry is one where “diversity is just a standard we don’t even have to think about and stresses that “good intentions need structure” - from reforming education and funding access to ensuring leadership reflects the communities it serves.
Dr Ejikeme describes an industry where “every clinic, brand and educational institution has the data, training and tools to treat all skin types safely and effectively. This is how Inclusion becomes the standard, not the exception.”
And Dr Fairris draws inspiration from the transformation seen in the cosmetics world: “Twenty years ago, inclusive makeup did not exist. Today, brands like Fenty and Huda Beauty have shown that inclusivity equals success.” The same, she believes, can be true for aesthetics… if the commitment is genuine.
"To me, a truly inclusive aesthetics industry is one where diversity is embedded at every level, from leadership and training to patient care and product development," adds Dr Nortley. "It means seeing a range of identities and cultural backgrounds not as a niche, but as the norm. Everyone, regardless of their background, feels welcomed, represented, and respected."
Black History Month offers an opportunity not just to celebrate progress, but to measure it honestly. Across these four perspectives, one message resonates: diversity in aesthetic medicine is not a charitable ideal but a professional standard, essential to safety, excellence and trust.
The challenge now is to make inclusion permanent, not a talking point in October, but the foundation of every patient interaction, every syllabus, every stage, and every boardroom.
Only then will aesthetic medicine reflect the beauty of the world it serves.
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