Scalar Visions of Race: The Durability of Race Across Perceptual Scales in American Dermatology

How to understand and attend to material differences in race and skin color in practice is a salient issue in American dermatology. For dermatologists, it is important to understand and articulate the material bases for differences in skin color, especially as they attempt not to reproduce disparities in care and attention along racial lines. In this paper, I present three scales through which dermatologists understand skin color and race: the clinical scale, the microscopic scale, and the geographic scale. I argue that across these scales, even as dermatologists attempt to evade talking about race explicitly, racialist logics about fundamental differences between racial groups continue to undergird the stories dermatologists tell about differences in skin color. One of the predominant ways dermatologists attempt to engage with skin color more ethically is through limiting explicitly racial language. However, I argue that these approaches can end up problematizing innate differences between people rather than problematizing the racism that produces material differences in outcomes. Moreover, I suggest that racialized narratives remain durable across perceptual scales that dermatologists shift between in their daily practices and that these narratives naturalize rather than challenge racialized differences.