The skin I’m in – Glass meets aesthetics expert Dr Ifeoma Ejikeme, who helped found a groundbreaking professional board challenging racial bias in the industry
TO say Dr Ifeoma Ejikeme is well qualified is something of an understatement. After graduating from Bristol University, she studied at Imperial College, London, followed by Columbia University NYC and New York Medical College, where she specialised in head and neck surgery. On her return to the UK, Dr Ejikeme gained a masters in aesthetic medicine at Queen Mary, University of London, making her one of only a few doctors in the UK to have such a specialist training.
She now trains plastic surgeons, dermatologists, doctors and dentists on safe and effective aesthetic procedures. In 2017, she established the Adonia Medical Clinic in west London, where she offers a wide range of aesthetics services from fillers to treating hair loss.
“The reason for completing my general medical training first was because I truly believe that with aesthetics you need to have a really good foundation in general medicine to provide the best care,” she tells me.
However during her training, she was shocked to see most of the studies were done on white skin – and treatments and procedures were not tested on all communities: “I would search the literature to find the equivalent for black skin, and my knowledge continued to grow through persistent and consistent learning,” she says.
“During my electives and post-graduate training, I trained in areas of the world with a highly diverse population such as New York and London enabling me to consolidate my learning.” This in part led her to being one of founders of the Black Aesthetics Advisory Board (BAAB) last June.
Adonia Medical – Dr Ifeoma Ejikeme
As well as being a leading aesthetic doctor, you are also a medical consultant with a post doc fellowship in head and neck surgery. Can you tell me something about your journey into aesthetic medicine? Why did you become interested in this area?
During my training as a junior doctor, I left the UK to do a fellowship in head and neck surgery at Columbia University. I was very passionate about head and neck surgery then and I spent some time with a rhinologist on a placement. It was in 2010 and he was doing nose augmentations using dermal filler for the time it was very unusual but the results were amazing.
Very few people in the world were using dermal fillers in this way. We would have patients come into the practice in the morning for a non-surgical procedure using filler and be able to return to work in the afternoon, whilst we would have patients come in for rhinoplasty surgery in the afternoon and have bruising and swelling for weeks after. Yet when I looked at the results for both patients, they were very similar.
This sparked a fascination for me in aesthetic medicine and non-surgical procedures so I completed my medical training and then did specific training in aesthetic medicine at Masters level. The reason for completing my general medical training first was because I truly believe that with aesthetics you need to have a really good foundation in general medicine to provide the best care.
I understand that when you studied aesthetic medicine all the case studies of, for instance fillers, toxin treatments and body contouring etc are all shown on Caucasian skin, including in the published literature. As a black woman and a medical professional, when you wished to study black skin, did you have to seek out additional courses or training? And if so, how did you manage to do this?
Not all the case studies are of Caucasion skin but most of them were. As I learnt about the changes in the skin I would often be told the skin would look red but I noted it would take a lot for my skin to go red and there were other indications that were more important than the redness, such as the feeling of burning or heat. During my training whenever these disparities would pop up I would search the literature to find the equivalent for black skin and my knowledge continued to grow through persistent and consistent learning.
During my electives and post graduate training I trained in areas of the world with a highly diverse population such as New York and London enabling me to consolidate my learning. Later on in my training, I have chosen mentors that have had a vested interest in black skin so that I could learn from them. Now, in clinical practice, I have a hugely diverse patient population who now benefit from this. At Adonia Medical Clinic we are able to offer a huge variety of treatments for all skin types.
What are the different skincare concerns of the black community? Do you think they are well understood in the UK and Europe? If not, can you share with Glass some of your plans and strategies to deal with, and, also educate people within the medical profession and the general public?
The most popular request is for glowing skin and even skin tone. The most common issue for black skin is hyperpigmentation so at Adonia Medical Clinic we look at treating that and hydrating the skin to create a glow and even skin tone. Outside that most skin types really have the same concerns of acne and irregular texture as well as age related changes to the skin.
It is a misconception that black skin does not age. It ages differently to caucasion skin but it does age. Common ageing complaints include dark circles around the eyes, loss of fat in the mid face and DPN (Dermatosis Papulosa Nigra).
While I do think there is a lack of education on black skin I think there are many more elements that are similar across different skin types. Everyone wants radiant glowing skin free from premature signs of aging. Everyone wants to look healthy and hydrated. The challenge sometimes comes in advanced procedures.
In my practice we use some of the same treatments on different skin types often darker skin types need to prepare their skin before the treatment. Once the prep is complete the treatment is safely done.
The brands and companies need to understand that there is a huge demand for products for black skin so they need to invest into the scientific research behind the products to prove they are effective.
We also need a revised and expanded medical curriculum – with diverse case studies that place emphasis on skin conditions on different types of skin. These include the different shades of black and brown.
Finally, we need a change in aesthetics training – for both beauty and medical aesthetics. We need modules for treating skin of colour for all treatments out there so that all treatments are accessible to all skin types.
The Black Aesthetics Advisory Board has engaged with all levels of the industry with a purpose driven survey, which was launched in early July. The BAAB will be publishing a report as a result from this survey later this year, which will provide guidance to brands and professionals, inform training and improve access to aesthetics for black patients.
What led you to becoming one of the founders of Black Aesthetics Advisory Board (BAAB) this year? Can you tell me something about its aims and what progress is it making?
It started with an informal phone call between myself and the other three founders. We were chatting about the current events and had all felt disappointed by the response – or lack of it – from some brands and companies off the back of the BLM movement. We had expected more outrage and more support. We had all individually been thinking about doing something to act so decided to join forces and launch the BAAB.
The black lives matter movement and the events leading up to it had a huge impact on each of the founding members of BAAB. I had friends and colleagues reaching out to me to discuss their own experiences. I expected to see this reflected in the aesthetic industry but from many there was silence. I interpreted that silence as either they did not see there was a problem or this problem was not important to them.
This spurred us to start the Black Aesthetic Advisory Board. Our goal is to help identify the issues faced by Black patients and clients, to understand the experiences of Black practitioners and to help companies improve their practices, process and education to create a better experience for Black professionals and patients.
Dr Ifeoma Ejikeme
Can you tell Glass something about your philosophy of skincare? Can you share some tips such as the two or three most important things you can do to look after your skin?
My philosophy on skin care focuses on five main elements:
- Cleansing well
- Incorporating gentle exfoliation into your skincare routine on a weekly basis
- Adding in antioxidants to prevent free radical damage
- Picking key ingredients to treat your underlying concerns – such as pigmentation, redness or dryness
- Protecting the skin with daily use of sunscreen – factor 50 on the face
Three of the most important things you can do to look after your skin are:
- Wash the skin every evening – clearing away the make-up, oils, products and dirt from the day
- Add in a retinoid – these have lots of evidence and are extremely helpful in increasing the skin’s turnover. When using a retinoid, make sure the skin is hydrated with a good moisturiser before and after application.
- The best thing you can do is wear sunscreen – SPF 50 everyday.
How are you dealing with Covid19, professionally and personally? How was the lockdown for you?
Personally, lockdown gave me an opportunity to slow down and be a bit more introspective. I had a baby in May and while it was definitely an unusual time to be pregnant and give birth, the lockdown gave us the opportunity to spend quality time together as a family.
Professionally, my team and I have engaged with our patients that live far away. We launched virtual consultations and virtual facials as soon as we went into lockdown, which allowed my patients to gain access to myself and the team.
Due to lockdown and working from home, people have also been spending a lot more time looking at themselves – on zoom or in the mirror – and noticing a lot of different changes to their skin or underlying issues they may not have spotted before – such pigmentation, redness, wrinkles etc. The virtual consultations have allowed us to address those skin concerns and have been so successful that we are going to be continuing them.
Additionally, although Adonia Medical Clinic is already CQC registered – meaning we have hospital standards of cleanliness – Covid-19 has led us to build even further on our standards, addressing and improving our protocols to increase patient safety.
What do you see as the future of aesthetic medicine and treatments?
Regarding the future of black skin in the industry, I think this is moving in a really positive direction. The industry is waking up to the needs to black consumers and that this will continue to spark change. People are now aware that there are differences and that there is a demand from black people to have many different beauty and aesthetic treatments. There are brands that have already stepped up to change and others are following.
For the future of aesthetics medicine in general, I believe that we’ll be seeing a lot more treatments and devices launching that focus on areas of the body that can be seen – and not hidden by masks. Masks are here and they are here to stay.
So, treatments for the forehead, the eyes and the body will be popular. I see an increase in popularity for devices that train, shape and sculpt the body, arch the brows, lift the upper face, reduce dark circles under the eyes and brighten the eyes.
At Adonia Medical Clinic, we are about to launch a new fat freezing device called Claatu Alpha. This removes the unwanted, stubborn pockets of fat that lockdown may have left us with or in areas that we are struggling to shift even with diet and exercise, such as in the love handles, neck, thighs and stomach. We are also bringing in new peels specifically to treat pigmentation to even the skin tone and create a glow – available for all skin types.
Can you share with Glass any future plans? Are you planning a YouTube channel or to launch your own range? Does TikTok appeal?
It is important for experts to be in the spaces that their patients are. So, if people are on TikTok or Instagram or Youtube, then it is important that we are on there to share our knowledge and encourage safe treatments. Otherwise, there is a gap for people that are not experts to be giving wrong advice on these platforms.
As for plans for the future, a YouTube channel may be on the cards. All I’ll say for now is watch this space.
by Caroline Simpson