Review Explores Skin Health Risks of US Migrant Populations

US migrant populations experience various dermatologic conditions linked to exposures before, during, and after migration, often exacerbated by barriers in accessing health care. | Image Credit: wladimir1804 - stock.adobe.com

Among migrant populations located in the US, exposures impacting their skin health before, during, and after migration and access to health care are associated with their overall skin health, according to a scoping review published in JAMA Dermatology.¹

Increasing migrant populations reflect a global shift toward further mobility and displacement. In 2022, about 46.2 million immigrants were in the US, representing approximately 13.9% of the total population. Oftentimes, a complex interplay of factors connects dermatologic health and migrant communities. Prior research has found that for some migrants, the period of transit may have little to no health consequences, but for many others, the journey can greatly influence the development and/or exacerbation of dermatological diseases and skin conditions.²

“This scoping review aimed to understand the spectrum of dermatologic conditions seen in migrant populations, identify considerations for dermatologic care delivery, and synthesize the current literature on skin health in US migrant populations,” the review authors stated.¹

They reviewed and identified 87 articles that encompassed 12,633 individuals, representing cross-sectional studies (42.5%), case reports and case series (41.4%), qualitative studies (3.4%), and a mixed-methods study (1.1%). More than half of the articles (86%) reported the sex of individuals, with more than half who identified as male (73%). Almost 10% of all articles focused exclusively on migrant women (8%). Only a few articles included children (11%), with 8 total articles focused exclusively on migrant children.

Between 2000 to 2022, the volume of articles published fluctuated each year. Articles covered a wide range of dermatologic conditions, with infection as the most reported (51.7%), along with inflammatory skin conditions (37.9%). Other dermatologic conditions included traumatic wounds (18.4%), neoplasms (51.7%), pigmentary disorders (11.5%), signs of torture/violence (4.6%), cosmetic (3.4%), hair/nail disorders (1.1%), and genodermatoses (1.1%).

Of 65 articles (74.6%) that reported the country of origin, 41 countries were represented. The study mentioned Mexico most often (43%), followed by Guatemala (21.5%), and Vietnam (12.3%).

Environmental and Violence-Related Skin Health Risks During Migration

Migrant individuals in the articles (35.6%) reported certain skin health risks that environmental exposures and violence caused or influenced before and during the migration journey. There were 23 case reports of several endemic infections before or during migration including mycetoma, leishmaniasis, leprosy, scabies, and more.

One mixed-methods study assessed water quality in relation to skin infections among deported US migrants from Mexico. Another article focused on the association of climate change with infectious skin disease among migrants. One review discussed skin diseases in migrants associated with suboptimal infrastructure and environmental factors, in addition to the signs of torture and gender-based violence.

Postmigration Environmental and Occupational Skin Health Risks

Many environmental and occupational exposures increase migrants’ risk of dermatologic disease, as reported in 38 (43.6%) articles. There were 4 case reports about skin-related issues among farmworkers, including contact dermatitis in tobacco workers. Additional topics of focus included skin diseases, skin-related quality of life, occupational health needs, tattooing practices, sun-protective behaviors, and housing conditions, among other factors.

Barriers to Health Care Access for Migrants With Dermatologic Conditions

Approximately 10% of the articles focused on the challenges migrants face in accessing health care. Some examples included skin disease and health care utilization by migrant farmworkers, providing dermatologic care for displaced populations, discussing lack of insurance access in association with delays in diagnosis, and barriers to skin cancer prevention.

Educational Strategies for Improving Migrant Skin Health

Only 3.4% of the articles focused on educational and training interventions targeting health care clinicians and migrant populations that aimed to improve health outcomes and safety practices. A service learning opportunity promoted competency in dermatology for nurses in a migrant farm worker clinic. Additionally, a forensic dermatology curriculum for dermatology residents and a training program for migrants working in nail salons improved occupational health risks and safety knowledge.

Seven percent of the articles mentioned immigration status as a demographic characteristic but did not discuss its association with the condition reported.

Limitations

Potential bias could arise from the review’s search approach of capturing published literature with certain keywords. The search strategy did not seek to capture articles focused on low-income or safety-net populations, which tend to include migrants. Additionally, many relevant articles could have been missed, including gender-based violence articles.

The high proportion of articles from North Carolina, California, and New York may limit the generalizability of the study findings. Many migrants are unable to access dermatologic care and engage in clinical research due to social drivers, such as health insurance, limited English language proficiency, and legality status, leading to underrepresentation in literature that has been published.

However, the review authors concluded that exposures before, during, and after migration and structural factors are linked to the skin health of US migrant populations.

“These opportunities include research focused on a broad spectrum of dermatologic diseases, countries of birth, occupations, and vulnerable populations, such as women and children, as well as implementing and evaluating policy that addresses structural barriers migrants face in accessing quality health care,” they wrote.

References

1. Castillo Valladares HB, Kim-Lim P, Chang AY. Dermatologic care and skin health of migrant populations in the US: a scoping review. JAMA Dermatol. Published online April 9, 2025. doi:10.1001/jamadermatol.2025.0404

2. Bartovic J, Padovese V, Pahlman K. Addressing the challenges to skin health of refugees and migrants in the WHO European region. Trop Med Int Health. 2021;26(5):602-606. doi:10.1111/tmi.13552