Eczema on Black Skin: Is It Different?

What is Eczema?

Eczema is a chronic inflammatory skin condition that leads to itchy, dry, red rashes on the skin. Anyone can experience it anytime, however it is more common among children below the age of 5. 

In some cases, it resolves as the child grows older, while in most cases it may become a lifelong condition and flare up from time to time. The time when the symptoms associated with eczema become worse is known as a flare-up and the period when they are not so irritated is known as the remission period. 

Skin conditions are color blind, they can affect anyone, no matter what skin color you have. 

How Common is Eczema on Dark Skin?

Many often ask, “Are people with darker skin tones more prone to developing eczema?” The truth is eczema is the second most common skin condition that affects African Americans. 

In old times most of the research regarding eczema was conducted on fairer skin tones. Which often made it difficult for the doctors to fully diagnose eczema on a darker skin tone. 

However, in recent times, more and more research has been conducted on it and it has been found that eczema is more common on dark skin and usually is more severe, especially among children. 

According to the National Eczema Association, around 19% of children with darker skin tones, 16% with fairer skin tones, and 7.8% of Asian children experience atopic dermatitis in the USA. 

What Does Eczema Look Like on Black Skin?

Thanks to the recent studies regarding eczema on darker skin tones we now know what eczema looks like on black skin. Some of the common eczema symptoms that you will notice in darker skin tones are:

• Itchy skin
• Dry skin
• Skin inflammation
• Purple, brown, or gray rashes
• Warm skin
• Hyperpigmentation
• Hypopigmentation (mostly when a flare-up starts healing)
• Small bumps
• Cracked scaly skin
• Skin lichenification
• Bumps that may ooze (in severe cases)

In darker skin, eczema usually affects the chest, elbows, knees, back, arms, legs, and skin folds. The symptoms may vary from person to person depending on the severity of the condition and age. 

For example in young children and babies, eczema usually affects the cheeks and outside of the elbow and knees, while in adults it is more common on the inside of the elbows and knees.

How is Eczema Different in Skin of Color?

Most of the symptoms associated with eczema are the same no matter what skin color you have. However, there are a few differences between eczema on lighter skin and darker skin. On lighter skin tones eczema usually appears as a red or pink rash. 

However, it can be difficult to detect on darker skin tones as the skin rashes generally appear as purple, brown, ashy, or a little darker than the skin color. 

A few studies have found that dark skin tones are rich in melanin which makes it hard for the skin to retain moisture and as a result, black skin is more prone to dryness. This is one possible reason why eczema appears more severe in black people. 

Additionally, eczema on the face can also lead to dark circles around eyes in black skin while it is not a prominent symptom in lighter skin tones. 

Small bumps caused by eczema are also more common. These bumps usually develop around the hair follicles and look quite similar to goosebumps, this scenario is also known as follicular accentuation.

One hidden effect of eczema which is often overlooked is it can cause anxiety and depression in black Americans. This is usually due to the hyperpigmentation and hypopigmentation caused by eczema which is more prominent on darker skin tones and can last for months leaving the patient worried about how they look. 

Images of Eczema on Black Skin

These pictures will help you understand what does eczema rash on dark skin look like.  

What Causes Eczema on Black Skin?

Eczema no matter what skin color you have, the causes are pretty much the same. The exact cause of eczema is still not known by the researchers. However, it is believed to be caused by a combination of factors. 

Genetics

Genetics plays an important role in developing eczema. People who have a family history of eczema, atopic dermatitis, asthma, hay fever, and allergies are more prone to developing it. A genetic mutation in the filaggrin genes (that help protect the skin against outside irritants) is believed to be a possible reason. 

To read more in detail about how genetics can trigger eczema read this blog. 

Skin Barrier

Another possible factor that makes one prone to developing eczema is an impaired skin barrier. Our skin contains a natural barrier that helps protect it against outside irritants and retains moisture. 

However, when due to any factor such as alterations in the immune system, hormonal changes, or environmental factors this natural barrier can become weak. It is unable to retain moisture and as a result, the skin becomes dry more readily, making it prone to eczema. 

Immune System 

Even though research is still being done on it. Some researchers believe that people with eczema have an overactive immune system due to which even a minor trigger can lead to a severe eczema flare-up. 

Environmental Triggers

Environmental triggers are believed to be an important factor in developing or triggering eczema flare-ups. Triggers such as 

• Cigarette smoke
• Pollution
• Pollen
• Extreme weather conditions
• Harsh chemicals in products
• Pet dander
• Certain fabrics
• Medication 

The environmental triggers usually vary from person to person. And it can be hard at times to pinpoint which one might be triggering your eczema. 

Social Inequalities

According to recent studies, social inequalities increase the chances of developing eczema in black skin. Additionally, eczema is often more challenging to detect on darker skin tones. Another factor is oftentimes medical training of physicians may prominently be done on one race or ethnicity and physicians may be trained to recognize eczema on lighter skin tones but may not readily recognize the presentation of eczema in people with darker skin tones. This delay in diagnosis can worsen the condition and lead to severe eczema in black people. 

Types of Eczema on Black Skin

Eczema is a term used to describe various skin conditions. The symptoms of these skin conditions are often similar. A person may be experiencing more than one type of eczema at the same time. 

Atopic dermatitis is believed to be one of the most common types of eczema not only among black skin but also among lighter skin tones. Some other types of eczema that are more common among people with darker skin tones are:

• Papular Eczema: 

It causes small raised bumps on the skin which are also known as papules. These bumps can lead to intense itching, inflammation, and irritation. 

• Asteatotic Eczema: 

It is also known as xerotic eczema or eczema craquelé. It causes dry, cracked skin that often flakes. The itching associated with this type is very severe making it hard to resist the scratch. It is believed to be caused by excessive water loss from the topmost layer of the skin or stratum corneum. 

• Nummular Eczema:

It is also known as discoid eczema because it usually appears in round or oval-shaped lesions. This is why it is also often confused with ringworm. The lesions are often raised above the skin, are very itchy, and sometimes even ooze. 

• Stasis Eczema:

This type of eczema usually affects the legs and is believed to be caused due to poor blood circulation in the legs. It can also cause itching, swelling, and discoloration of skin in people with black skin. 

How to Treat Eczema on Black Skin?

Even though there is no permanent cure for eczema, the treatment prescribed to soothe the symptoms is usually the same for all skin colors. However, as we have discussed before eczema on dark skin can be severe which is why the use of prescription medications is frequently advised by the doctor along with a proper daily skincare regimen. 

If you are also searching for ‘how to treat eczema on black skin, here is how to do it:

Eczema Skincare Routine

Whether you have mild or severe eczema, an eczema skincare routine is one the first things advised by doctors and dermatologists. At times a mild flare-up can be soothed at home with the help of this skin care routine. 

Your skincare routine should include the two following steps.

• Keeping the Skin Clean

It is advised to bathe once daily using an eczema shampoo and cleanse if you are experiencing flare-ups on body parts that are exposed to the sun and environment such as the face, feet, and hands. 

Always cleanse the skin every time you come from outside or experience excessive sweating. Cleansing the skin will help remove the harmful bacteria, viruses, irritants, and allergens that can penetrate the skin and make your condition worse. 

The best eczema cleanser is the one that is fragrance-free, sulfate-free, paraben-free, dye-free, and phthalate-free, like Happy Cappy Daily Eczema Shampoo and Body Wash. 

It is pediatrician-developed and is specially formulated for eczema-prone, sensitive skin. It contains natural ingredients like licorice root extract and apple fruit extract that help soothe the itching and irritation associated with eczema. 

• Keeping the Skin Moisturized

The second step in your skincare routine should be to keep your skin moisturized. Moisturizing the skin using an Eczema cream at least twice daily is essential. 

However, if you suspect that your skin becomes dry more often then you can use it more than twice daily. Always remember to moisturize your skin after taking a bath. More specifically within 3 minutes of taking a bath–while the skin is still a little damp. 

Just like the cleanser you are using, the moisturizer you are using should also be free from harsh chemicals.

Happy Cappy Moisturizing Cream for Eczema is free from skin-irritating chemicals and contains ingredients like glycerin that help restore the skin’s natural barrier. 

Wet Wrap Therapy

Wet wrap therapy is sometimes prescribed by doctors for severe itching. Especially in children who find it difficult to resist the itch or find it hard to sleep at night due to the itch. 

In this therapy, first medications such as prescription topical steroids are applied to the skin. Many times the topical creams are mixed with moisturizing cream for eczema to make the application process easier. 

After that, the affected area is covered with a wet gauze or cloth followed by a dry cloth. This application can be left overnight to soothe the itching. Some dermatologists also prescribe the soak and seal method. 

In this, it is advised to take a bath with an eczema body wash at night and then apply the wet wrap therapy at night. Applying steroids in this manner should only be done under the direction of your physician or a dermatologist. 

Avoiding the Triggers

Eczema can flare up and become worse in some people due to certain triggers. If you know that a certain factor can trigger your eczema flare-up then try avoiding it. For instance, in some people stress can trigger eczema. 

If you are also dealing with stress-related eczema then reducing the stress with the help of yoga, meditation, and exercise can help soothe the symptoms. However, if you are unaware of your triggers, then you can consult a doctor who may help you figure them out with the help of a skin prick test or patch test.

Topical Medications

If your condition is not getting better with a daily skincare regimen of cleansing and twice daily moisturizing, then there are chances you are dealing with a more severe case of eczema, that requires prescription treatment along with the regular daily skincare regimen. 

These medications can be in the form of creams, emollients, pills, or injectables. Some of the most common ones prescribed are:

• Calcineurin inhibitors
• Topical corticosteroids
• PDE4 inhibitor
• biologic medication
• Janus Kinase inhibitors (JAK)

However, these medications should only be used when prescribed by the doctor. And should be used as advised by them because using them for a longer period of time can cause hypopigmentation in people with darker skin tones. 

Light Therapy

Light therapy is also known as phototherapy. It is an in-office procedure that is usually performed by a dermatologist. The affected area is exposed to a special UV light that helps reduce the itching and irritation. 

However, it is essential that you first discuss all the side effects and possible complications with the doctor first, because it can sometimes cause alterations in pigmentation in people with darker skin color. 

Home Remedies for Eczema

Apart from the treatment mentioned above, there are a few lifestyle changes that you can make to try and prevent the condition from getting worse. Here are a few things that you can do:

• Always use lukewarm or cool water to wash the skin.
• Avoid taking long hot baths.
• Always use hypoallergenic skincare products that are free from fragrances, sulfates, parabens, and phthalates. 
• Use a fragrance-free detergent to wash your clothes and bedding. 
• Consider using a humidifier to keep the air inside your room, house, and office moisturized. 
• Keep your body hydrated by drinking plenty of water. 
• Wear loose-fitting clothes made with soft, breathable material.
• Protect your skin from direct sunlight by covering the skin or using sunscreen. 

These environmental modifications may help you calm the itching, irritation, and redness associated with an eczema flare-up and provide some relief.  

Conclusion

Eczema is a common chronic skin condition that causes dry, scaly, itchy rashes on the skin. Skin conditions can affect anyone no matter the age, color, or gender. Eczema can also appear in people with darker skin tones. ‘

In fact, various research studies show that eczema is more common and severe among children with dark skin as compared to those with lighter skin tones. Most of the eczema symptoms are the same no matter what skin color it affects. 

However, in black skin, the red rashes may appear as gray, ashy, purple, or brown. Also, eczema on black skin can lead to hyperpigmentation, the appearance of small visible bumps, and dark circles around the eyes. 

The eczema treatment for black skin is the same as it is for lighter skin. The first step is to follow a proper skincare routine that includes keeping the skin clean and moisturized, the second step is to avoid the trigger that might make your condition worse and make a few lifestyle changes. 

If your condition does not get better with proper care then consult a doctor who may prescribe certain medications to help soothe the symptoms. 

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