References And Further Information
Skin Deep is a website that contains images of people with different skin tones to help patients and doctors better understand and describe symptoms of different skin conditions: .
The PDF document below shows what eczema can look like on different skin tones.
Scratching Often Leads To Hyperpigmentation
Inflammation and scratching stimulate pigmentation. Simply scratching the skin, even without eczema, can cause brown patches, for example on the back. Eczema lichenificationthe thickening of the skin due to scratchingoften appears hyperpigmented on dark skin.
This hyperpigmentation is temporary and is gradually reduced with treatment.
We also observe on dark skin a particular form of lichenification comprised of, for example, isolated spots .
Whats The Difference Between Dermatitis And Rosacea
Rosacea can cause red skin that looks like dermatitis. However, rosacea can also cause pimples, and the redness is typically found on your forehead, nose, chin and cheeks. Have your healthcare provider take a look at your skin to determine if your condition is dermatitis, rosacea, or something else.
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Ashley Lora The Eczema Warrior
At Aveeno, we are committed to advancing skin health equity and advancing eczema awareness and education gap in skin of color.
Eczema is the second most frequent skin disease to affect African Americans, but experts believe it may be underdiagnosed. This is due in part to the fact that historically, physicians have been trained primarily to diagnose eczema on white skin. In fact, a recent study found that less than 5 percent of the images in general medicine textbooks showed conditions on darker skin and the standard outcome measures used have poor reliability and validity in patients with very dark skin, making it even more difficult for doctors to recognize and diagnose on skin with more pigment.
People of color are also half as likely as white patients to see a dermatologist for the same conditions. Black children with eczema are 30 percent less likely to see a doctor for their eczema than white children, and those who see a doctor tend to have more visits and receive more prescriptions than white children, indicating more severe disease.
Pseudofolliculitis Barbae And Dark Skin
This skin condition is characterized by bumps under the surface of the skin, and is often confused with acne. But the problem actually stems from ingrown hairs. It most often occurs in black and Hispanic people, due to the distinct shape of the hair follicle.
If the bumps are squeezed or manipulated in any way, they can become inflamed or infected. But even when left alone, they can be difficult to cover and sometimes cause pain.
Recent studies have shown that laser hair removal is an effective treatment.
Because this condition is often confused with acne, it’s important to have your diagnosis confirmed by a dermatologist familiar with dark skin.
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What Foods Can I Eat Or Avoid To Reduce My Risk Of Dermatitis
If you have food allergies, then one of the reasons why you must avoid that food is that it may cause or worsen dermatitis. Up to 25% of people with dermatitis herpetiformis have celiac disease, a sensitivity to gluten. Examples of common allergies include peanuts, dairy, eggs, sugar and alcohol. Pay attention to what you eat. If your dermatitis flares up after you eat a certain food, then you might have an allergy.
Discuss diet changes with your healthcare provider. It may also be helpful to see a dietician. Dieticians can help you create new meal plans.
Are There Complications Of Dermatitis
There are complications that come with dermatitis. The following do not apply to all types, and do not apply to all people, but are still common:
- Viral skin infections. Try not to scratch because that can worsen the infection.
- Bacterial skin infections. Try not to scratch because that can worsen the infection.
- Sleep loss.
- Blepharitis .
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What Tests Are Done To Diagnose Dermatitis
Usually your healthcare provider will be able to diagnose dermatitis based on examining your skin. However, when there is doubt, they may perform the following tests:
- Blood tests to check for causes of the rash that might be unrelated to dermatitis.
- A skin biopsy to distinguish one type of dermatitis from another.
- An allergy skin test.
What Worsens Dermatitis What Triggers It
Try your best to figure out what triggers your dermatitis. Its important to remember that it can affect people differently.
Is your dermatitis triggered by a chemical you clean with? Do you get it every time you go to your uncles house, because hes a smoker? Does your scalp feel itchy since you started that new shampoo? Did that rash on the inside of your wrist appear after you tried that new perfume? Does excessive sunlight make your dermatitis better or worse? Do you feel itchy every time you wear that wool sweater?
Remember what else worsens dermatitis: stress, hot showers, allergens like pollen and pet dander, etc. Find out what worsens your dermatitis and do your best to avoid it.
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Where Does Dermatitis Form On The Body
The location of your dermatitis depends on the type. For example, atopic dermatitis can appear anywhere on your skin. But, in teens and adults, its typically on the hands, inner elbows, neck, knees, ankles, feet and around the eyes. Seborrheic dermatitis and cradle cap are typically on your scalp, face and ears. Periorificial dermatitis is found around your eyes, mouth, nostrils and sometimes the genitals.
Identifying Eczema On Dark Skin
Eczema appears differently on darker skin than it does on lighter skin tones. On lighter skin, eczema usually appears red and dry. However, on darker skin tones, eczema can appear:
- Dark brown
- Ashen gray
Since eczema on darker skin does not appear red, healthcare providers can look for other characteristics to make a diagnosis. Other signs of eczema include:
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What Causes Atopic Dermatitis
This is a complex disease. Researchers have discovered that the following likely play a role in causing atopic dermatitis :
Family history of AD, food allergies, asthma, or hay fever
What youre exposed to in everyday life, such as stress, pollution, and tobacco smoke
Some people are more susceptible to AD
African American and Asian American children tend to develop atopic dermatitis more often than white children.
Heres what the findings from these studies show:
AD runs in families: Researchers have found you are more likely to develop AD if blood relatives have AD, food allergies, asthma, or hay fever. These findings mean that genes are involved in causing AD.
In fact, researchers have found that certain genes affect a part of your skin called the epidermal barrier. This is the outer layer of skin that protects us from losing too much water and prevents germs from getting in through your skin. AD causes gaps in this outer layer, which seem to be inherited just like your eye color.
Researchers have also found that even if you have genes that increase your risk of developing AD, you may not develop AD. What youre exposed to also affects whether you develop AD.
Where you live: Climate cannot cause AD. However, when a child inherits genes for AD, climate can be a tipping point. Children who have a higher risk of developing AD tend get it more often when they live in a:
Climate may also affect how well treatment for AD works
Which Symptoms Are Similar Among Skin Tones
- Itching: It may be bad enough to disrupt your focus at school or work.
- Skin thickening from scratching: This may appear very dark on darker skin tones.
- Scratches: These may show up as marks or cuts and could lead to infection.
- Swelling: Fluid buildup or infection usually causes this.
- Oozing: This is often the result of seeping or leaking of fluid from edema.
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Whats The Clinical Treatment
Treatment of eczema is similar for all types of skin. Gentle skincare and liberal use of moisturizers are the basis of treatment. For some patients, topical or even systemic medications, may be needed depending on the level of complexity and distribution of the involved skin. Atopic skin tends to be dry and sensitive, so rough and scented skincare products should be avoided to prevent the worsening of atopic dermatitis.Increasing the moisture content of the skin is also essential. Unscented emollients should be used at least once a day, ideally immediately after bathing. Thicker moisturizers, such as creams and ointments , tend to work better. Shea butter is a useful natural alternative to commercially available moisturizers.
In addition, eczema patients should bathe and shower in warm water and limit the time to less than 10 minutes. Hot water can dry out the skin and cause itching, making eczema worse. This tends to be particularly problematic for us because we are more prone to dry, itchy skin. Prescription drugs may also be needed to properly control eczema. Topical corticosteroids are usually the first-line treatment, but they are usually used for limited periods of time. Nonsteroidal creams and ointments such as pimecrolimus, tacrolimus, and crisaborole may also be prescribed. These medications are highly effective and safe for use on all skin types.
Eczema Risk Factors On Darker Skin
The National Eczema Association reports that family history also plays a role in why some populations have more severe eczema. Eczema tends to run in families with a history of eczema, allergies, hay fever, asthma , and other allergic conditions.
You are also at a higher risk of getting eczema if you are diagnosed with allergies or asthma or if you have a family history of other inflammatory skin conditions.
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What Is Dermatitis And What Does It Look Like
Dermatitis is a word used to describe a number of skin irritations and rashes caused by genetics, an overactive immune system, infections, allergies, irritating substances and more. Common symptoms include dry skin, redness and itchiness.
In the word dermatitis, derm means skin and itis means inflammation. The word as a whole means inflammation of the skin. The rashes range from mild to severe and can cause a variety of problems, depending on their cause.
Dermatitis causes no serious harm to your body. It is not contagious, and it does not mean that your skin is unclean or infected. There are treatment methods and medications that can manage your symptoms.
Which Skin Type Are You
Skin type is described by the Fitzpatrick classification , which determines the colour of skin by phototype, which depends on the amount of melanin pigment in the skin.
In this article we describe skin as lighter or darker.
Skin types: Fitzpatrick classification, adapted from:
Skin changes are caused either by active eczema or by scratching as a result of eczema itch. These changes can result in two types of pigmentary skin changes in eczema:
- HYPO-PIGMENTATION Loss of skin pigment or colour, usually seen as patches of skin that are lighter than overall skin tone.
- HYPER-PIGMENTATION Patches of skin becoming darker than the normal skin tone.
Hypo- and hyper-pigmentation are more visible in darker skin types but can occur in any skin type and can be concerning and distressing for anyone with eczema.
The main way of improving skin pigmentation changes is to treat the underlying eczema and inflammation. But discoloration can last for months or years, even after the eczema is treated.
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Beyond Dermatology: Holistic Healthcare Can Provide A Wider Range Of Treatment Options
Charnae Sanders said she wished her dermatologist knew there was more to her condition than what shows up on her medical chart. Even though the effects of my eczema can be seen physically, she said, there is emotional and mental pain I live with: its important that dermatologists are mindful of how they talk to patients and recognize that the scars we carry arent limited to what the eye can see.
I would recommend that doctors lean towards using more of a holistic approach, Charnae said. I appreciate it when my dermatologist does not just limit the conversation to better care but also discusses how to manage my stress and find support groups for people who also have eczema.
What Is It Like Living With Dermatitis
Dermatitis is both common and normal. Many people live with it.
Managing your symptoms is important for living with dermatitis. Do your best to keep your dermatitis under control. You can do this by following your healthcare providers instructions. Try your at-home remedies and take any prescribed medications.
You may find that there are times when your dermatitis disappears. This is known as a remission period. Other times you may have a flare up, which is when your dermatitis gets worse.
Do your best not to scratch your dermatitis as this can lead to infections and scars.
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Whats The Difference Between Eczema And Ad
Eczema refers to a group of conditions that cause inflamed skin. There are many types of eczema. Atopic dermatitis is the most common type.
Other types of eczema include contact dermatitis, nummular eczema, and dyshidrotic eczema. People often say eczema when referring to any one of these conditions.
While AD is only one type of eczema, it can develop on the skin in many ways. Youll see pictures of AD and the different ways that it can appear at: Atopic dermatitis: Symptoms
Eczema More Common In Black Patients
Lisette HiltonDermatology Times
An expert speaks with Dermatology Times about the nuances of diagnosing, treating and managing eczema in black patients.
Eczema, or atopic dermatitis, is more common in black than in white patients yet, less is known about how do diagnose and treat eczema in skin of color patients, according to Andrew Alexis, M.D., M.P.H., chair of dermatology at Mount Sinai St. Lukes and Mount Sinai West, and professor of dermatology at the Icahn School of Medicine at Mount Sinai.
Prevalence of childhood atopic dermatitis in white children is about 11%, whereas for non-Hispanic black children its 17%, says Dr. Alexis, a speaker for the National Eczema Association.
Beyond the epidemiologic differences there are clinical and morphological differences in how eczema behaves in patients of color.
CLINICAL DIFFERENTIATORSEczema in darker skin types presents in unique ways, according to Dr. Alexis.
The follicular presentation of eczema is more common in individuals with African ancestry. Another pattern called the lichenoid presentation of atopic dermatitis is more commonly seen in patients with African ancestry, he says.
One solution is for providers to calibrate their eyes to better detect erythema in patients with skin of color.
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Prevalence Of Eczema On Black Skin
While eczema can affect anyone, research suggests that certain ethnic groups are at a greater risk.
The National Health and Nutrition Examination Survey, which assesses the health and nutritional status of adults and children in the United States, found that 19.3 percent of African-American children have this skin condition , compared to 16.1 percent of white children and 7.8 percent of Asian children. Another study found that African-American children are 1.7 times more likely to develop atopic dermatitis than caucasians.
Now, atopic dermatitis usually begins during infancy and early childhood , but adults can also develop this skin condition. Adult-onset disease appears to be more common in Asia than in Western countries.
Erythema a common skin finding related to eczema, presents as redness in the involved skin area in patients with lighter skin tones. It is more difficult to perceive in the background of melanin-rich skin. Instead of shades of red and pink, dermatologists may see lesions that look purplish, grayish, reddish-brown, or very brown color and may be confused with other conditions. Another hallmark of atopic dermatitis in black skin is the tendency to develop pigmentary alterations from hyper- or hypopigmentation.
Discussing Cultural Differences Can Lead To More Informed Shared Decision Making
Reggie mentioned the importance of food as an essential part of Black culture. Never in all my conversations with dermatologists have I heard any questions about Black culture and food, he said. There may be things in our diet, as a culture, that are eczema triggers. People are so sensitive to inclusion and acceptance: we want to talk about how were all the same, but there are things that are different about us, and its okay that they are different.
Ashley Hardy had also considered the possibility that her diet was impacting her dry skin. I went to see a new dermatologist and told him what I had eaten before having the reaction. Ashley had not changed anything in her diet recently, but she had just experienced her worst flare up in years and asked if it could have been something she had recently eaten. I just figured it was stress and sweat, she said. But after testing for allergies I found out I was allergic to egg whites and gluten. I was devastated, but I did see relief in my skin.
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