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Types Of Eczema On Black Skin

How Eczema Affects The Skin

Eczema (Atopic Dermatitis) in Skin of Color: Black Skin, Brown Skin, Dark Skin

Eczema looks different depending on a persons skin type.

On light skin, eczema typically causes inflamed pink or red patches that are dry and itchy. These lesions are harder to detect on dark skin tones.

When people with light skin scratch eczema lesions, hyper and hypopigmentation can occur. Skin pigmentation can progress gradually, and its subtle changes make it hard to detect.

People with dark skin tones are more likely to get hyper and hypopigmentation. They are also more likely to have follicular prominence, which is when eczema presents as small, itchy bumps called papules. These mainly appear on the forearms and torso.

How Is Eczema Treated

While much of eczema care focuses on preventing flare-ups from occurring, there are also treatments that you can use when symptoms occur.

Generally speaking, eczema treatments are very similar across all races and ethnicities. They often involve the combination of medications with other therapy types.

Proven Home Remedies For Eczema Scars

The suggested home made remedies for eczema scars may or may not work for an individual as the symptoms of eczema vary from one person to another. Hence, if a remedy doesnt provide a significant result, dont lose hope. We highly recommend to seek medical intervention for eczema and related concerns. Always contact your medical provider before using any of the methods, or changing your treatment regimen. Meanwhile you can install Eczema tracker app to get advice and information that helps you manage your eczema symptoms.

Eczema Tracker App is available for iPhone, iPad and Android.


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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.

How To Spot Eczema On Black Skin

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Eczema tends to look darker brown, purple or ashen grey in color.

Without the characteristic redness, skin swelling, warmth, dryness/scaling or itching may help patients and doctor confirm the diagnosis.

The itching due to eczema has been shown to have a greater impact in Black patients. Black patients are also more likely to a more severe form of the condition.

The treatment of eczema is similar in people of all races and ethnicities. Gentle skin care and liberal use of moisturisers is the key treatment for most. For some patients, topical or systemic medications may be needed.

Aramidé says it is this difference in how eczema can present on dark skin that leads to a lack of understanding.

In the most respectful way, white people cant see what is wrong with your skin the perception is you must see redness for there to be a problem, she says.

But the reality is that eczema affects all skin colours and does not distinguish between them.

Dark and light skin tones are equally affected by inflammatory symptoms like redness , itching, swelling , dryness and thickening of the skin, explains Dr Bjorn Herpers, clinical microbiologist.

The underlying causes of inflammation are the same as well. Regardless of skin colour, eczema is characterised by a barrier defect in the skin, making it more sensitive to triggers that set off an inflammatory response.

Dr Herpers says Eczema can be suspected if the skin is lightly pigmented, raised, scaled, burning or itchy.

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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 type
VI Skin black

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.

Diagnosis And Treatment Of Darker Skin Poses Unique Issues

byKate Kneisel, Contributing Writer, MedPage Today September 2, 2021

In the U.S., the prevalence of atopic dermatitis is higher among African Americans, at almost 20%, compared with European Americans and Hispanic Americans .

In addition, the prevalence of childhood AD has been growing over the past 2 decades, with an increasing representation of African-American children being a major contributing factor, noted Jonathan Silverberg, MD, PhD, MPH, of George Washington University School of Medicine and Health Sciences in Washington, D.C.

“The observed differences are likely multifactorial. However, one contributing factor is poor disease control and greater disease persistence in African-American/Black children, which suggests there are racial disparities. As a field, we need to do a better job assessing and managing AD across all patient races and subsets,” Silverberg told MedPage Today.

The trend may also reflect a growing number of AD diagnoses resulting from increased access to healthcare, said Danny Del Campo, MD, of Chicago Skin Clinic.

“Other factors include environmental and daily habits that ultimately influence the allergic immune response. Excessive bathing is a frequent factor and chronic disruption of the skin barrier is likely a key player in the increased prevalence of AD,” Del Campo told MedPage Today.

Management of post-inflammatory pigmentary changes often depends on the location on the body and the degree of severity, noted Del Campo.

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How To Heal From Eczema Scars

From seborrheic dermatitis to atopic dermatitis, there are several different types of eczema. While the different types each have defining characteristics that set them apart from one another, one common symptom is intense itchiness.

Unfortunately, relentless scratching can sometimes lead to scarring, especially if the skin cracks or bleeds. Lets take a closer look at how to heal eczema scars in our post below.

What Other Questions Might My Healthcare Provider Ask To Diagnose Dermatitis

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The conversation with your healthcare provider will need to cover a lot of information. Be sure to be specific about your symptoms.

  • Where is your dermatitis located?
  • What have you used to try to treat your dermatitis?
  • What medical conditions do you have? Allergies? Asthma? Celiac disease?
  • How long have you had symptoms of dermatitis?
  • Do you take hot showers?
  • Is there anything that makes your symptoms worse?
  • Are you around chemicals?
  • Have you noticed that something triggers or worsens your dermatitis? Soaps? Detergents? Cigarette smoke?
  • Is there so much pain or itchiness that you have trouble sleeping? Working? Just living your normal life?

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Other Types Of Eczema

Eczema is the name for a group of skin conditions that cause dry, irritated skin. Other types of eczema include:

  • atopic eczema the most common type of eczema
  • contact dermatitis a type of eczema that happens when you come into contact with a particular substance
  • discoid eczema a long-term type of eczema that appears as circular or oval patches on the skin

Page last reviewed: 25 October 2019 Next review due: 25 October 2022

Eczema Affects All Skin Colors

Eczema is a common disease affecting mostly children, and it does not discriminate against skin color. Light skin and dark skin tones are equally affected.

Similar symptoms appear in dark skin as in light skin:

  • Changes in skin color on the eczema patch
  • Swelling
  • Thickening of the skin

In atopic eczema, which presents in flare-ups, skin also feels dry and tight, even in periods of remission. Intense itching can impede sleep and cause children to become irritable.

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Use A Moisturizer On Your Skin Every Day

Moisturizers help keep your skin soft and flexible. They prevent skin cracks. A plain moisturizer is best. Avoid moisturizers with fragrances and a lot of extra ingredients. A good, cheap moisturizer is plain petroleum jelly . Use moisturizers that are more greasy than creamy because creams usually have more preservatives in them.

Regular use of a moisturizer can help prevent the dry skin that is common in winter.

Is There A Difference Between Eczema And Dermatitis

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Although the terms dermatitis and eczema may overlap in how theyre used, specific types of skin conditions are better known by just one of the names. For example, many doctors use the terms atopic dermatitis and eczema interchangeably but wouldnt use the term contact dermatitis in place of eczema.

There are also a number of distinct types of eczema and dermatitis, and, to complicate matters, its possible to have more than one type at the same time.

While both eczema and dermatitis typically cause redness and itching, some types also cause blistering and peeling.

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What Does Eczema Look Like In Darker Skin

Most people think of eczema as a red, dry, and itchy rash how it appears in light skin. However, in dark skin, including brown skin, dark brown skin, Black skin, and other darker skin tones this redness may be difficult to see. Eczema flare-ups tends to look darker brown, purple or ashen grey in color. In the absence of characteristic redness, skin swelling, warmth, dryness/scaling or itching and oozing may help patients and physicians confirm the diagnosis. Lichenification is also one of the eczema symptoms that may appear differently in darker skin tones. The itching due to eczema has been shown to have a greater impact in Black patients, who are also more likely to have severe disease.

Beyond differences in severity, skin color and symptoms of eczema, unique forms of atopic dermatitis may be seen in darker skin tones. Black Americans more commonly develop small bumps on the torso, arms and legs . Sometimes, bumps develop around hair follicles and resemble goosebumps .

Black Americans also tend to have more extensive skin dryness and dark circles around their eyes. People who repeatedly rub and scratch the eczema-prone areas may develop skin thickening and firm, raised bumps on the skin called prurigo nodules.

Do Use Mild Moisturizing Soaps

Eczema triggers extreme skin dryness, which is the source of a lot of itching and irritation.

Normal soaps and cleansers can further dry out your skin and worsen these symptoms. This is because they come with certain chemicals that strip the natural oils from your skin over repeated use.

Thus, look for soaps that are chemical-free and moisturizing. Replace your normal soaps with pH-balanced soaps . Ask your doctor to recommend suitable options.

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Is It Cradle Cap

Cradle cap in babies is a condition that doctors call seborrheic eczema or seborrheic dermatitis. It appears as oily, scaly patches on the scalp. In contrast, atopic dermatitis is more often found on the cheeks, though it can also affect the scalp. Also unlike eczema, cradle cap typically isnât itchy. Usually cradle cap clears up without treatment in a few weeks or months.

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Do not touch your thighs if you see the skin darkening in the armpits or sensitive areas, just apply a few drops and spread this natural cream on the skin. It guarantees a good improvement of the complexion. Often the skin becomes dry due to the weather or hormones and fine wrinkles form.

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Add An Acid To Your Skincare Routine

Before you self diagnose your skin condition, Dr. Agbai recommends consulting a dermatologist to determine what type of hyperpigmentation youre dealing with so you know how to best treat it. She warns that some skin cancers, fungal infections, inflammatory disorders, or signs of systemic disease could look like dark patches on the skin and you wouldnt want to be treating the wrong thing.

If it does turn out you have PIH, the best time to treat scars is when they are fresh, says Dendy Engelman, MD, a dermatologist in NYC. Look for salicylic acid or glycolic acid peels that will help promote cellular turnover to remove the top layers of the skin that hold the pigment.

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If youre hoping to achieve a more even complexion overall, she recommends brightening ingredients like kojic acid, phytic acid, and L-ascorbic acid .

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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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Rashes On Skin Of Color

The appearance of a rash varies with skin tone. On skin of color, a rash may be purple, gray, or white while medical texts often simply describe these rashes as red. Some redness may appear, but typically not very much.

This is due to melanin, a molecule that gives the skin and hair their color. Generally, the more melanin a person has in their skin, the darker their skin tone. It affects how the skin reacts to sunlight, damage, and health conditions that cause rashes.

Some doctors are unaware of how skin conditions present on darker skin. A 2018 study of four major medical textbooks found that darker skin tones were underrepresented in the imagery.

The studys authors report that while, at the time, 20.4% of the U.S. population was Black, only 4.5% of the photographs in the textbooks showed people with dark skin. They suggest that this is likely an example of racial bias in the healthcare system.Below, we explore how various health issues can appear in skin of color.

Heat rash, sweat rash, and prickly heat are all common names for miliaria, a skin condition that occurs when the skins sweat ducts become blocked.

The symptoms of heat rash include:

  • small, raised blisters on the skin
  • swelling
  • itchiness

On darker skin, the blisters may be gray or white.

Eczema causes patches of dry, itchy skin, and the affected area may also be flaky or scaly. If the skin is very dry, it may crack or bleed.

There are several types of eczema, including:

How Is Dermatitis Diagnosed

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Your healthcare provider will take a close look at your skin. They will look for classic signs of dermatitis such as a rash, redness, scales, dryness and more. They will ask about the symptoms youre experiencing. Are you itchy? Does your skin feel like its burning? Is your skin dry? Have you come into contact with anything that might irritate your skin?

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Causes Of Discoid Eczema

The cause of discoid eczema is unknown, although it may happen as a result of having particularly dry skin.

When your skin is very dry it cannot provide an effective barrier against substances that come into contact with it. This could allow a previously harmless substance, such as soap, to irritate your skin.

Its important to look carefully at all the chemicals in cosmetics and toiletries that may have come into contact with your skin. Contact dermatitis, a type of eczema caused by coming into contact with a particular irritant, may have a role in discoid eczema.

Some people with discoid eczema also have a history of atopic eczema, which often happens in people who are prone to asthma and hay fever. However, unlike atopic eczema, discoid eczema does not seem to run in families.

What Are The Clinical Features Of Atopic Dermatitis

The clinical phenotype of atopic dermatitis can vary greatly, but is characterised by remission and relapse with acute flares on a background of chronic dermatitis.

Acute dermatitis is red , weeping/crusted and may have blisters . Over time the dermatitis becomes chronic and the skin becomes less red but thickened and scaly. Cracking of the skin can occur.

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