Eczema And Structural Inequality
African American and Hispanic children are more likely to develop severe or persistent eczema. While genetics play a part in the formation of eczema, environmental factors also have an effect.
A 2018 review found that structural racial inequality in the U.S. is likely to affect atopic dermatitis severity in African American children.
Indigenous and Latinx children may also be at a higher risk of developing severe or recurrent eczema due to structural racial inequality.
Researchers have found that social inequalities mean that these children are more likely to be from lower-income households and disproportionately live in areas with higher pollution levels. These are risk factors for developing severe atopic dermatitis.
Racial inequality in healthcare is also a contributing factor.
Since eczema may be more difficult for some physicians to diagnose in darker skin types, some doctors may underdiagnose the severity of eczema in people of color.
This means that people of color can be more likely to develop more severe eczema than people with lighter skin.
On darker skin, eczema can cause darker brown, purple, or gray patches. The affected areas may be swollen, warm, itchy, dry, or scaly. After a flare-up, the affected skin may look darker or lighter than the surrounding area.
Eczema can appear anywhere on the body. However, Black people can be more prone to papular lesions, which look like small bumps on the torso, arms, and legs.
Where Can Eczema Appear On Your Legs
Most types of eczema can appear anywhere on your legs, including your thighs, your calves, and the backs of your legs.
Eczema is more common on joints and areas where the skin regularly stretches and bends. So, while it can appear anywhere, leg eczema most often pops up on the knees, hips, ankles, and feet.
Eczema is more likely to break out on dry skin, but sweat can also trigger a flare. Basically, eczema is an unpredictable little bugger. Who knows where itll pop up next?
Why Skin Colour Matters When It Comes To Eczema
Most dermatology training in the UK is based on white skin yet the prevalence of eczema and psoriasis is significant across all skin tones. It was reading an excellent article on this that prompted us at Cotton Comfort to ask ourselves how we can ensure we better represent and support the broad spectrum of skin tones that exists within our itchy skin community.
As well as starting to take a good look at our own practices, including our product range and photography, we wanted to open up the discussion in our blog and are really excited to share our latest piece by journalist Sue Omar: Why Skin Colour Matters when it Comes to Eczema.Sue has a breadth of experience writing for various publications including The Times, The Evening Standard, ELLE UK, & Grazia UK and we think youll love reading her below insights on this important and timely topic.
From psoriasis to eczema, there are many skin conditions that are overwhelmingly overlooked in Black and other ethnic minority groups. Although eczema impacts over 15 million people in the UK alone according to Allergy UK there is still very limited medical information or imagery available on how it shows up and manifests in melanin-rich skin-tones. But why is this?
How To Identify Eczema In Dark Skin
Signs and symptoms of eczema in dark skin:
Treatments & Solutions For Eczema In Dark Skin
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What Are The Signs & Symptoms Of Eczema
The signs of eczema :
- are mainly dry, itchy skin. Because it is so itchy, it is often called “the itch that rashes.”
- include redness, scales, and bumps that can leak fluid and then crust over
- tend to come and go. When they get worse, it is called a flare-up.
- may be more noticeable at night
Symptoms can vary:
- Infants younger than 1 year old usually have the eczema rash on their cheeks, forehead, or scalp. It may spread to the knees, elbows, and trunk .
- Older kids and teens usually get the rash in the bends of the elbows, behind the knees, on the neck, or on the inner wrists and ankles. Their skin is often scalier and drier than when the eczema first began. It also can be thicker, darker, or scarred from all the scratching .
What Do Doctors Do
If you think you have eczema, your best bet is to visit your doctor, who may refer you to a dermatologist . Diagnosing atopic eczema can be difficult because it may be confused with other skin conditions. For example, eczema can easily be confused with a skin condition called contact dermatitis, which happens when the skin comes in contact with an irritating substance, like the perfume in a certain detergent.
In addition to a physical examination, a doctor will take your medical history by asking about any concerns and symptoms you have, your past health, your familys health, any medications youre taking, any allergies you may have, and other issues.
Your doctor can also help identify things in your environment that may be contributing to your skin irritation. For example, if you started using a new shower gel or body lotion before the symptoms appeared, mention this to your doctor because a substance in the cream or lotion might be irritating your skin.
Emotional stress can also lead to eczema flare-ups, so your doctor might also ask you about any stress youre feeling at home, school, or work.
If youre diagnosed with eczema, your doctor might:
- prescribe medications to soothe the redness and irritation, such as creams or ointments that contain corticosteroids, or antihistamine pills
- recommend other medications to take internally if the eczema is really bad or you get it a lot
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Wear Gloves To Protect The Skin On Your Hands
Wear vinyl or plastic gloves for work that requires you to have your hands in water. Also, wear gloves when your hands are exposed to anything that can irritate your skin. Wear cotton gloves under plastic gloves to soak up sweat from your hands. Take occasional breaks and remove your gloves. This will prevent a buildup of sweat inside your gloves.
Wear gloves when you go outside during the winter. Cold air and low humidity can dry your skin. Dryness can make your eczema worse. Wear clothes made of cotton or a cotton blend. Wool and some synthetic fabrics can irritate your skin.
Can Your Gut Health Play A Role In Stress Rash
When it comes to stress rash, Felton believes the gut plays a part. ‘We know that stress can disrupt the connection between the brain and the skin, but the gut also plays an important role. The skin, mind, and gut work in synergy… so if one of them is unbalanced it will show and it is very likely to show in the form of inflammation,’ she tells WH.
‘Our gut microbiome is composed of bacteria, viruses, and fungi which all play a key role in the body. ‘They protect us against foreign invasions such as toxins, but most importantly boost and support our immune system. An unbalanced gut flora will not have the ability to fight against the development of autoimmune disorders and inflammation.’
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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.
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Ways To Reduce Eczema
There are also many options you can take to reduce your eczema symptoms in general. First, visit your dermatologist so that they can properly diagnose you and perform tests to see what type of eczema you have and why you have eczema. There are many different types of eczema, some of which include atopic dermatitis, contact dermatitis, dyshidrotic eczema, and seborrheic dermatitis. There are a variety of treatment options for eczema like:
- OTC Products
- Prescription Products Many of these include topical creams with medications like corticosteroids, PDE4 inhibits, hydrocortisone, or topical calcineurin inhibitors to help relieve symptoms. Using hydrocortisone for eczema is a common practice and one that we explore in additional detail in our blog.
- Light Therapy
In addition to treating your eczema treatment, if you are suffering from the other common co-occurring conditions such as anxiety, depression, or auto-immune diseases, you should schedule an appointment with your general doctor as well. They will be able to offer treatments for these conditions that will help not only help them, but eczema symptoms as well. If you have questions on eczema or any other skin conditions, do not hesitate to contact us today!
How Common Is Eczema
Eczema affects up to 15 million Americans. Infants are prone to eczema and 10% to 20% will have it. However, nearly half outgrow the condition or have significant improvement as they get older.
Eczema affects males and females equally and is more common in people who have a personal or family history of asthma, environmental allergies and/or food allergies.
Ways To Relax In 15 Minutes
CATCH YOUR BREATH. Sit up straight in a chair with your feet on the floor and close your eyes. Breathe in long and deep and breathe out long and slow. Repeat ten times.
FOCUS ON THE HERE AND NOW. When were feeling stressed, our minds are constantly ten steps ahead. This simple mindfulness exercise gently brings us into the present moment:
- Five things you can see: Stop what youre doing, look around and closely observe five things in your environment especially those youve never really paid attention to before.
- Five things you can hear: Next, listen intently to five different sounds. Notice how they ebb and flow and their pitch, tone or rhythm.
- Five things you can feel: Finally, notice the sensation of five different things on your skin.
TAP INTO THE ISSUE. The Emotional Freedom Technique is an approach that involves tapping key acupuncture points. Some research indicates that it may help anxiety or pain though it is unclear how it works.
- Focus on the feeling or problem that you want to work on and put it into a short sentence. For example I feel completely overwhelmed with work.
- Score the intensity of the feeling on a scale of 1 to 10 .
- Tap the side of your hand the part that would touch an object in a karate chop and repeat three times: Even though I feel , I deeply and completely accept myself.
- Focus on the problem, tapping each of the following points :
-Top of the head
-Bone beside the outer corner of the eye
-Under the eye
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Diagnosing Nummular Eczema And Ringworm
Youll need to see your doctor for a diagnosis of either condition.
Its best to have nummular eczema diagnosed by a dermatologist. A doctor specializing in skin conditions or even your primary care doctor can help determine a treatment plan and rule out other conditions.
Nummular eczema is diagnosed with a physical exam. A doctor can usually make a diagnosis by looking at the skin. Nummular eczema is most prominent in these areas of the body:
If you have open sores within any of the rashes, your doctor may take a sample to see if you have an infection. This is especially important if your symptoms look like ringworm.
A sample can help them determine if you have a staph infection from eczema, or if its a fungal infection related to ringworm.
Red, circular rashes on the skin are a telltale sign of ringworm, but your doctor may also test a sample to confirm. Theyll look for signs of a fungal infection. If the fungal test is negative, then you dont have ringworm.
Once you have an accurate diagnosis, your doctor can explain treatment options.
Narrowing Down The Cause
One key to finding the cause of your rash is to observe how long the rash persists. A rash that keeps coming back may be related to hay fever, rather than temporary exposure to something.
Also, what time of year does the rash normally appear? If you notice youre developing recurring rashes consistently during certain seasons , it may be related to the pollens of that season. This is known as seasonal allergies.
Note that allergic reactions arent limited to the pollens in the spring. Fall allergies are common and, in some areas, trees and certain plants grow in the winter and summer that can cause skin irritation. Ragweed and grass can cause hay fever during spring and summer, the two best-known seasons for allergy problems.
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Tiny Black Dots On Skin
Does your skin have small or tiny black spots? Tiny dark marks can appear in various part of your skin. Usually, they can show up on the face, arms, back, shoulders, on genital organs, inner thighs, legs or on any other parts of the body skin.
Tiny black spots on skin can occur due to the accumulation of melanin on one point or part of the skin tissue. Hyperpigmentation of the skin usually appears due to excess production of melanin pigment in the affected area.
Small dark dots can appear on the skin of anybody. However, the adolescent stage is commonly associated with tiny dots on the face that develop from acne. Blemish, zit or dark marks on the face during adolescent cannot develop into serious skin condition but it can make the facial skin look less attractive hence a beauty problem.
A baby face can also develop tiny spots on face. Baby acne caused by milia spots can result to tiny black scarring on the face of infant or toddlers. Heat rash is a common cause of tiny dark, red, brown or black scarring on the skin of children.
Adults cannot escape tiny black dots on the skin. As you grow to adulthood, you are likely to develop more dark dots or patches on your skin. This is a clear reason to explain why people with advanced age have a more prominent dart dots on their body skin.
How Is Eczema Diagnosed What Tests Are Done
Your healthcare provider will take a close look at your skin. They will look for classic signs of eczema such as a redness and dryness. They will ask about the symptoms youre experiencing.
Usually your healthcare provider will be able to diagnose eczema based on examining your skin. However, when there is doubt, they may perform the following tests:
- An allergy skin test.
- 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.
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What Does Stress Rash Look Like
‘Stress increases our innate “fight or flight” response, boosting certain hormones such as cortisol and chemicals such as interleukins within the body, all of which increase inflammation,’ adds Dr Granite. ‘Inflammation affects our skin, ramping up swelling, redness, and heat, which in turn can cause an itchy, angry rash.’
So, for some, stress can cause hives which is a ‘stress-induced rash that appears on the skin as welts,’ explains Felton. Alternatively, stress-induced inflammation can exacerbate skin conditions that youre predisposed to such as cold sores, acne, eczema and psoriasis.
Questions To Ask Your Doctor
- What treatment is best for me?
- Should I use a steroid cream or ointment?
- What are the side effects from the steroid cream or ointment?
- Do I need to take any other medicines?
- What is the best way to prevent flare-ups from eczema and atopic dermatitis?
- Is there a certain type of soap I should use?
- My child has eczema. What kind of moisturizer is best for him/her?
- How can I keep my child from scratching the rash?
- I have eczema. Will my children have it?
- How should I care for the rash if I have a flare-up?
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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 .
What Is The Connection Between Stress And Eczema
Doctors have long known that stress isnt good for your health. What is stress not connected to? says Dr. Hussain. Many chronic medical conditions and mental health conditions are affected by stress. This includes skin conditions like eczema. The more stressed you are, you do tend to get worse eczema breakouts. Theres a connection there.
Whats challenging is that stress can be difficult to measure. Stress isnt quantifiable its not something we can do a test for like we do for diabetes or blood pressure, says Dr. Hussain. But stress affects pretty much everything in your body, including how quickly you heal after surgery or how quickly you respond to medication. Its very subjective.
However, doctors do know the link between stress and eczema has something to do with hormones. The feel-good hormones, your endorphins, tend to be suppressed when youre in a state of stress, says Dr. Hussain. When youre in a fight-or-flight mode, your heart rate tends to go up, your blood pressures going to respond accordingly, and your body is going to release other hormones.
When youre stressed out, these hormones protect you. However, being in fight-or-flight mode constantly can be detrimental to your health, Dr. Hussain notes. Its definitely not good for you. And thats when you can get an eczema outbreak.
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