Eczema

What is eczema?

Eczema is a common skin disorder seen worldwide and in the United States.

Eczema is the second most frequent skin disease in African Americans and is one of the most common skin disorders seen in infants and children overall. 

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 brown or black skin, this redness may be difficult to see. Eczema tends to look darker brown, purple or ashen grey in color. Because eczema in different skin tones may look different, physicians may confirm diagnosis by looking for skin swelling, warmth, dryness/scaling or itching. The itching due to eczema has been shown to have a greater impact in African-American patients.

Beyond differences in severity, color and symptoms, unique forms of atopic dermatitis may be seen in darker skin. African Americans more commonly develop small bumps on the torso, arms and legs (called papular eczema). 

Following resolution of eczema, darker-skinned patients experience a greater rate of pigmentary changes. The healed skin may look darker or lighter than the surrounding normal skin. In some patients, this color change is more bothersome than the original eczema itself. Fortunately, once the eczema is controlled, the skin color typically returns to normal. This may take several months.

How do I treat Eczema?

  • Avoid harsh and fragranced skin care products.
  • Use thicker moisturizers, such as creams and ointments (rather than lotions)Avoid harsh and fragranced skin care products.
  • For children with clothes-based eczema flare-ups, dress your baby in natural fabrics only. These include cotton, linen, silk, and hemp, just to name a few. Whatever natural fabric you choose, it should be smooth, pliable, and pleasant to the touch.
  • Prescription medications may also be needed to adequately control eczema.
  • Topical corticosteroids are typically the first-line treatment but are generally used for limited periods of time.
  • Non-steroid creams and ointments such as pimecrolimus (Elidel), tacrolimus (Protopic), and crisaborole (Eucrisa) may also be prescribed. These medications are highly effective and safe for use in all skin types.