Black Skin Eczema: Visual Guide, Signs, and Remedies
In managing eczema, individuals with darker skin tones require a tailored approach due to differences in skin biology and associated complications. Eczema, also known as atopic dermatitis, affects people of all skin tones, but those of African American and Hispanic descent are more likely to develop severe or persistent forms of the condition.
Common treatments for eczema include topical applications and systemic therapies. Topical treatments, such as emollients, regularly used to hydrate and repair the skin barrier, are essential for all skin tones. Topical corticosteroids, which effectively reduce inflammation, should be used carefully in darker skin tones to avoid thinning of the skin or triggering post-inflammatory hyperpigmentation (PIH). Calcineurin inhibitors, non-steroidal options suitable for sensitive areas or for use in darker skin tones where PIH is a concern, are also beneficial.
Systemic and advanced therapies, such as oral corticosteroids, biologics, JAK inhibitors, and phototherapy, are effective across all skin tones. However, phototherapy may cause skin darkening, making hyperpigmentation more noticeable in darker skin tones. Newer biologics like lebrikizumab have been shown to improve not only eczema symptoms but also PIH in many patients with darker skin.
In darker skin tones, the risk of post-inflammatory hyperpigmentation is higher after eczema lesions resolve, requiring careful management to minimize dark patches. Eczema may also present differently in darker skin tones, sometimes leading to underdiagnosis or misdiagnosis. Cultural and cosmetic concerns, such as hair texture and styling practices, may influence the choice and delivery of scalp treatments.
In the United States, the prevalence of atopic dermatitis is higher among African American children compared with European American children and children of Hispanic heritage. Black people are more likely to develop papular eczema, which is characterized by small bumps on the torso, arms, and legs, and can resemble permanent goosebumps. Common triggers for eczema flare-ups include irritants, stress, sweating, humid weather, dry, cold weather, hormone changes, and allergens.
A dermatologist can diagnose eczema by examining physical symptoms, assessing a person's medical history, and asking about any family history of eczema or associated conditions. During a flare-up, people can apply a moisturizer several times per day. The Skin of Color Society advises avoiding hot or extremely cold showers, fragrances, tight-fitting clothes, and using fragrance-free cleaning products, beauty products, and detergents to manage eczema on darker skin.
In conclusion, eczema treatment in darker skin tones follows a similar framework as for lighter skin, but with added attention to managing and preventing pigmentation changes and tailored approaches for diagnosis and therapy. It is essential to consult dermatologists experienced in treating skin of colour to address specific needs.
- Multiple medical-conditions, such as diabetes, migraine, and depression, can coexist with eczema, requiring a comprehensive approach in treatment.
- Science has established the association between obesity and the severity of eczema, underscoring the importance of maintaining a healthy weight for eczema management.
- In managing eczema, skin prep with emollients is essential for all skin tones to hydrate and repair the skin barrier.
- Calcineurin inhibitors, a non-steroidal treatment option, are beneficial for darker skin tones, as they reduce inflammation without causing thinning of the skin or triggering post-inflammatory hyperpigmentation (PIH).
- Systemic therapies, including oral corticosteroids, biologics, JAK inhibitors, and phototherapy, are effective for all skin tones, but phototherapy may cause skin darkening in darker skin tones.
- In darker skin tones, the risk of PIH is higher after eczema lesions resolve, making careful management crucial for minimizing dark patches.
- When eczema resolves in darker skin tones, dry skin may persist due to impaired skin function, necessitating continued skincare.
- Eczema may present differently in darker skin tones, sometimes leading to underdiagnosis or misdiagnosis, emphasizing the need for increased awareness among treaters.
- The macular degeneration associated with HIV may complicate eczema management in affected individuals, requiring close monitoring and coordinated care.
- Spondylitis, a type of arthritis, can coexist with eczema in some persons, particularly those with HLA-B27-associated spondylitis or ankylosing spondylitis.
- Health-and-wellness practices, such as stress management and a balanced diet, can help improve eczema symptoms and overall quality of life.
- In some cases, eczema on darker skin may require customizable treatments tailored to each person's unique skin and culture, taking into account factors like hair texture and styling practices.
- Eczema is an established entity that affects people of all skin tones, but those of African American and Hispanic descent are more likely to develop severe or persistent forms of the condition.
- Individuals within diverse cultural and ethnic backgrounds, referred to as personas, can benefit from established eczema treatments when adapted to their specific needs and concerns, ensuring effective and safe management of this chronic condition.
