Eczema causes patches of dry, inflamed skin. On darker skin tones, eczema may appear darker than the surrounding area, or have a gray, purple, pink, or red hue.

Eczema is a common condition and can appear anywhere on the body. It can cause swelling, dryness, and skin discoloration. This skin discoloration will appear differently on different skin tones.

This article covers what eczema looks like on skin of color, as well as how to diagnose and treat it.

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Eczema is an umbrella term that describes several common skin conditions.

These conditions include:

All forms of eczema can cause skin inflammation, dryness, and itchiness. People may have more than one type of eczema simultaneously.

Eczema tends to follow a relapsing-remitting pattern. This means that people can have periods where they experience no symptoms, followed by periods where the symptoms flare up.

Globally, atopic dermatitis is most common in Africa and Oceania, according to a 2018 review of literature.

In the United States, the prevalence of atopic dermatitis is 19.3% among African American children compared with 16.1% among European American children and 7.8% among children of Hispanic heritage, according to the 2005-2006 National Health and Nutrition Examination Survey.

The prevalence of eczema decreases with age. In the United States, 80% of people affected by atopic dermatitis first experienced symptoms prior to age 6 years, according to the National Eczema Association.

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, such as having a family history of the condition, environmental factors also have an effect.

A 2018 research review suggests that structural racial inequality in the United States likely affects 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 typically mean these children are more likely to live in lower income households and disproportionately live in areas with higher pollution levels. These conditions can be risk factors for developing severe atopic dermatitis.

Racial inequality in healthcare may also be 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 (hyperpigmentation) or lighter (hypopigmentation) than the surrounding area.

Eczema can appear anywhere on the body. However, Black people can be more prone to papular lesions. They look like small bumps on the torso, arms, and legs.

This is called papular eczema, and it may resemble permanent goosebumps. Black people are also more likely to develop lesions on the extensor surfaces.

Extensor surfaces are skin surfaces on the outside of a joint.

These bumps can develop around hair follicles, a condition called follicular accentuation.

People of Color with eczema may often experience extensive dryness and dark circles around their eyes due to the condition.

A dermatologist, a doctor who specializes in skin conditions, can diagnose eczema.

To diagnose eczema, a dermatologist will first examine physical symptoms and assess a person’s medical history. They will also ask about any family history of eczema or associated conditions, such as asthma. They can help diagnose the type of eczema and recommend a treatment method.

Something to keep in mind

However, eczema symptoms on darker skin can look different than on lighter skin. This may lead to an underdiagnosis of eczema severity or misdiagnosis.

Eczema treatment is similar for all skin colors. However, it can depend on a person’s symptoms and the severity of the condition.

Treatment options can include:

Soak and moisturize

Soaking the affected areas in lukewarm water for around 15–20 minutes can help hydrate the skin. People should then pat the area dry before applying a moisturizing cream or ointment.

During a flare-up, people can apply a moisturizer several times per day.

Tar preparations

Some healthcare professionals recommend using products that contain tar extract to help ease eczema symptoms.

Topical steroids

Steroid creams can help treat flare-ups by reducing inflammation and itching. These creams usually require a prescription. People can apply steroid creams after a soak or bath. It’s important that they wash their hands after application.

Doctors typically do not recommend using steroid creams long term or more than twice per day unless a healthcare professional specifically advises it.

Oral steroids

Doctors will only prescribe oral steroids for eczema in exceptional circumstances due to their adverse effects.

A doctor may prescribe oral steroids to treat severe flare-ups. These medications help fight inflammation. However, doctors typically discourage the routine use of these medications for eczema because they may cause adverse side effects when taken over long periods.

Antihistamines

Itching can be one of the most aggravating symptoms of eczema. Taking antihistamines consistently can help reduce general itching.

Other treatment options

Doctors may use other treatments for eczema. These can include:

  • topical calcineurin inhibitors
  • dupilumab (Dupixent)
  • phosphodiesterase-4 (PDE-4) inhibitors
  • topical and systemic Janus kinase (JAK) inhibitors
  • phototherapy
  • other systemic treatments like methotrexate (Otrexup (PF), Xatmep, Trexall)

Eczema is a chronic condition. However, it is possible to prevent or minimize flare-ups with the right management.

The Skin of Color Society offers the following advice to help manage eczema:

  • avoid taking hot or extremely cold showers or baths
  • avoid using fragrances, such as perfumes and colognes
  • choose fragrance-free cleaning products, beauty products, and detergents
  • avoid wearing tight-fitting clothes
  • bathe for 5–10 minutes each day, followed by patting skin dry and immediately moisturizing the skin

Many people find that certain things or situations can trigger a flare-up. Common triggers include:

What does eczema look like on African American skin?

On black skin, eczema can cause darker brown, purple, or gray patches. The affected areas also may feel swollen, warm, itchy, dry, or scaly. After a flare-up, the affected skin may temporarily appear darker or lighter than the surrounding area.

What can trigger eczema?

Eczema triggers can vary between individuals, but some common triggers include fragrances, weather extremes, allergens, and stress.

What is good to clear up eczema?

Doctors may recommend moisturizing the skin often. Treatment may also include topical steroids, antihistamines, or other topical or systemic medications.

Does eczema ever go away?

People with eczema typically experience periods of flare-ups where they experience symptoms followed by periods of remission. Some children with certain types of eczema may outgrow the condition.

Eczema refers to a group of common skin conditions that can present differently in people of different skin tones.

On darker skin, eczema patches may look dark brown, purple, or gray. In some cases, the condition presents small, firm, raised bumps.

Treatment and management are similar for all skin tones. Anyone experiencing the symptoms of eczema should see a doctor for diagnosis and treatment.