Eczema causes patches of dry, inflamed skin. On skin of color, these patches may appear darker than the surrounding area, or have a grey, 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.

In the United States, the prevalence of atopic dermatitis is 19.3% among African American children compared with 16.6% among European American children and 7.8% among children of Hispanic heritage.

The prevalence of eczema decreases with age. In the U.S., 7.3% of the adult population has a form of eczema that initially began under 2 years of age.

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.

Learn more about why eczema is more common among Black people.

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.

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

Extensor surfaces are the skin areas on and around a person’s joints.

These bumps can develop around hair follicles, which is called follicular accentuation.

People of color may often experience extensive dryness and dark circles around their eyes due to eczema.

A dermatologist, a doctor who specializes in skin conditions, can diagnose eczema. However, eczema symptoms on darker skin can be different than on lighter skin. This can often lead to an underdiagnosis of eczema severity or misdiagnosis.

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.

Eczema treatment is similar for all skin types. However, it will 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.

Learn about the best moisturizers and lotions for use on dry skin.

Tar preparations

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

Learn more about coal tar treatments.

Steroid creams

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. However, they should be sure to wash their hands after application.

People should not use steroid creams long-term or more than twice per day unless specifically advised to be a healthcare professional.

Learn more about how steroid creams help treat eczema.

Oral steroids

In the case of severe flare-ups, a doctor may prescribe oral steroids. These medications help fight inflammation. However, it may cause adverse side effects over long periods. However, doctors typically discourage the use of these medications for eczema.

Due to their adverse effects, doctors will only prescribe oral steroids for eczema in exceptional circumstances.

Learn more about the different types of steroids for eczema.

Antihistamines

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

Learn more about antihistamines.

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 and dry thoroughly

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

Learn more about the causes of eczema flares.

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

The condition is most common in Africa and Oceania. In the U.S., eczema is most prevalent among African American children.

Systemic racial inequality means that African, Hispanic, and Indigenous Americans are more likely to have misdiagnosed, severe, or persistent eczema due to socioeconomic risk factors.

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.