Scratching eczema patches can lead to changes in the skin, including both hypopigmentation and hyperpigmentation. Some treatment creams can also cause skin discoloration.
Eczema is a common skin condition that causes itchy, dry, and irritated lesions. Experts are not sure what precisely causes eczema. However,
Eczema causes lesions on the skin that are itchy and dry. Many people feel the urge to scratch the affected skin, which can worsen the irritation. The skin may change color due to scratching, inflammation, and the steroids people can use to treat the condition.
The change in color can be hypopigmentation, which is a loss of color, or hyperpigmentation, which is a darkening of color.
Read on to learn about the link between eczema and skin discoloration, the treatment options, and more.
Eczema lesions, also called atopic dermatitis, can be itchy and uncomfortable. Scratching eczema is a common behavior, but it may lead to changes in the skin’s appearance and texture.
Eczema can cause two types of skin pigment changes: hypopigmentation and hyperpigmentation. Hypopigmentation is a loss of pigment or color, usually presenting in patches that are lighter than a person’s skin tone. Hyperpigmentation refers to patches of skin that become darker than the skin surrounding them.
Hypo and hyperpigmentation are both
People with eczema can find the change in skin appearance distressing, and it can affect their quality of life. Even after treatment for eczema, the skin may not return to its previous color.
During an eczema flare-up, the body releases cytokines. In an effort to protect the body, they cause inflammation.
The cytokines
This reaction leads to increased pigment production.
The darker a person’s skin, the more melanin they have. As a result, people with darker skin release more pigment when the reaction occurs.
Eczema looks different, depending on a person’s skin type.
On light skin, eczema typically causes inflamed pink or red patches that are dry and itchy. These lesions are harder to detect on dark skin tones.
When people with light skin scratch eczema lesions, hyper and hypopigmentation can occur. Skin pigmentation can progress gradually, and its subtle changes make it hard to detect.
People with dark skin tones can be more likely to get hyper and hypopigmentation. They can also be more likely to have follicular prominence, which is when eczema presents as small, itchy bumps called papules. These mainly appear on the forearms and torso.
Hyperpigmentation
Darker skin patches, or hyperpigmentation, occurs as a result of inflammation. This triggers melanocytes to increase melanin synthesis, which is the process of making skin pigment.
The increase in synthesis encourages the transferal of pigment to the epidermis, the top layer of the skin. If a person scratches or rubs the skin, this releases the melanin.
Types of hyperpigmentation include:
Post-inflammatory pigmentation
After an eczema flare-up resolves, it can leave a darker patch of skin. This is post-inflammatory pigmentation.
Although it is temporary, it can persist for months, but it does tend to last longer on dark skin tones.
Sunlight stimulates post-inflammatory pigmentation, so it is advisable to cover affected areas and use sun protection.
Lichenification
If a person rubs and scratches at the affected areas of the skin, it can thicken. This may leave thick, leathery lesions with visible scratch marks, which is lichenification.
These areas of hyperpigmentation may present as gray on dark skin and as dark pink on light skin.
Hypopigmentation
Lighter skin patches, or hypopigmentation, can occur when an eczema flare-up is in the process of resolving.
Eczema hypopigmentation often presents as pityriasis alba, which is low grade eczema marked by light, scaly patches. It usually causes between one and 20 rounded or oval patches on the neck, face, upper arms, and shoulders.
Pityriasis alba is more common on dark skin tones, and it frequently occurs after a person’s skin experiences exposure to the sun. Although the scales and dryness may be more apparent during the winter months, the actual hypopigmentation is more common during the summer.
The lesions usually resolve in 1 year, but they can take 2–3 years to disappear.
There is currently no specific treatment for skin pigment changes. However, eczema is treatable in people of all skin types.
Hyper and hypopigmentation usually fade and resolve on their own. Using a moisturizing cream or ointment can help the dryness, and sun protection will prevent hyper and hypopigmentation patches from worsening.
If a person’s eczema or pigmentation does not resolve on its own, they can contact a doctor or dermatologist to establish a treatment plan. This may include oral and topical steroids, nonsteroid creams, and more.
Hyper and hypopigmentation due to eczema usually resolve on their own.
People having difficulty managing their eczema can
Here are some questions people often ask about eczema.
Can eczema cause white patches on skin?
One low grade type of eczema can cause white patches. It is called pityriasis alba. It is more common in children and affects around 5% of children globally. Hypopigmentation is more evident on darker skin tones than lighter ones. It usually disappears after around 1 year, but it can take between a few months and 2–3 years to resolve.
Can eczema cause dark skin discoloration?
Eczema is an inflammatory condition that often leaves dark patches of skin when it heals, especially on darker skin tones. The skin cells that affect pigmentation are sensitive to inflammation.
During the post-inflammatory stages, these cells produce extra pigment, leading to lichenification and dark spots. They can resemble acne scars and may last weeks to months. Eventually, they typically go away.
Will eczema skin discoloration go away?
First, a person needs to treat eczema. Once the eczema heals, changes in skin color will resolve over time. However, it may take a while, according to the American Academy of Dermatology.
Eczema causes dry, itchy, inflamed lesions. When irritated, the skin can develop patches of hyper or hypopigmentation.
There is currently no specific treatment for hypo or hyperpigmentation related to eczema, and the conditions will usually resolve on their own over time. A person can contact a dermatologist to treat their eczema.