Eczema is a skin condition characterized by rash, itching, dryness, discolouration, and infection. Eczema is a common skin concern, but studies reveal that dark skinned people are more prone to it. According to research, black people are at least 1.7 times more prone to eczema than white people, and the ratio is even lower for asians.
Eczema on black skin appears as a dark brown or purple patch on dark skin with itching and dryness. The appearance of small bumps is another common representation of eczema. It is not life-threatening, but it can be very irritating and cause discomfort due to continuous itching. Management of eczema includes proper care, symptomatic treatment and avoiding the cause. This article will cover all the imperative details of understanding eczema on black skin, its symptoms, and treatment.
What Is Eczema?
Eczema is a prevalent, chronic skin condition, sometimes referred to as atopic dermatitis by laymen. It is inflammation of the skin due to irritants or allergens. These irritants and allergens can be different for everybody. Eczema is an umbrella term which contains the following skin conditions,
- Atopic dermatitis
- Contact dermatitis
- Dyshidrotic eczema
- Nummular eczema
- Stasis dermatitis
- Seborrheic dermatitis
The most common type of Eczema is Atopic dermatitis. During the course of the disease, the period when symptoms are most prominent is called a flare-up. This stage can last for days or even weeks. The best way to manage eczema rash on black skin is with palliative care and avoiding the triggers.
Understanding Eczema on Black Skin
Eczema rash on black skin is usually characterised by a red, itchy rash in the masses; however, it appears very differently on black and brown skin. Eczema black skin rash appears as dark brown, purple, or grey discolouration. Sometimes, the patch contains small bumps as well. Other signs of eczema on black skin include swelling, warmth, itching, scaling, and oozing. Another prominent sign in patients with long-standing eczema on dark skin is Lichenification, which means thickening skin due to continuous irritation and scarring.
There are speculations about why eczema is more common on black skin; however, more studies are required to establish facts. There are a few specialised types of eczema indigenous to black skin people, such as papular eczema; small bumps on the torso, arms and legs, and follicular accentuation; bumps around hair follicles.
What Causes Eczema on Dark Skin?
Dermatitis eczema on black skin’s aetiology is often a combination of genetic, immune, and external factors that disrupt the skin barrier and make it vulnerable to triggers like allergens and irritants. The significant causes of eczema on the face of black skin are discussed below.
Genetics
Genetics is perhaps the primary instigator of eczema. A family history of eczema, asthma, and other allergies increases the chances of eczema on face black skin. Inherited genes or even gene mutations can predispose to a dysfunctional skin barrier, leading to eczema.
Immune system
A hyperactive immune system can also increase the chances of eczema dark skin by reacting to triggers and causing inflammation, itching and redness.
Dysfunctional skin barrier
The skin barrier is the human body’s imperative defence against pathogens, allergens, and irritants. A disrupted skin barrier predisposes to the risk of eczema dark skin, as it cannot retain moisture and prevent allergens and irritants from triggering an immune response.
Allergens
Allergens like pollen, dust mites, dander, foods including milk, eggs, gluten, etc, can trigger eczema or atopic dermatitis black skin. Usually, allergens that contact the skin are more likely to cause eczema.
Irritants
Atopic dermatitis black skin can be caused by contact with irritants like harsh soaps, chemicals, detergents, and certain fabrics. Sometimes, skincare products containing harsh chemicals can also cause irritation and eczema.
What Are the Symptoms of Eczema Black Skin?
The symptoms of atopic dermatitis eczema on black skin resemble those of an allergy. Some symptoms are general and present in all types of eczema, while some are pathognomic to specific types, such as the appearance of papules. Some generic symptoms of eczema are,
Itching
The hallmark symptom of eczema rash black skin is itching. It might start even before the formation of rash. Itching or pruritus is severe and becomes worse at night. It might lead to scaring as well. Here is a complete guide on why eczema itches.
Rash
The rash may not be very prominent in the early stages of eczema on black skin. During the flare-up stage og eczema, the rash appears to be purple, brown or grey. Sometimes the rash also has white bumps.
Dry Skin
The skin barrier in eczema patients is dysfunctional, resulting in a loss of moisture and dry skin. In severe cases, the dry skin becomes scaly and very itchy.
Lichenification
Lichenification means thickening of the skin. These symptoms are present in patients with long-term, poorly managed, or very severe cases of eczema. Skin becomes leathery due to continuous scratching.
Discolouration
Discolouration appears after the inflammation has subsided(post-inflammatory). It might be hypopigmentation (light spots) or hyperpigmentation (dark spots). Sometimes this discolouration is even more challenging to treat than the eczema itself.
Eczema Heat Rash on Black Skin: Common Triggers
Eczema heat rash on black skin appears as small white bumps on the exposed skin with a dry and discoloured patch. This rash may appear white, grey, or darker than the surrounding skin. Some of the triggers causing eczema heat rash on black skin are discussed below.
Heat and Humidity
Heat and humidity are the primary culprits causing eczema heat rash on black skin. Intense heat and humidity can trap sweat and clog pores, leading to irritation and inflammation.
Extreme weather
Exposure to extreme hot and cold weather conditions can also increase the chances of developing an eczema heat rash on black skin.
Clothes
Wearing tight and unbreathable fabrics in hot weather can cause eczema heat rash. Some synthetic fabrics that don't let air pass through irritate the skin and can cause eczema.
Sweating
People with hyperactive sweat glands have more chances of developing an eczema heat rash on black skin because the sweat can clog pores when trapped. This can trigger the formation of heat rash.
Irritants
As discussed earlier, harsh chemicals and other irritants, such as soaps, detergents, chemicals, skincare and cosmetic products, can also trigger an eczema rash in black skin.
Treatment Options for Eczema on Black Skin
The treatment for atopic dermatitis black skin is symptomatic primarily, which means it is more about reducing and managing the symptoms. Patients are advised to consult a healthcare professional for the treatment and prescription of medication. In some cases, establishing a good skincare routine and avoiding triggers is enough to subside the flare-ups of eczema. Here are a few treatment options for the patients.
Bathing, Soaking and Moisturising
- It is highly recommended for patients with atopic dermatitis black skin to keep their skin hydrated.
- Bathing with lukewarm water is very effective for soothing the skin.
- Avoid hot water baths.
- Soaking the affected area in warm water is also beneficial.
- Keeping the skin moisturised with a non-fragrant, mild but thick moisturiser is also very helpful.
- Using natural oils, such as coconut, olive, and sunflower oil, on the body is also known to be helpful in treating eczema.
Avoiding Triggers
- Another primary step in managing atopic dermatitis eczema black skin is avoiding the triggers.
- Eczema is a skin condition that can be managed but not completely cured, like diabetes. So, effective management to avoid flare-ups includes avoiding triggers like harsh chemicals, synthetic fabrics, and extreme dry weather.
Wet Dressing
Wet dressing is done in severe cases where moisturising alone is not helpful.
A topical corticosteroid is applied to the affected area, which is then covered with wet surgical gauze and wrapped with dry gauze to lock in the moisture.
Topical and Oral Corticosteroids
Topical corticosteroids are used in cases where the methods mentioned earlier fail.
- Corticosteroid creams need a prescription and should not be used without consulting your healthcare provider. Overuse of topical corticosteroids may cause hypopigmentation on dark skin.
- In severe cases, the doctor might prescribe oral or injectable corticosteroids to effectively and quickly manage severe atopic dermatitis and eczema black skin. However, prolonged use of oral corticosteroids may lead to morbid complications.
Antibiotics and Antihistamines
This line of defence is used in severe cases of eczema where patients have developed secondary bacterial infections.
- Antibiotics are prescribed by the doctor for secondary infections.
- Antihistamines are the drugs that treat itching. Patients with external itchy wounds are prescribed an antihistamine.
- Please note that any medication without consultation with the doctor might lead to complications.
Complications of Eczema in Dark Skin and Pigment Changes
Multiple factors can complicate eczema in dark-skinned people. Undiagnosed or poorly managed eczema might worsen and develop complications. These complications can occur as infections, formation of papules, skin thickening, or pigmentation changes on dark skin. These complications are briefly discussed below.
- Post-inflammatory pigment changes in the black skin due to eczema are perhaps the most significant and troublesome complication. These changes may manifest as hypopigmentation(light skin) or hyperpigmentation(dark skin). These pigment changes are temporary in many cases. However, there are treatments to treat the discolouration effectively.
- Secondary infections are common in patients with severe itching, lack of proper care, and failure to avoid the triggers. The compromised skin barrier can let the pathogens enter the skin and cause infection. These secondary infections can be treated with antibiotics.
- Persistent itching and scratching can cause raised bumps that are hard and firm, called Prurigo nodules.
- Another complication of eczema is skin thickening, also known as Lichenification, caused by continuous scratching of the affected area.
Why Eczema Is Underdiagnosed in People with Darker Skin
Eczema in dark skin is often misdiagnosed or underdiagnosed. There are multiple reasons why eczema is difficult to diagnose in people with dark skin. All these factors combine to form the reason for underdiagnosed eczema in hundreds of patients, where it is mistaken for discolouration or hyperpigmentation.
- The primary reason for the underdiagnosis of eczema dark skin is the fact that eczema has long been established as a red patch, which is not true for people with dark skin, where it usually presents as a purple, brown, or grey patch. This different appearance often leads to misdiagnosis of the patch as discolouration by the clinicians.
- Another culprit for the underdiagnosis of eczema in dark skin is the lack of training and images in medicine. Lack of accurate imagery of eczema on dark skin results in non-identification of the lesion.
- Eczema can leave behind hyperpigmented patches on the skin. This is the reason why sometimes dark eczema flare-ups are misdiagnosed as post-inflammatory hyperpigmentation.
Social & Structural Factors That Increase Eczema in Black Communities
Eczema is undoubtedly more common in dark skinned people. Eczema disparities are multifactorial. There are various factors that contribute to increased eczema incidence in black communities; a few of these factors are discussed below.
Access to Care
- Lack of access to proper care and hospitals leads patients to miss their appointments or reschedule them, delaying the diagnosis and treatment.
- In addition, healthcare comes with a cost. Lack of finance or health insurance also leads to undiagnosed eczema on the face of black skin that can develop complications.
Education Inequality
- Lack of education and awareness leads to a lack of understanding of skin problems. Such patients are prone to improper medication use or not following treatment religiously.
Low Income
- Low income is also a contributing factor to the eczema disparity in black communities. Lack of finances leads to no health insurance or the inability to afford medicine and treatment. Low-income households often reside in substandard houses, which might expose them to dust mites and other allergens.
- Houses with no air conditioning can also trigger eczema on dark skin due to heat.
Environmental Triggers
- Eczema on black skin can be caused by exposure to environmental triggers at home or at work, such as air pollution, tobacco smoke, and heat, as well as working conditions.
Stress
- Stress is a known factor that aggravates eczema rash on black skin. Black communities are often exposed to stress because of difficult living conditions, socioeconomic conditions, inequality, and racism.
Conclusion
Eczema on black skin is a common skin condition characterised by rash, itching, and inflammation. Although it is not a morbid condition, eczema can be very uncomfortable and decrease the quality of life. Hence, management of eczema rash on black skin is crucial. It can be conveniently managed through palliative treatment.
The black communities are more prone to eczema and its complications due to various factors, including socioeconomic disparity, inequality, and lack of access to care. Genetics also plays an important role in the development of eczema. It has been seen that eczema is more prevalent in black children, even in the absence of any other triggers.
To control eczema in black skin and prevent its complications in black people, it is very important to spread awareness. Public health should start outreach programs for communities that are deprived of healthcare access. Imparting knowledge and awareness can greatly increase the chances of early diagnosis and better management of eczema.
The management of eczema on dark skin is primarily symptomatic. It is important to establish a good skincare regimen with non-irritating and mild products. It is highly recommended to use skincare, cosmetics, soaps, creams, and other products for the body that are dermatologically approved.
Determining and avoiding the cause of irritation and certain foods that might trigger inflammation is also very important. If you have eczema, it is highly recommended to consult a dermatologist to get things under control.
If you are already past the inflammatory phase of eczema and facing desquamation issues, you can get skin treatments, such as chemical peels, for correction.
FAQs
What does eczema look like on black skin?
On black skin, eczema looks like a dark brown, purple, or grey patch. Sometimes these discoloured patches also have tiny bumps. The patch is usually darker than the surrounding skin.
Is it common for black people to have eczema?
Yes, it is very common for black people to have eczema. According to various studies, eczema is more prevalent in black people. But because of many reasons, it can remain undiagnosed or mistreated as hyperpigmentation.
How can people of colour prevent eczema?
People of colour can prevent eczema by taking proper palliative care.
- They should avoid harsh chemicals in soaps, detergents, cosmetics, and skincare products.
- Avoid extreme heat and sweating.
- Keep the skin moisturised by applying thick but mild creams.
- Avoiding any specific triggers.
How can you treat eczema on the skin of a Black baby?
You can effectively treat eczema on the skin of a black baby by taking proper care of hygiene, hydration, and avoiding triggers. For babies with eczema, you should not use regular soaps, washes, and creams. Use mild and non-fragrant creams suitable for eczema-prone skin.
