Hands of varying skin colors presenting different eczema patterns are all meeting in the middle.

Eczema in Skin of Color

Atopic dermatitis (AD), also known as eczema, is the most common skin disease in the general population. It can affect everyone, but some ethnic groups are at higher risk. Understanding how eczema presents in non-white skin and the most effective treatments for it is important. Even though most studies are done in those with European ancestry with white skin, eczema occurs more frequently in Asian and Black people than white people.1,2

How does knowing about eczema in skin of color help?

Knowing more about eczema in skin of color can help you identify potential eczema so you can get medical attention sooner, resulting in faster treatment and better quality of life.

How common is eczema in skin of color?

Eczema can occur in anyone, regardless of ethnicity. However, it is more common in certain populations. In the United States, 19.3 percent of Black children have eczema, compared to 16.1 percent of white children and 7.8 percent of Asian children. Black children are 1.7 times more likely to develop eczema than white children.3

Eczema typically starts in childhood, but adult-onset disease does occur.

What causes eczema?

Genetic and environmental factors can influence the development of eczema. Genetic changes that affect the skin barrier are hereditary, so those with a family history of eczema are more likely to be affected. These mutations are more common in certain ethnic groups, as well. Environmental risk factors can include:2,3

  • Living in a city
  • Contact with cigarette smoke
  • Dust mite allergy
  • Environmental pollution
  • Climate

What does eczema look like in skin of color?

Examples of eczema are often shown as a red or pink color, but this is only how it looks on lighter skin. On skin of color, it can look dark brown, purple, or ashen gray. Skin swelling, warmth, dryness or scaling, or itching can also be present.3

Itching and small bumps called papular eczema are more common in Blacks with eczema. Black people also tend to have more severe dryness of the skin and dark circles around the eyes. After initial treatment, skin of color may undergo pigment changes that make it lighter. This is temporary and typically resolves within a few months.3

How is eczema treated in skin of color?

Although eczema often starts in infancy and childhood, most research is done in adults with eczema. This means research might be missing the earliest triggers of eczema. There is also little research on how well typical therapies for eczema work on non-white skin.1,2

Treatment of eczema is usually the same across ethnicities and races. A main part of treatment is gentle skincare and the generous use of moisturizers. Sometimes topical (applied to the skin) or systemic (medicine that works throughout the body) drugs are necessary, depending on the person and their past treatments.3

Skincare routine and baths

Avoiding harsh skincare products and using thick moisturizers at least once a day are usually recommended. Bathing in warm (not hot) water for no more than 10 minutes is recommended to reduce drying the skin out, especially for those with darker skin. If prescription treatments are needed, topical corticosteroids are usually given first, but only for a short amount of time. Non-steroidal creams or ointments may also be given. In severe cases of eczema, phototherapy or immunotherapy may be used.3

Natural and alternative treatments

Cultural or traditional medicine practices that involve herbs or natural remedies might initially reduce symptoms of eczema, but they may also have other side effects that can affect your health. If you are using any cultural, traditional, or alternative treatments or supplements for your eczema, let your doctor know. Sometimes these can also interact with treatments your doctor prescribes or suggests, so it is good to discuss any possible interactions.

Things to consider

More research is needed to look at racial and ethnic differences in eczema and its treatment. Genetic differences need to be explored, as well as differences in treatment response and safety among various racial and ethnic groups.

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