Eczema is a group of conditions that make the skin dry, itchy, and inflamed. It is very common and can appear anywhere on the body.

Eczema can look different on different skin tones. In this article, learn about what eczema looks like on black skin, as well as how to diagnose and treat it.

What is eczema?

Eczema on the knees
Eczema can describe skin conditions such as atopic dermatitis and stasis dermatitis.
Image credit: Medicshots / Alamy Stock Photo

Eczema is an umbrella term that describes several common skin conditions that affect people with any skin tone.

These conditions include:

  • atopic dermatitis
  • contact dermatitis
  • dyshidrotic eczema
  • nummular eczema
  • seborrheic dermatitis
  • stasis dermatitis

All forms of eczema can cause the skin to become dry, itchy, and inflamed. People with one form of the condition can also develop other types.

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

Prevalence of eczema in black people

Eczema is more likely to affect African American children than those from other racial backgrounds.

According to the National Eczema Association, 20.2% of African American children in the United States have some form of eczema. That is compared with 13% of Asian, 13% of Native American, 12.1% of white, and 10.7% of Hispanic children.

The same is not true of adults. Just 7.7% of African American adults have eczema, compared with 10.8% of Hispanic, 10.5% of white, 9.1% of Asian, and 7.8% of Native American adults.

More than 30 million people in the U.S. have some form of the condition. Overall, it is more common in women than in men.

Symptoms

<img src="http://www.medicationjunction.com/wp-content/uploads/2019/04/eczema-on-black-skin-what-to-know-1.jpg" alt="Eczema on the legs
Image credit: Custom Medical Stock Photo / Alamy Stock Photo
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A black person with eczema may have darker brown, purple, or gray patches on their skin.
Image credit: Custom Medical Stock Photo / Alamy Stock Photo

Black people are likelier to develop more severe forms of eczema than people of other ethnicities.

On black skin, eczema can cause darker brown, purple, or gray patches. The affected areas may be swollen, warm, itchy, and dry or scaly.

Many black people with eczema experience more extensive dryness and dark circles around the eyes than people from other racial backgrounds.

Having eczema around the eyes can cause people to rub or scratch the area due to itchiness. This can cause the skin to thicken and bumps to form. These bumps are called prurigo nodules.

After a flare-up, the affected skin may look darker or lighter than the surrounding area. With proper treatment, the color will usually return to normal over time.

Eczema can appear anywhere on the body, but black people are more prone to developing small bumps on the torso, arms, and legs. This is called papular eczema, and it may resemble permanent goosebumps.

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

Diagnosis

A dermatologist, which is a doctor who specializes in skin conditions, can diagnosis eczema. They will usually examine the skin and take a medical history.

They will probably 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.

Treatment

Eczema treatment is similar for all skin types, but 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.

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

Tar preparations

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

People can ask their pharmacist for a cream containing 1–5% liquor carbonis detergens. It is best to avoid using tar gels that contain alcohol, as they may irritate sensitive skin.

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

Doctors do not recommend using steroid creams long-term or more than twice per day, as they can cause adverse side effects.

Antihistamines

Itching can be one of the most aggravating symptoms of eczema. Some doctors suggest taking a regular antihistamine tablet, which may need several weeks to take effect.

Steroid tablets

In the case of severe flare-ups, a doctor may prescribe oral steroids. These medications help fight inflammation but may cause adverse side effects over long periods of time.

Management

<img src="http://www.medicationjunction.com/wp-content/uploads/2019/04/eczema-on-black-skin-what-to-know-2.jpg" alt="Eczema on a mans back
Image credit: Mohammad2018, 2018
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A person can help manage eczema by not taking very hot and very cold showers.
Image credit: Mohammad2018, 2018

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

The Skin of Color Society offer 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, before patting the skin dry and immediately applying a fragrance-free moisturizer

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

  • irritants, such as from nickel jewelry or cigarette smoke
  • stress
  • sweating
  • humid weather
  • dry, cold weather
  • hormones
  • allergens

Summary

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

The condition may be more common in black children than in those from other racial and ethnic backgrounds. It is less common, however, in black adults.

On black skin, eczema patches may look dark brown, purple, or gray. In some cases, the condition presents as 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.