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How Eczema Looks on Melanated Skin & How to Treat It

Apr 30, 2022 04:00PM ● By Boitumelo Masihleho
woman applying cream on arm with eczema

Eczema is the second most common skin condition in the Black community but many don't know they have it. According to the American Academy of Dermatology (AAD), 1 in 10 Americans has eczema, with the condition being more common in children of African and Asian descent. It’s also often more severe in children of African descent. According to the National Eczema Association, 20% of Black children in the United States have some form of eczema. That's compared to 13% of Asian children, 13% of Native American children, 12% of White children, and 11% of Hispanic children.

Eczema is a chronic condition where an overactive immune system leads to an impaired skin barrier that can cause dry, itchy skin and even skin infections. It is the umbrella term that includes a few itchy skin rashes, but it most commonly refers to the condition known as atopic dermatitis. It can appear as early as infancy and usually shows up on the face, elbow, and knees. From there, it can eventually spread to other parts of the body.

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Eczema can be caused by a few things including genetics, environment, stress, or even allergies and asthma. A 2014 study has shown that Black skin doesn’t retain as much water as white skin, which means that Black people are more likely to have dry skin. The causes have to do with both the composition of the skin itself and the environment some Black people are living in. “Black skin has increased trans-epidermal water loss and decreased ceramide levels, which can lead to more significant dryness,”  said board-certified dermatologist Dr. Laura Scott in an interview. “Also, eczema rates are higher in urban settings, where there are higher levels of environmental pollutants.”

In general, eczema rashes are very itchy, with dry patches on the skin. On lighter skin, they often appear red, but on darker skin, they can appear purplish or brown. Many Black people with eczema experience more extensive dryness and dark circles around their eyes than people from other racial backgrounds. A 2018 study found that less than 5 percent of the images in general medicine textbooks showed conditions on dark skin. That may make it more difficult for doctors to recognize and diagnose eczema on skin with more pigment. 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.

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Most symptoms tend to be the same for people with darker versus lighter skin. However, those with darker skin may also experience changes in skin color on the affected area, swelling or oozing, or a thickening of the skin. Wearing wear loose-fitting, breathable clothes while avoiding tight-fitting garments could help to combat flare-ups. Additionally, wash any new clothes prior to wearing them for the first time. Currently, there’s no way to prevent developing eczema. However, if you have eczema, there are steps that you can take in your daily life to help reduce the risk of having a flare-up. 

Try to avoid the things that cause your flare-ups. These can be different for every individual but can include things like soaps, fragrances, or stress. Use a fragrance-free lotion, cream, or ointment to add moisture to your skin. It’s a good time to moisturize including right after showering and anytime your skin feels dry. It’s important to choose products carefully. Some soaps, detergents, and skincare products can irritate the skin and cause a flare-up. Try to test them on a small area of skin before using them on larger areas. Oral corticosteroids like prednisone may be prescribed on a short-term basis for severe flare-ups. Some healthcare professionals also recommend using products that contain tar extract to help ease eczema symptoms.

While a heavy moisturizer can help keep moisture locked into the skin,  a flare-up will often require a topical steroid. Topical steroids calm down the inflammation and help to control itch, but shouldn’t be used long-term. If you’re looking for a non-steroid option, talk with your dermatologist to see which option would be best for you. Limiting the length of your showers to about 15 minutes in total, using water that’s warm, and not hot is another way to treat your eczema. When you’re done showering, gently pat yourself dry with a clean towel and moisturize. Remember that some conditions can increase the risk of a flare-up. For example, colder temperatures can lead to drier skin that may require additional moisturizing.

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 Boitumelo Masihleho is a South African digital content creator. She graduated with a Bachelor of Arts from Rhodes University in Journalism and Media Studies and Politics and International Studies.  

She's an experienced multimedia journalist who is committed to writing balanced, informative and interesting stories on a number of topics. Boitumelo has her own YouTube channel where she shares her love for affordable beauty and lifestyle content. 

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