Eczema in Dark-Skinned Women: What You Need to Know

The Effects of Eczema on Black Skin

Everything You Need To Know About Eczema On Black Skin:
What Is Eczema?

Eczema (pronounced eg-zuh-muh) is a medical term that describes several common skin conditions.

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

This is why you should always be attentive to how your skin looks and feels.

Prevalence of Eczema on Black Skin

While eczema can affect anyone, research suggests that certain ethnic groups are at a greater risk.

The National Health and Nutrition Examination Survey, which assesses the health and nutritional status of adults and children in the United States, found that 19.3 percent of African-American children have this skin condition (the most common eczema condition), compared to 16.1 percent of white children and 7.8 percent of Asian children. Another study found that African-American children are 1.7 times more likely to develop atopic dermatitis than caucasians.

Now, atopic dermatitis usually begins during infancy and early childhood (before the age of 5), but adults can also develop this skin condition. Adult-onset disease appears to be more common in Asia than in Western countries.

Erythema a common skin finding related to eczema, presents as redness in the involved skin area in patients with lighter skin tones. It is more difficult to perceive in the background of melanin-rich skin. Instead of shades of red and pink, dermatologists may see lesions that look purplish, grayish, reddish-brown, or very brown color and may be confused with other conditions. Another hallmark of atopic dermatitis in black skin is the tendency to develop pigmentary alterations from hyper- or hypopigmentation.

What Does Eczema Look Like On Black Skin?

Most people think of eczema as a red, dry, itchy rash, as the way it appears on light skin. However, on brown or black skin, such redness becomes difficult to spot. Actually, Eczema tends to look like a brown, purple, or ashy gray patch when it appears on black skin.

In the absence of the characteristic redness, skin inflammation, heat, dryness/scaling, or itching can help patients and physicians confirm the diagnosis. Itching caused by eczema has been shown to have a greater impact on African-American patients. They may also more likely be at risk for other potentially annoying to possibly serious medical issues. This can include such health conditions as asthma, allergic rhinitis (“hay fever”), food allergies, and other skin infections.

Other Characteristics of Eczema on Black Skin

Beyond differences in severity, color, and symptoms, there are unique forms of atopic dermatitis seen in our community:

• We most commonly develop small bumps on the torso, arms, and legs (called popular eczema).
• Sometimes, bumps develop around the hair follicles appearing to look like goosebumps (this is known as follicular accentuation).
• We also tend to have dryer skin and dark circles around the eyes.
• Those who repeatedly rub and scratch eczema-prone areas may develop thickening of the skin and firm, raised bumps on the skin called itchy nodules.
• After the resolution of eczema, we experience a higher rate of pigment changes. Cured skin may look darker or lighter than the surrounding normal skin.

In some patients, this color change is more uncomfortable than eczema. Fortunately, once the eczema is controlled, skin color usually returns to normal. This can take several months.

How do I Know If I Have Eczema?

See your doctor who can diagnosis eczema. He will usually examine the skin and take a medical history. He may also ask about any family history of eczema or associated conditions, such as asthma. Moreover, he can help diagnose and recommend a treatment method. If your diagnosis is complex or atypical they may additionally consult a dermatologist.

What’s the Clinical Treatment?

Treatment of eczema is similar for all types of skin. Gentle skincare and liberal use of moisturizers are the basis of treatment. For some patients, topical or even systemic medications, may be needed depending on the level of complexity and distribution of the involved skin. Atopic skin tends to be dry and sensitive, so rough and scented skincare products should be avoided to prevent the worsening of atopic dermatitis.
Increasing the moisture content of the skin is also essential. Unscented emollients should be used at least once a day, ideally immediately after bathing. Thicker moisturizers, such as creams and ointments (rather than lotions), tend to work better. Shea butter is a useful natural alternative to commercially available moisturizers.

In addition, eczema patients should bathe and shower in warm (not hot) water and limit the time to less than 10 minutes. Hot water can dry out the skin and cause itching, making eczema worse. This tends to be particularly problematic for us because we are more prone to dry, itchy skin. Prescription drugs may also be needed to properly control eczema. Topical corticosteroids are usually the first-line treatment, but they are usually used for limited periods of time. Nonsteroidal creams and ointments such as pimecrolimus, tacrolimus, and crisaborole may also be prescribed. These medications are highly effective and safe for use on all skin types.

In severe cases, eczema can be treated with phototherapy (light-based treatments) or systemic medications that target the immune system. These treatments can be pills or injections. In general, some herbal and traditional eczema remedies have the potential to make eczema worse through skin irritation or allergy. In addition, many herbal products have not been studied, and their side effects are largely unknown.

 

This Is How You Can Naturally Treat Eczema

To help reduce itching and relieve skin inflammation, try the following self-care measures:

1. Moisturize Your Skin At Least Twice A Day

Find a product or combination of products that is right for you. You can try bath oils, creams, ointments, or sprays.

For children, one option may be to apply an ointment before bedtime and a cream before going to school. Ointments are greasier and cause less burning when applied.

I recommend a lotion and than a sealant of that moisture added on top (such as any thick cream or even vaseline). A sealant will prevent that underlying moisture from evaporating.

2. Apply an anti-itch cream to the affected area

Use of over-the-counter hydrocortisone cream, containing at least 1 percent of hydrocortisone, may temporarily relieve the itching. Apply it to the affected area, after moisturizing, no more than twice a day. It is not recommended that you use any over the counter steroid longer than 14 days. if your symptoms are not improving you should discontinue and consult a doctor.

Using a moisturizer before applying the medicated cream helps it penetrate the skin better. Once the reaction improves, you can use this cream less often to prevent exacerbations.

3. Take an oral allergy or anti-itch medicine

Some of the options are over-the-counter allergy medications (antihistamines), such as cetirizine (Zyrtec) or fexofenadine (Allegra).

In addition, diphenhydramine (Benadryl, others) may be helpful if the itching is very intense. However, it causes sleepiness, so it is best to use it before bedtime.

4. Don’t scratch

Instead of scratching when you feel itchy, try pressing on the skin. Cover the itchy area if you can’t help scratching. For children, it may help to cut their nails and have them wear gloves at night.

5. Put on bandages

Covering the affected area with “breathable” bandages helps protect the skin and prevents scratching.

6. Take a warm bath

Sprinkle the bathwater with baking soda and uncooked or colloidal oatmeal. Soak for 10 to 15 minutes and then pat dry. Apply a moisturizer while skin is still wet, moisturizers with Shea Butter are great for this.

7. Choose soft soaps, without dyes or perfumes

Use a super-fat, non-alkaline soap. Be sure to rinse the soap thoroughly.

8. Use a humidifier

Hot, dry indoor air can be harmful to your skin. It can dry out sensitive skin and make the itching and flaking worse. A portable humidifier or one placed in the furnace, adds moisture to the air inside your home.

9. Wear cool, soft-textured clothing

Reduce irritation by avoiding itchy, tight, or rough clothing. Also, wear appropriate clothing during hot weather or when exercising to prevent excessive sweating.

10. Treat stress and anxiety

Stress and other emotional problems can potentially make atopic dermatitis worse. So recognizing this as a possible trigger can help you on your way to better skin.

Eczema is a chronic condition, this means that unfortunately, there is no cure for it (yet). But it is possible to prevent or minimize flare-ups with the right management.

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 (as I previously mentioned)
• Sweating
• Humid weather
• Dry-cold weather (people commonly have flare-ups in the winter)
• Hormones
• Allergens

Things to Remember about Eczema

We are almost at the end of this article. So, here is a list of things to keep in mind about Eczema

• Eczema affects people of all races and ethnicities, but it appears to be more common in our community.
• The redness manifests differently in black skin, making areas of eczema appear dark brown, purple, or gray.
• Genetic and environmental factors influence the risk of developing atopic dermatitis and may explain differences in the frequency of the condition among ethnic groups.
• Liberal use of moisturizers and short, warm (rather than hot) baths and showers are essential for controlling eczema.
• Topical, oral, and injectable medications for atopic dermatitis are effective and safe for use on all skin types.

Eczema can be especially stressful, frustrating, or embarrassing for young boys and girls in their teen years and young adults. It can disturb sleep and even cause depression.

Don’t hesitate to seek psychological support from therapists, support groups, your friends, or your family if you need it.

Final Words: Effects of Eczema on Black Skin

Remember that this condition is common and typically easily treated. For further information see your doctor. And if you want to know about other common skin conditions in our community, take a look at the other blogs.

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