People with dark skin (including African American children) are nearly twice as likely to develop a form of eczema. Symptoms may include darker brown, gray, or purplish-hued patches, fine scaling, and bumps around the hair follicles.

Those with darker skin tones may have differing experiences with eczema compared to people with lighter skin tones.

This may mean watching for varying effects and symptoms, and how they appear on the skin. Some people may notice more extreme symptoms, based on how their skin responds to eczema.

A healthcare professional can best advise people on the proper eczema care for their darker skin and how to manage and treat eczema symptoms that may be more challenging to see versus those with lighter skin tones.

There’s a higher prevalence of atopic dermatitis (a form of eczema) in African American children, compared to their European American counterparts. African American children are almost twice as likely to develop atopic dermatitis.

This disparity may be due to a complex relationship between many factors, including environmental triggers, socioeconomic status, and access to healthcare. There may also be genetic and biological influences.

Research has shown that eczema tends to be worse among Black people than white people.

African-Americans with eczema may experience itchy, flaky skin. They may also notice changes in their skin color because of condition-related inflammation. This may be temporary, but it can also be concerning no matter how long it lasts.

Healthcare professionals may help by recognizing symptom changes in those with darker skin types. Getting a proper diagnosis can help treat and manage eczema better.

In dark skin, eczema may be darker brown or gray or have a purplish hue. There may be less redness on dark skin than lighter skin types, as well.

It’s important for healthcare professionals to look closely to identify symptoms of eczema that are specific to darker skin. People with dark skin and eczema may have fine scaling and bumps, which tend to be located around the hair follicles.

Scratching eczema patches can lead to a few different types of skin changes.

Chronic itch can lead to chronic scratching, and this can result in thickening of the affected skin, which is also known as lichenification.

Scratching can also lead to changes in skin color, including patches that appear darker (hyperpigmentation) or lighter (hypopigmentation) than the rest of the skin.

While these symptoms may be temporary, the color changes can take months of eczema treatment to reverse.

Treating dry patches of skin often involves using topical corticosteroids to improve affected areas. Other topical medications for eczema include calcineurin inhibitors, which help prevent the skin changes that can occur from long-term treatment with topical steroids.

When used appropriately, topical corticosteroids don’t affect skin pigmentation. However, with chronic overuse of steroids, you can see decreased pigmentation of the skin.

Other potential effects of chronic overuse of topical steroids on the skin include the appearance of stretch marks (known as striae) or fine blood vessels (telangiectasias).

With that said, failing to treat eczema can also cause changes in skin color. That’s one of many reasons why it’s important to find an effective treatment.

If eczema symptoms don’t improve after trying topical medications, a healthcare professional may recommend treating eczema with ultraviolet light (phototherapy) and systemic medications, including dupilumab, JAK inhibitors, and other immunosuppressive medications.

No matter your skin type, it’s important that your healthcare team can properly recognize and diagnose eczema to treat it effectively. You may consult with your primary care doctor, an allergist, or a dermatologist.

Symptoms may be different for people depending on age, regardless of skin color.

  • Babies and toddlers: Eczema can affect the face along with other parts of the body.
  • Older children: Symptoms may appear on the arms, legs, and skin behind the ears.
  • Teenagers and adults: Eczema can be worse on the hands and scalp and can also affect areas around the eyes.

It’s very important for healthcare professionals to also consider other symptoms beyond how the skin looks, such as itching as a common eczema symptom.

In situations where a diagnosis is unclear or other potential conditions might exist, a healthcare professional may order a skin biopsy to help clarify the diagnosis.

People with darker skin tones and types may have more difficulty getting eczema diagnosed and treated effectively. There may be changes to skin pigmentation and how eczema symptoms appear. This can make it more difficult to recognize and diagnose eczema, delaying treatment.

While applying moisturizer regularly can sometimes help symptoms, you may need prescription medications to treat eczema.

Make sure to consult your primary care doctor and healthcare team and possibly visit a dermatologist or allergist with expertise in eczema and other skin conditions.