Eczema is a common skin disorder seen worldwide and in the United States. It usually presents as dry, itchy, red or darker areas of skin. Sometimes referred to as “the itch that rashes”, the term eczema is used interchangeably with dermatitis, which literally means inflammation of the skin. In people with skin of color, eczema often appears “ashen”, brown, or grayish in color. Eczema is the second most frequent skin disease in African Americans and is one of the most common skin disorders seen in infants and children overall. 1,2
There are several types of eczema or dermatitis, some of which are discussed below:
(a.k.a. atopic eczema), often used synonymously with eczema, is a disease of unknown cause. It usually starts in infancy3 and is characterized by itchy, scaly lesions, xerosis (dry skin), and lichenification (accentuation of skin markings). Atopic dermatitis is commonly associated with other atopic diseases such as asthma or allergic rhinitis.4 The frequency of atopic dermatitis appears to be increasing4 and appears to be more common among Blacks, Asians, and Pacific Islanders.3 In infants, eczema is usually seen on the forehead and cheeks. In children, eczema is seen on the hands, wrists, ankles, feet, and elbow and knee creases. In adults, eczema is usually seen on the face, neck, upper arms and back, elbow and knee creases, and back of the hands, feet, fingers, and toes.2
(a.k.a. nummular eczema) appears as itchy “coin-shaped” areas of inflammation and can be crusty or scaly.
Xerotic (asteatotic) Eczema:
(a.k.a asteatotic eczema), in this type of eczema, extremely dry skin becomes inflamed and may require treatment beyond moisturizers.
in this form of eczema, skin irritation can form from excessive contact with irritants (e.g., soap, detergents, harsh chemicals) and allergens (e.g., poison ivy, nickel, fragrances, etc.)
Eczema can also look different in darker skinned patients. Some of the unique forms of eczema seen more commonly in darker skin include papular eczema (bumps) and eczema with follicular prominence.3
A major concern for people of color is the skin discoloration associated with eczema. Eczema or scratching secondary to the itch of eczema can lead to darkening (hyperpigmentation) or lightening (hypopigmentation) of the skin. This discoloration can last for months to years, even after the eczema is treated3. Darkening of the skin is especially visible in children with skin of color. If the patient’s underlying eczema and inflammation is treated, however, the changes in skin color can be improved.2
What is the cause of Eczema?
The cause of atopic dermatitis and many forms of eczema is unknown but is potentially due to a dysfunction in filaggrin, a protein that maintains the membrane of skin cells.5 It is also thought that genetics (inheritance) and an improperly functioning of the local immune system contribute to the development of atopic dermatitis. Environmental factors also likely play a role. Atopic dermatitis tends to be more common in industrialized nations and urban areas, and the incidence appears to be increasing in developing nations as they become more Westernized.3 Xerotic eczema is due to very dry skin. In contact dermatitis, an irritant or allergen directly causes the rash. However, in many cases of allergic or irritant contact dermatitis, a clear trigger cannot be found.
How do I know if I have Eczema?
Eczema is usually diagnosed clinically. Direct physical examination and taking of a medical history allow dermatologists to accurately recognize the different forms of eczema. They may also ask about family history of eczema and associated diseases.
How is Eczema treated?
There are many helpful, easy ways to treat or soothe eczema. The first step is to avoid irritants or allergens, to which your body may react. Vigilant moisturization is the mainstay of treatment of atopic dermatitis1 and is also quite helpful in other forms of eczema. Gentle skin care is also recommended:
Avoid extremely hot or extremely cold showers/baths
Avoid other irritants such as tight-fitting clothing. If a patient with eczema also has food allergies, avoiding those foods may help resolve eczema symptoms.6
Bathe for 5-10 minutes with a gentle cleanser no more than once daily followed by patting skin dry and immediately moisturizing the skin
LUse bland, fragrance free emollients (moisturizers) at least daily. Ointments and creams are best. For active flares of eczema, placing a lukewarm, clean cloth on the affected area or soaking in lukewarm water can help to soothe the itch. An emollient MUST be applied immediately after removing the cloth or exiting the bath.
Take baths with rice starch added to the bath water or bleach baths using one quarter cup of bleach for a half-full bath or one half cup of bleach for a full bath. Immediately apply moisturizers after these baths.6
Avoid using alternative medicines such as herbal therapy, vitamins, naturopathy, traditional healing, homeopathy, and Ayurveda. These treatments may have allergens and irritants that can trigger an eczema reaction.7
A dermatologist may also prescribe a topical corticosteroid. These steroids help with both acute and chronic eczema and help to reduce inflammation.6 Eczema, especially atopic dermatitis, is often secondarily infected, so your dermatologist may also prescribe antibiotics or anti-bacterial cleansers to treat any associated infections. Rarely, in severe cases, eczema is treated with systemic medications that alter the immune system.
1. Halder, R.M., Grimes, P.E., McLaurin, C.I., Kress, M.A., & Kenney, J.A. (1983). Incidence of common dermatoses in a predominantly black dermatologic practice. Cutis, 32, 388-390.
2. Spergel JM, Paller AS. Atopic dermatitis and the atopic march. The Journal of allergy and clinical immunology. 2003;112(6 Suppl):S118-27.
3. Desai, N., & Alexis, A.F. (2009). Atopic Dermatitis and Other Eczemas. In A.P. Kelly & S.C. Taylor (Eds.), Dermatology for Skin of Color. China: McGraw-Hill.
4. Kang, K., Polster, A.M., Nedorost, S.T., Stevens, S.R., & Cooper, E.D. (2008). Atopic Dermatitis. In J.L. Bolognia, J.L. Jorizzo & R.P. Rapini (Eds.), Dermatology (2nd ed.). Spain: Mosby.
5. Dermatology atlas for skin of color. New York: Springer; 2014.
6. Boguniewicz M, Eichenfield LF, Hultsch T. Current management of atopic dermatitis and interruption of the atopic march. The Journal of allergy and clinical immunology. 2003;112(6 Suppl):S140-50.
7. Silverberg JI, Lee-Wong M, Silverberg NB. Complementary and alternative medicines and childhood eczema: a US population-based study. Dermatitis : contact, atopic, occupational, drug. 2014;25(5):246-54.
Eczema Parul Kathuria, MD and Roopal V. Kundu, MD Photo: Courtesy of Kesha Buster, MD Eczema is a common skin disorder seen worldwide and in the United States. It usually presents as dry, itchy, red or darker areas of skin. Sometimes referred to as “the itch that rashes”, the term eczema…
Junko Takeshita, MD, PhD, MSCE
Invited Speaker | 19th Annual SOCS Scientific Symposium Dr. Takeshita is a board-certified dermatologist and epidemiologist who leads an R01-funded research program that is dedicated to identifying, understanding, and eliminating health and healthcare disparities related to dermatologic diseases, particularly chronic inflammatory skin diseases. She uses quantitative, qualitative and mixed methods research techniques to study health…
ScabiesNonye Ogbuefi, BA and Brandi Kenner-Bell, MD What is scabies? Scabies is an infestation where tiny mites burrow into the skin and cause an itchy rash. Scabies is very contagious and affects both children and adults worldwide. The most common symptom of scabies is itching that is worse at night. As a result, scabies can…
Pityriasis Rosea Farinoosh Dadrass, MS and Wendy Kim, DO What is pityriasis rosea? Pityriasis rosea is a rash that consists of scaly spots that look like tiny, raised bumps found on the chest, stomach, back, arms, and legs. It is most common in older children and young adults.1 The rash can be itchy, but in…
Enhanced Patient Education Resources on the SOCS Website
We are pleased to offer a wide variety of patient educational resources on the Skin of Color Society (SOCS) website, now available in English and Spanish translations! Thanks to expert contributions from many SOCS members, the Patient Dermatology Education section of the site features informative articles to help patients of color better understand the following dermatologic…
Experiences of some of our SOCS Observership Grant Recipients 2023 SOCS Observership Grant Recipients 2023 SOCS Observership Grant Recipients Mentee: Kelita WatertonMentor: Nayoung Lee, MD, FAADRonald O. Perelman Department of Dermatology at NYU Grossman SOM Mentee: Harry Liu, MDMentor: Michi Shinohara, MD, FAADUniversity of Washington Mentee: Kristin Tissera Mentor: Nicole Gunasekera, MD, MBA, FAADBrigham and…
Candrice Heath, MD, FAAD
Moderator | Meeting the Challenge Summit: Diversity in Dermatology Clinical Trials Dr. Candrice Heath is a highly respected triple board-certified dermatologist. She is board certified in dermatology, pediatrics and pediatric dermatology. She enjoys providing care to entire families, from newborn to 115 years young. Dr. Heath was motivated to pursue a career in dermatology after witnessing…
In the News
2022 'We can get skin cancer': Dermatologists talk sunscreen for Black, brown people Click on the image to read the full piece Expert Q&A: Common Skin Conditions That Affect People of Color Click on the image to read the full piece "SOCS 2021 Achievement Highlights" Click on…
2017 SOCS Media Day Delivers High-Interest Expert Content!
“KNOW YOUR SKIN!” Advancing patient and public understanding about skin of color issues… from everyday concerns to life-altering conditions The Skin of Color Society’s 3rd Annual Media Day took place at the Kitano Hotel Penthouse in New York City, on December 5, 2017, attracting strong interest among numerous media attendees. Entitled, “Know Your Skin,” this…
2017 SOCS Media Day
JOIN US FOR THE SKIN OF COLOR SOCIETY’S 3rd ANNUAL MEDIA DAY “KNOW YOUR SKIN!” Advancing patient and public understanding about skin of color issues… from everyday concerns to life-altering conditions Tuesday, December 5, 2017 | 12-2 pm The Kitano Hotel Penthouse, 66 Park Ave, New York City Featuring Skin of Color Society dermatologic expert…