What is Eczema, and Does it Affect People of Color Differently?

Updated 04/16/19
Be careful about soap and other cleansers when you have eczema. JGI/Jamie Grill / Blend Images / Getty Images

Eczema, in the . most basic terms, is a chronic inflammatory skin disorder. The most common form is atopic eczema, which is also known as atopic dermatitis. Atopic eczema runs in families, most often associated with a history of asthma and allergies like hay fever. The signs are:

  • Dry, extremely itchy skin that can start to crack
  • Blisters with oozing and crusting
  • Red skin and red skin around the blisters
  • Raw areas of the skin from scratching, which can also cause bleeding
  • Dry, leathery skin areas that either becomes lighter or darker than normal skin tone
  • Scaly or thickened skin

Instead of always appearing reddish on dark skin, it sometimes looks dark, ashen or grayish in color. On lighter people of color, it appears brownish in lighter skin tones. In black or dark skin it can go either way, and cause hypopigmentation (lightening of the skin) and/or hyperpigmentation (darkening). It tends to show up on most adults on the surfaces of knees, elbows and on the ankles. Sadly, it can also appear on the face and neck.

Unfortunately, although we know those things about eczema, we don't know much more about what causes it. It's believed to be a combination of things—genetics, a compromised immune system, a hormonal imbalance and/or environmental factors. Eczema can affect anyone, but it's at its worst when it's present in children and babies. The condition typically begins in infancy sometime after three months, but unfortunately it can show up at any time in someone's life. Some children grow out of it between ages two and five.

For others, it can last into the teenage years and then subside. And still, for some people, it goes into adulthood or never goes away.

Possible Triggers

  • Soaps, laundry detergents, fabric softener and cleaning products
  • Extreme (cold or hot) weather and very high/low humidity levels
  • Dust, molds, pollen, fungi, bacteria
  • Pet dander/fur, dust and dust mites
  • Sweating
  • Rough fabrics (like wool) that irritate the skin
  • Perfumes, creams and other cosmetics with irritating ingredients like formaldehyde, deodorants with aluminum chloride
  • Stress (physical, mental and emotional)
  • Nickel (like belt buckles, jewelry with nickel (gold less than 24 Karats))
  • Environmental allergens
  • Certain foods like cows milk and wheat gluten

Other Types of Eczema

Contact eczema (aka contact dermatitis) causes eczema when an allergen or irritant touches the skin. There are two types: irritant contact dermatitis, which is when a rash develops from soaps, detergents, harsh products, or prolonged contact with mild irritants (like bubble bath and sweat). Allergic eczema (allergic contact dermatitis) develops when an allergic reaction occurs in the skin, to people who have an allergy to a specific substance, such as the oil from poison ivy, poison sumac and poison oak, or nickel (which can be found in items like belt buckles and jewelry).

Hand eczema is exactly what it sounds like. It's related to contact eczema, because it's caused by things like repeated hand washing and exposure to strong detergents or latex.

Varicose eczema tends to occurs in older people. It affects the lower legs, and you know you have it because the skin around your ankles gets itchy and inflamed. It's caused by poor blood circulation.

Nummular eczema causes solid round, coin-sized patches of irritated skin—on the legs, arms or chest. 

Xerotic or asteatotic eczema, is a eczema that presents itself as the fine cracks in the dry skin of the lower legs, because there are fewer oil glands there. It's common in the elderly, and generally flares up during the winter in a low humidity environment.

If you suspect that you have eczema and are unable to treat the symptoms, you should see a dermatologist or a doctor ASAP. The doctor will be able to diagnose the problem by looking at the appearance of the skin. They'll ask about personal and family medical history, do a patch test to identify allergies, ask if you're under treatment for other skin conditions (medications can sometimes exacerbate eczema), and test the skin to rule out other diseases or infections. Eczema can be extremely uncomfortable, but it's treatable.

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