What Is Eczema? How Does It Appear on Skin of Color?

Washing with certain soap can aggravate eczema.
Be careful about soap and other cleansers when you have eczema. JGI/Jamie Grill / Blend Images / Getty Images

Eczema is a chronic inflammatory skin disorder. The most common form is atopic eczema (also known as atopic eczema and atopic dermatitis.) Atopic eczema runs in families and is often associated with a history of asthma and allergies like hay fever.

Causes of Eczema

The cause of eczema is still unknown. It is believed to be a combination of things—genetics, a compromised immune system, a hormonal imbalance and/or environmental factors.

Eczema can affect people of all ages and races, but especially affects infants and children. This condition typically begins in infancy, after three months of age, but can begin at any time in an affected person’s life. Some children grow out of it between the ages of 2 and 5. For others, it could last into the teenage years and then subside. And still, for some people, the condition can remain from infancy and into adulthood.

Other Types of Eczema

Contact eczema (or contact dermatitis) causes eczema when an allergen or irritant touches the skin. There are two types: irritant contact dermatitis, when a rash develops from soaps, detergents, harsh products or prolonged contact with mild irritants like bubble bath or even 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 related to atopic eczema in that it is caused by repeated hand washing or exposure to strong detergents or latex (from latex gloves for example).

Varicose eczema occurs in middle to later years, affects the lower legs (the skin around the ankles get itchy and inflamed) and is caused by poor blood circulation.

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

Xerotic or asteatotic eczema, is a dry skin eczema that causes fine cracks in the skin in the lower legs (where there are fewer oil glands), and is common in elderly and can flare up during the winter in a low humidity environment.

Signs of Eczema

  • 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

Adults will often notice eczema inside surface of knees, elbows and on the ankles, but it can also appear on the face and neck.

How Eczema Appears on Skin of Color

Instead of appearing reddish, on dark skin it can look dark, ashen or grayish in color or brownish in lighter skin tones (like Asian skin). In black or dark skin it can cause hypopigmentation (lightening of the skin) and hyperpigmentation (darkening).

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

What to Do If You Suspect You Have Eczema

Eczema can look different on dark skin. If you suspect that you have eczema and are unable to treat the symptoms, see a dermatologist or doctor. The doctor will diagnose the problem by looking at the appearance of the skin, ask about personal and family medical history—whether asthma, allergies or eczema runs in the family, or will do a patch test to identify allergies, find out if you are under treatment for other skin conditions (medications can sometimes exacerbate eczema), and test the skin to rule out other diseases or infections.