Eczema on black skin: symptoms, treatment, and plant-based relief that works
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Eczema on black skin is different
Eczema on Black skin is more common, often more severe, and frequently is not diagnosed — and it simply doesn't look the way most doctors are trained to recognize it. Instead of appearing red, eczema in people with darker skin tones can show up as grey, purple, or simply as a rough, bumpy patch that's sensitive to touch and intensely itchy. One of the big challenges that Black people have with eczema is that they may not think they have eczema, so they aren't seeking diagnosis and therapy.
We can’t solve the diagnosis problem, but we can contribute to both education and treatment. Read on!
Eczema on black skin?
On Black skin, eczema looks and feels very different from its presentation on white skin. Instead of being reddish, for instance, it can be grey or purpleish or just darker. It is also common for eczema to be sneaky, without a color change but instead being bumpy or rough and sensitive to touch, with extreme itching. On the scalp it often manifests as itchy and sensitive patches that are crusty or flaky, and is easily confused with the dandruff caused by dry skin. Worse still is that untreated eczema on dark skin can lead to permanent discoloration.
Eczema may present differently in infants and adults, but can occur on elbows, knees, hands, and face, particularly on the cheeks and around the mouth in children. It can also affect the neck, scalp, behind the ears, and other folds of skin, and annoyingly in the crotch. Black infants can present with whole body scratching and rash-like symptoms as well.
Remember, if you are Black your eczema might be steady or might come and go, with symptoms like these:
- Skin is rough over an area with occasional or consistent itching
- Skin appears bruised, purple or grey tinted, or discolored - often this is assumed to be hyperpigmentation and ignored
- Skin is sensitive to the touch, or to coarse fabrics, or synthetics.
- Thickening of skin where scratching has been regular
- Itching areas of skin that feel 'funny'
- Bumpy sores that may be closed or open - often confused with acne
- Hair loss on head, eyebrows, beard, etc and usually with stubborn dandruff
And alas, if you are Black, you can go your whole life without knowing that those areas that look a bit “off” and itch are a treatable eczema! A lot of the blame for that lies with the medical establishment and the history of neglecting the different medical experiences of minorities and women (we are in the USA, where racism is real and ugly).
Helpful links for eczema on black skin, with some images
Instead of turning this blog post into a twenty page scientific explainer, here are three solid top resources that also help explain eczema on Black skin:
The Eczema in Skin of Color organization's photo examples
Greatist: "Eczema on Black Skin: Symptoms, Signs, and Treatment Options"
Medical News Today: Eczema on Skin of Color: What to Know"
Statistics and overview of eczema in the black community
Eczema is more common in Black children than it is in Hispanic or white kids. A rigorous study found that Black children were about twice as likely to have eczema compared with Caucasian children. The rate of eczema for Black kids in that study was 19.3% (Racial differences in atopic dermatitis, Patrick M. Brunner & Emma Guttman-Yassky, 2019). Not only do Black people tend to have more eczema, it also tends to be more severe – so Black people have about twice as much eczema, and it is poorly diagnosed, and it tends to be more severe. Oh, and only a small subset of clinical studies have looked at differences in outcomes with clinical treatment.
The environment and racism make black eczema worse
The thing about eczema is that it is an autoimmune disease, just like allergies and asthma and arthritis – and sadly one can lead to another for those who are regularly exposed to allergens and pollution and racism. These exposures are more common for poorer people, urbanites, and anyone living near existing or historical chemical or manufacturing sites – which is a lot of people. These exposures work together to damage the immune system further, and racism itself contributes to eczema (for instance, "Structural racism and its pathways to asthma and atopic dermatitis", Adali Martinez, Rosemarie de la Rosa, et al., 2019 - see also "Structural racism and its influence on the severity of atopic dermatitis in African American children", Tackett, Jenkins, et al., 2020).... not to mention the effects of racism on almost every other health outcome.
Apologies for the heavy science citations there, but sometimes people deny the reality of racism in the USA so solid data is needed.
Interactions of genetics, environment, and stressors is called "exposome"
Scientists are finally studying these interactions, and some of them are scary. This is called the “Exposome” – the full collection of all exposure sources from our genes to our childhoods to our environment. Did you know that racism is as toxic as smoking, for example? Generally speaking the less money you make, the more toxins you are exposed to in work and home life. The list goes on.
People with eczema or other immune function disorders should know more about all of this. We have a couple of video explainers with suggestions on YouTube:
Part 1 – “Do you know your EXPOSOME?”
Part 2 – “Easy ways to reduce your exposures.”
If you want to dive in a bit more, the Skin of Color Society is a solid resource.
How and why we created plant-based eczema relief
Because eczema can be so much worse for Black people, for so many reasons, the usual lotions and potions often fail to work well, or stop working over time. Knowing this, we didn’t try to make yet another lotion. We interviewed experts in traditional African and Caribbean medicine about the best approaches for Black skin, and we reviewed a lot of the scientific literature too.
We took all this into account as we developed our products. The XZ Skin Relief product has been developed over the last six year through a series of formulation changes that are then tested by family and friends and other locals in our area (Marietta, GA). We have a really diverse test population, even if it wasn’t a randomized clinical trial. About half of our testers are Black or Hispanic, so we’ve had lots of great learning as we changed and adapted the formulation until it was ready for release. We kept experimenting with ingredients and ratios for five years until we had a plant-based formulation that worked for everyone.
Natural plant-based eczema relief for black skin, white skin, all skin
No water or preservatives are used, no chemicals, no emulsifiers – nothing to irritate the skin barrier: we respected the advice from the elders and use only natural oils and extracts. Check out our ingredients - no chemicals!
Then we put that blend into a roll-on so it can be applied without having to use fingers on sore or sensitive areas. The size is handy, you can take it with you in your pocket or purse, it’s legal to carry on flights, and it won’t leak.
Our motto is: “Nothing wicked, nothing weird.” XZ Skin Relief - It might be magic, but it is good science for every skin type and color.
About the author: Scott Hampton is a cosmetic and drug delivery expert with CDM, Inc., focusing on formulations for melanin-rich skin. Based in Marietta, GA. Bio and LinkedIn.