Dr Jack Mann, a Skin Care Network consultant dermatologist, looks at the increasing rate of eczema and effective options for treatment.
In general usage, dermatitis and eczema refer to the same condition. One which can be inherited and tends to be brought on by temperature change, stress, foods, or other allergies, with patches of reddened skin seen as a common symptom.
This highlights the first misunderstanding regarding darker skin, where the irritated areas can be red but often range from ashen grey, to brown. The second area of confusion is the prevalence of eczema for people with different skin tones.
The image of bright red patches on white skin is strongly associated with eczema, yet research shows that people with black, or brown skin are at least as likely to suffer from the condition, perhaps more so.
Misconception can lead to wrong advice, seeing a dermatologist with knowledge of different skin types will help. This is important as eczema on dark skin, or associated scratching, can lead to darkening (hyperpigmentation) or lightening (hypopigmentation) of the skin.
Types Of Eczema
Apart from looking different in darker skinned patients, other differences are more likely, such as bumps called papular eczema, or follicular eczema. The predominant conditions are still seen across skin colours.
Atopic eczema (or dermatitis) is a common type, often starting in early childhood and associated with conditions such as asthma, or allergic rhinitis. Although not exclusively inherited, this does tend to run in families.
Nummular, or discoid eczema creates areas of inflammation which are coin, or disc shaped, perhaps more crusty in appearance. This can be triggered by an injury to your skin, including a burn, or through an insect bite.
Contact Dermatitis is a form of eczema caused when your skin is irritated by a particular substance. Soaps, detergents, or a range of chemicals are common culprits, although plants such as poison ivy, or elements including nickel can be a cause.
There are types which effect specific areas, such as varicose eczema on your legs, or seborrhoeic eczema, which appears on facial areas, or your scalp. Dyshidrotic eczema can be seen on darker skin, which causes small blisters on the palms of your hands.
There are other rare types, with a range of symptoms, from dry, scaly skin, to serious inflammation, to a release of fluid. Treatment will also vary, according to eczema type and symptoms, individual assessment is the key.
Diagnosis & Treatment
Every facility is available at our London clinic, from skin patch testing, to digital microscopy. The cornerstone of diagnosis is still the consultant who will carry out your consultation.
Their experience and examination of your skin will help identify the exact condition you have. This will include a review of your personal and family medical history, perhaps daily activities, your diet, stress levels, substances you come into contact with.
Changes to routine can be part of treatment, to avoid triggers, alter bathing, or moisturising regimes. Beyond skin emollients, corticosteroid medication can help, immodulator drugs, such as tacrolimus, or pimecrolimus can repair the skin’s barrier function and reduce thickening.
Other medication may be of benefit, or phototherapy (light treatment) or antihistamines. Reducing symptoms can be useful, although an individual treatment plan aimed at clearing up your eczema and preventing future onset is the target.
There is no guaranteed cure for eczema but for many people, long term relief is practical and in difficult cases, symptoms can be significantly improved. For darker skin, emaphasis should also be given to reducing, or avoiding pigmentation issues.
The latter point is helped by early intervention. Eczema diagnosis and treatment at our London clinic can be quickly arranged for patients of all ages, please contact us to arrange a visit, or see more on dermatology for darker skin.