Atopic Dermatitis in Skin of Color: Your Questions Answered

Atopic dermatitis, sometimes known as eczema, is a specific issue for Black Americans and other people of color. This persistent skin condition is common and can occasionally be quite severe. The skin of Black Americans is more susceptible to the dryness, itching, inflammation, and scarring caused by Atopic Dermatitis.

This article provides answers to frequently asked concerns regarding how Atopic Dermatitis affects people with skin of color and what patients may do to control their symptoms, get the proper diagnosis, and receive medical care.

What is the most common symptom associated with Atopic Dermatitis? Do symptoms differ from one patient to the other?

Itching is the most common sign of Atopic Dermatitis in people of all races. The defining symptom is one in which the doctor states, "If it's not itching, it's probably something else”.

Eczema can result in bumpier skin, especially in people of color because of the higher collagen (a protein that gives skin its structure). People with darker skin can become bumpy, as opposed to Caucasians who can become scaly. When you run your fingers over it, it almost has the sensation of a spine.

Patients with atopic dermatitis of color may have more of a dark grey, somewhat purple skin color than the redness you would observe in white skin.

An individual can also develop hyperpigmentation or patches of skin that are darker than usual, and hypopigmentation, or lighter areas of skin, as a result of their higher melanin concentration.

Thickening happens frequently. It goes back to the fact that those with darker skin have more collagen, which also slows down the rate at which we age. The thickening of the skin in response to inflammation and itching is known medically as lichenification.

Hyperlinearity of the palms is another characteristic of atopic dermatitis in those with darker skin tones. As a result of the damaged skin barrier, you have more lines on your palms and deeper creases around your eyes.

Why is Atopic Dermatitis so grave in people of color?

Two factors have to be considered for answering this question. Firstly, the genetic factor is to be taken into account. Everyone's skin produces ceramide, a protein that aids in moisture retention. African Americans have a lower ceramide-protein ratio. Darker-complexion people, therefore, retain less moisture due to genetics.

Second, there is a situational-environmental factor at work in why African Americans experience more severe Atopic Dermatitis. That's because, generally speaking, a large portion of African Americans live in metropolitan environments that are full of irritants, allergens, pollution, humidity, higher UV radiation load, hard water, and dust, all of which can aggravate Atopic Dermatitis and weaken the immune system.

Is there any connection between common allergies and Atopic Dermatitis?

Although not all people with atopic dermatitis have allergies, they overlap at times.

Why does this happen? First, atopic dermatitis causes minor skin breaks from scratching and itching, which makes it easier for allergens to enter the body. Our skin is a solid barrier keeping things out, but Atopic Dermatitis weakens that barrier. As a result, an allergen may enter and trigger a higher inflammatory reaction than it would in a person with completely healthy skin.

Second, those who have atopic dermatitis—those who have asthma or seasonal allergies—genetically have a better immune reaction. It's comparable to having two children where one is calm and the other hyperactive. The second child resembles an atopic person's immune system. It is an immune response.

Is diagnosing Atopic Dermatitis difficult with patients of color?

Yes, diagnosing people of color might be more challenging for doctors. In many medical publications, only Caucasian persons are frequently shown. They conducted a study where white skin was depicted in 98 percent of the photographs in dermatological textbooks. You might not be exposed to this in your training if you are not an expert with darker skin.

Many medical professionals are unaware that atopic dermatitis might manifest differently in darker skin than it does in Caucasian skin. They might not be aware that African Americans can get lumps whereas Caucasians can develop scaly skin.

Atopic dermatitis may also manifest differently in dark skin than it does in white skin, which is also noteworthy. The flexors, the joints that bend within the elbows and behind the knees, are affected by atopic dermatitis.

However, studies have shown that atopic dermatitis affects the extensors, the front of the knees, and the rear of the elbows among African Americans. However, the criteria haven't even been updated because they don't include persons with a dark complexion.

Does Eczema lead to Changes in skin Pigment in People of Color?

A protective mechanism is a change in pigment. Melanocytes [skin cells that create the color melanin] are the only cells that are triggered because of inflammation.

You become darker as you have more pigment.

How to take care of Children of Color who are Suffering from Eczema?

Moisturizing is also very vital. Children from households with atopic dermatitis were used in a study to compare the effects of intensive moisturization versus less intense moisturization. And from birth to six months of age, children who received regular post-bath moisturization experienced fewer cases of Atopic Dermatitis as adults. For a young child, it is crucial to maintain a strong skin barrier.

Cover the skin if your child experiences skin itching. Make them wear full-length pajamas or onesies that are thin or made of cotton.

To prevent the child from scarring or having severe hyperpigmentation, you should seek dermatologic care from a doctor familiar with the skin color. We also know that scratching can prevent youngsters from getting enough sleep, which can affect their academic performance.


Eczema or Atopic Dermatitis may sound very troublesome but can be dealt with proper care and advice from dermatologists. Some simple steps that can be adhered to include- First, consuming Vitamin D helps stabilize immunity. Secondly, a humidifier helps maintain the skin barrier. Using it is a good idea. And thirdly maintaining the moisture levels helps keep Atopic Dermatitis away. By following these steps, people of color can effectively maintain Atopic Dermatitis.

Updated on: 21-Feb-2023


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