Guest post by Pragya Sharma Phd Biochemist at Queen's University Belfast, and Founder of GranLab.
It came as a bit of a surprise to me as a student of medicine, that none of my textbooks covered the topic of differentiating between the forms of eczema that can affect people with different tones of skin.
I first noticed eczema on a young black boys Adam* and Moi* (*name changed for privacy) three years ago, and all I could think about was how different it looked from what I was used to seeing in patients in India and in Belfast.
Eczema can manifest itself on darker skin as patches of a darker brown colour, or even purple or grey. After a flare-up, the affected areas may appear darker or lighter than the surrounding area, be swollen, warm, itchy, dry, or scaly, and have any combination of these symptoms.
Papular lesions, which can be recognised by their distinct appearance as small bumps on the torso, arms, and legs, are more common in people of colour. This condition is referred to as papular eczema, and it expresses itself as permanent goosebumps.
Additionally, the incidence of 'extensor surface' lesions is higher in black people. These are the areas of a person's skin that are located on and around their joints, as seen with both Adam and Moi in the pictures below:
This condition is known as follicular accentuation, and it causes these bumps to form around the hair follicles. Eczema can also result in severe dryness and dark circles under the eyes in people of black and brown skin tones.
These differences in symptoms and presentation can often lead to an underdiagnosis of eczema severity or misdiagnosis. People of all skin colors, races and ethnicities can be affected by eczema, yet much of what is currently known has been learned by studying eczema in white skin. Recent studies of the high eczema prevalence in diverse racial and ethnic groups has resulted in calls for more studies on eczema on darker skin or skin of color (SOC).
There is currently a scarcity of epidemiological, clinical, and therapeutic data on psoriasis and eczema in racial and ethnic groups other than Caucasians, making it increasingly important to raise awareness and create databases to prevent racial misdiagnosis.
Eczema triggers are however similar for all skin types. These include irritants such as metal jewellery, cigarette smoke, stress, sweating, humid weather, dry weather, cold weather, hormone changes, and allergens. Eczema treatment is also similiar on all skin types depending on a person’s symptoms and the severity of the condition.
The Skin of Color Society (SOCS) recommends the following:
- Showers or baths that are extremely hot or cold should be avoided. - Avoid using fragrances such as perfumes and colognes. - Select scent-free cleaning supplies, cosmetics, and detergents. - Wearing clothing that is too tight is not recommended. - Every day, bathe for 5–10 minutes and dry thoroughly.
Check out this useful article from the National Eczema Organisation on diagnosing and managing Eczema on Black and Brown Skin for further information.
This post was written by Pragya Sharma. Pragya is the founder of Gran Lab and a medical biochemist who works closely with people suffering from psoriasis and eczema, and has recognised the urgent need to remove colour bias from skin disease diagnostics.
Gran Lab has launched a new line of steroid-free, colour-inclusive, ethical, and environment-friendly topicals to treat psoriasis and eczema symptoms. If you want to learn more about this innovative oil, please contact Pragya via LinkedIn www.linkedin.com/in/pragya-sharma-54aab1a1 or Instagram handle: gran_lab
For more information on how Skinakin can help your child manage eczema, check out our blog posts. At Skinakin we want to make life better for children with trusted products that give them some respite from uncontrollable scratching. Together, we can make eczema management easier and improve the quality of life for your child.
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