Instead of the redness commonly seen in medical literature, eczema on Asian skin may appear gray, purple, or dark brown. This difference can sometimes make diagnosis more difficult, as the discoloration may not be as noticeable.

Research also indicates that eczema can be more severe in people with dark skin tones, including Asian people. Inflammation from eczema may also lead to hyperpigmentation, leaving dark patches even after the eczema has healed.

Yes, eczema is common among Asian people, and its prevalence has risen, partly due to rapid urbanization. A 2018 study notes that China’s urban population has increased over the last decade.

A 2021 review found that rapid urbanization in many Asian countries increases exposure to air pollution and environmental irritants, leading to higher rates of atopic dermatitis among Asian people living in urban areas.

• Mutations in the filaggrin gene: This gene mutation is more common in Asian people and often affects the skin barrier, increasing the risk of eczema.
• Diet: A 2021 study suggests a higher intake of processed and inflammatory foods can lead to skin sensitivity and inflammation, making eczema more likely in people who consume these foods.
• Environment: Humid and polluted environments, common in many Asian cities, can increase the possibility of developing eczema symptoms.
• Family history: Having a family history of atopic conditions like eczema and asthma can also increase the likelihood of developing eczema.

Accessing care for eczema can be challenging for people of color due to several reasons, including:

As eczema can appear differently on dark skin tones, this can often lead to misdiagnosis or delayed treatment.

Eczema typically presents as red, inflamed patches in people with light skin. However, on dark skin, it may appear as gray, purple, or dark brown patches, making it harder for healthcare professionals unfamiliar with these variations to diagnose the condition correctly.

Scoring systems like SCORAD, which assess eczema based on visual markers like erythema (redness) and dryness, can be less effective for people with dark skin. Erythema may not be as visible on dark skin tones, even though it still causes significant discomfort.

Additionally, fewer dermatologists specialize in treating people of color. Cultural and language barriers can also further limit access to proper care, especially for those living in non-diverse areas.

Managing eczema often involves a combination of lifestyle adjustments and medical treatments to manage symptoms and reduce flare-ups.

• applying a fragrance-free, thick moisturizer at least twice daily to keep skin hydrated
• using mild, soap-free cleansers that don’t strip natural oils from your skin
• identifying and avoiding eczema triggers like harsh soaps, allergens, stress, or certain fabrics like wool
• taking short, lukewarm baths because hot water can dry out the skin and worsen symptoms
• using medicated creams like topical corticosteroids or nonsteroidal options, as prescribed by a doctor, to reduce inflammation
• wearing soft, breathable fabrics like cotton and avoiding tight-fitting clothes to reduce irritation

A healthcare professional, such as a dermatologist, can recommend various treatment options for eczema, depending on the severity of your symptoms and the type of eczema.

Possible treatment options include:

• Topical corticosteroids: These medications help reduce inflammation and itching. Low-strength options, like hydrocortisone, are available over the counter, while stronger prescription options, such as fluocinonide (Vanos), may be necessary for severe cases.
• Emollients and moisturizers: Daily use of emollients and moisturizers may help keep the skin hydrated, forming a protective barrier to prevent eczema flare-ups. Options include thick creams or ointments.
• Antihistamines: These can help manage itching, particularly at night. Although they do not treat eczema directly, they reduce discomfort during flare-ups. A common example is cetirizine (Zyrtec).
• Phototherapy (light therapy): This treatment involves controlled exposure to ultraviolet light to reduce inflammation and improve symptoms in more severe cases of eczema.
• Biologics: Medications like dupilumab (Dupixent) target specific immune system pathways to reduce inflammation and other eczema symptoms. They are often used for moderate to severe eczema that does not respond well to other treatments.

Consider speaking with a doctor if your eczema symptoms worsen, don’t respond to over-the-counter treatments, or if you notice signs of infected eczema.

Symptoms of a skin infection include:

• pain or soreness
• pus-filled blisters
• increased itchiness
• increased warmth in the affected area
• crusting, oozing, or yellowish discharge
• increased discoloration, like patches that are darker than the surrounding skin

Eczema is common among Asian people, with increasing cases due to urbanization, genetic factors, and environmental exposure.

However, diagnosis can be challenging on skin of color, as eczema appears differently, and the scoring systems used to assess eczema may underestimate its severity.

Misdiagnosis, delayed treatment, and limited access to dermatologists specializing in treating skin of color can further complicate care.

Where possible, finding a dermatologist specializing in treating skin of color can be beneficial.