SHIFTER’s Kevin Bourne shares three reasons why Eczema disproportionately affects Black people and how to manage it.
In recent years, Black health has finally been getting the attention it deserves, both in Canada and the United States. This is not only true for the medical community, but academia. The University of Toronto’s Dalla Lana School of Public Health even launched a new Master’s program in Black health this year to prepare students for public health practice with Black communities.
What they’ve all grown to understand is that there are a number of medical conditions which disproportionately affect people with darker skin, including heart disease, high blood pressure, some Cancer, diabetes, stroke, sickle cell anemia[1], lupus [2]uterine fibroids. Whether the symptoms or complications mean mild discomfort or something even more severe, they affect the quality of life of countless Black individuals and families across North America.
One of the conditions that often flies under the radar when it comes to its impact on the quality of life of Black people is eczema, also known as Atopic Dermatitis. If you’re Black, you probably know at least one person who has this inflammatory skin condition that can come with scaly skin, oozing and severe itching. Despite being a non-contagious condition, what we often don’t account for is the shame and embarrassment that can sometimes come with eczema.
Why eczema disproportionately affects darker skin
1. Genetics
The available research offers three reasons why our community is disproportionately affected by eczema. The first is genetics.
Board certified dermatologist and co-founder and co-director of Oak Dermatology, Dr. Jeffrey T.S. Hsu told Medical News Today [4], “We know that there’s a strong familial trait to eczema, and a lot of it has to do with a genetic component.”
Children may inherit genetic mutations from their parents that raise their risk of eczema. A 2015 review by the National Library of Medicine [5] in the United States found that eczema is passed on to children through genetic mutations and that these mutations are more prevalent in Black people.
2. Environmental Factors
Another potential reason why eczema disproportionately affects Black people is environmental factors. According to a 2021 review by the Journal of Allergy and Clinical Immunology [6], this can include exposure to some chemicals, pollutants, and allergens like dust and mold that may also increase the risk or severity of eczema. This shows that systemic racism and housing policy can have a trickledown effect on the health of our people.
3. Stress
The relationship between stress and eczema has been well-documented. Stress leads to inflammation in the body which can worsen eczema symptoms.
The reality is many people in our community are going through psychological stress and trauma, especially in recent years, which can contribute to a number of conditions, including eczema.
Symptoms for darker skin
The symptoms of eczema can include:
- Dry, or even cracked, skin
- Itchiness
- Oozing and crusting
In the case of Black people, we can also experience:
- Bumps around our hair follicles known as “follicular accentuation”
- Small raised bumps on the torso, arms, or legs known as “papular eczema”
- Thickened skin
- Skin discolouration
- Dark circles around our eyes
Dr. E. Nikki Pritchett, associate professor in the Department of Dermatology at Howard University College of Medicine, told Medical News Today [7], “Black Americans may develop dark or light discoloration of the skin that can last for many months after the eczema resolves”.
I’d wager it’s the same for Black Canadians.
Treatment options for darker skin
Now that we know more about why eczema disproportionately affects our community and the symptoms, let’s take a look at treatment options.
There’s currently no cure for eczema. For some people, their symptoms can improve with age. Here are some treatments to help ease the symptoms in darker skin.
Moisturizers
The most common option to relieve eczema symptoms in Black skin is medicated moisturizers. My 10-year-old son has eczema on his legs and has very sensitive skin. The AVEENO® brand has a line of steroid-free, paraben-free and fragrance-free Eczema care products that work very well on the skin, especially itchy and sensitive skin. The line includes AVEENO® Eczema Care Body Wash, AVEENO® Eczema Care Itch Relief Balm, and AVEENO® Eczema Care Moisturizing Cream, as well as a wash, mosturizing cream, and nighttime balm for babies.
Other treatments
Other treatments include lifestyle changes like avoiding stressors, triggers and irritants, including avoiding certain fabrics, keeping your home cool, choosing the right detergents for your clothing, as well as making dietary changes.
All of these treatments and lifestyle changes can go a long way in helping Black people to manage their eczema symptoms.
Educational resources
With limited resources available to those with diverse skin tones with eczema, the makers of AVEENO® partnered with dermatologists and eczema patients in developing an educational resource highlighting the experiences of eczema on diverse skin tones – the #SkinVisibility tablebook.
The AVEENO® Skin of Colour Hub is a “one-stop shop” to support Canadians on their eczema journey.
The AVEENO® Canada Skin of Colour Hub includes:
- #SkinVisibility table book: Available for download on the hub, this is a visual resource for those struggling with eczema.
- Eczema Care Tips: The makers of AVEENO® provide a simplified look at the science behind eczema, what it is, how it impacts the skin’s microbiome as well as tips for management.
- Eczema Equality Hub: The Eczema Equality Hub supports parents with newborns with skin of colour, the makers of AVEENO® offer resources specifically for parents that provides information on identifying and treating eczema on babies with skin of colour.
For more information on how to manage eczema symptoms in diverse skin tones, visit the AVEENO® Canada Skin of Colour Hub.
[1] 7 Common Health Concerns African Americans Should Monitor. CentraState Healthcare System. Retrieved 2023, from https://www.centrastate.com/blog/7-common-health-concerns-african-americans-should-monitor/
[2] African American Women and Lupus: The Most Diagnosed and More Likely to Die Prematurely. Black Health Matters. Retrieved 2023, from https://blackhealthmatters.com/african-american-women-and-lupus-the-most-diagnosed-and-more-likely-to-die-prematurely/
[3] Eltoukhi, H., Modi, M., Weston, M., Armstrong, A., Stewart, E. (2013). The Health Disparities of Uterine Fibroids for African American Women: A Public Health Issue. National Institutes of Health. Retrieved 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874080/
[4] Expert perspectives: Why is eczema more common among Black people?. Medical News Today. Retrieved 2023, from https://www.medicalnewstoday.com/articles/expert-perspectives-why-is-eczema-more-common-in-black-people
[5] Paternoster, L., Standl, M., Waage, J., Baurecht, H., Hotze, M., Strachan, D., Curtin, J., Bønnelykke, K., Tian, C., Atsushi, T., Esparza-Gordillo, J., Alves, A., Altmaier, E., Sleiman, P., Xiao, F., Gonzalez, J … Weidinger, S. (2016). Multi-ethnic genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis. Europe PMC Funders Group . Retrieved 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753676/
[6] Croce, E., Levy, M, Adamson, A., Matsui, E. (2021). Reframing racial and ethnic disparities in atopic dermatitis in Black and Latinx populations. The Journal of Allergy and Clinical Immunology. Retrieved 2023, from https://www.jacionline.org/article/S0091-6749(21)01417-2/fulltext
[7] Expert perspectives: Why is eczema more common among Black people?. Medical News Today. Retrieved 2023, from https://www.medicalnewstoday.com/articles/expert-perspectives-why-is-eczema-more-common-in-black-people
