Brown Eczema: After the Rash is Gone

Dear Mahogany,

The primary difference between a brown skin person with eczema and another person with eczema is how the skin heals. A Caucasian person suffering from eczema may choose to take a corticosteroid (hydrocortisone, triamcinalone, etc.) or a TIM (protopic, elidel), after a few days the rash will have gone away, and only a red mark remains. The redness will soon fade as well. 

People of color have melanocytes, not only in the lowest layer of skin, but through out all three layers. When our rashes heal, a hyperpigmented area remains. A dark spot remains.

The rash is removed, the skin is healed. But your body still looks as if you are broken out because the darkened areas still remain where the rashes once were.

There are a few options that you and your dermatologist may discuss, after the rash is gone:

1. WAIT.

Even though dark spots remain where the rashes once were, they will fade away. For a dark skin person of my complexion it will take 6-12 months for the hyperpigmented area to clear up. That is 6 to 12 months without another outbreak in that same area. 

2. Bleaching Creams.

No, it's not the 70s. This is not to change your complete complexion. I'm sorry you weren't born with fairer skin. These may be prescribed and even recommended by some dermatologists to return the color of the darkened areas where rashes once were back to normal.

3. Corticosteroid Injections or Oral Medication

I am not sure why Atopic Steroids and Topical Immunomodulators (TIMs) leave hyperpigmentation and Corticosteroid Injections not only clear up the rash itself, but the hyperpigmentated area as well.  Oral Corticosteroid injections may actually remove hyperpigmentation as well.

Until the rash is gone, after the rash is gone, keep loving yourself until the dark spots are gone too. 

Love,

Lhea J.

Brown Eczema: Do You Need a Black Dermatologist?

Dear Brown Skin, 

To be a member of a community which prides itself on its style/appearance and have eczema can be a devastating phenomenon. What is a black woman if she does not have her looks?

Luckily, you may never have to find the answer to that question.

The first step is to find a great dermatologist. While you don't need an African-American dermatologist, you do need a skin specialist who is used to observing Black skin. 

In the mean time, there are a few simple steps that you may take to keep your skin healthy and most importantly, within your control.

PREVENTION

to decrease the chances of flare-ups...

• Find a great dermatologist with experience in treating Black skin
• Increase your water intake (8-12 glasses per day)
  
• Olive Oil and Baby Oil Gel soothe the skin
  
• Cera Ve Cream or Cetaphil Cream lock in moisture
  
• Avoid extremely hot showers and baths (dries skin faster)
• Oatmeal, itself, or Oatmeal-based soaps (such as Aveeno) are gentle
  

REACTION

to decrease the effect of flare-ups, once they have occurred...

• Monitor your diet: Caffeine increases breakouts that already begun
  
• Monitor your diet: Citrus often increases breakouts that have already begun
  
• Monitor your diet: Soy may increase breakouts that have already begun
  
• During bathing, cloths may irritate skin
  
• After bathing, do not towel dry
  
• After bathing, apply Olive Oil, Baby Oil Gel or Cream while still wet
  
• Prescriptions: An antibiotic may stop reaction. Reactions are often perpetuated by an infection
  
• Prescriptions: Hydrocortisone may decrease flare-up
  
• Prescriptions: Protopic (non-steroid) is better on the face
  
• Prescriptions: Triamcinalone will decrease flare up, if Hydrocortisone no longer works. Please note: Use of Triamcinalone WILL make your skin thinner. Your skin will tear and bleed much easier than it did prior to use.
  
• Prescriptions: Predisone (oral or injection) will decrease flare up, but may have long term effects on internal organs. Please ask your doctor about all long term side-effects before using the medication.
  

What Flare ups look like, on Black skin: (Face, Arm & Neck, shown below)