Eczema Across Skin Colours

Our skin has a natural beauty which transcends colour, a logical, evolutionary development across our planet.

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The perception of what is attractive can be societal and influence misconceptions about our skin. In a similar way, the type of skin conditions people often believe are prevalent does not match medical information.

Surveys reflect an incorrect view that eczema, or dermatitis are more common on fair skin, because of the way they are often illustrated. A belief that living in western countries adds to the condition doesn’t hold up either.

Research Across Borders

A 7 year study of a teledermatology project covering 12 African countries brought a few surprises. As a passing point, 5% of all diagnoses in under 18s were for melanoma, not to be ignored but the leading issue was atopic dermatitis.

This is one of one of the most common inflammatory skin diseases in Sub Saharan Africa. Not caused by living elsewhere and as with other research, a clear indication that dark skin brings no immunity.

Similar emerged from a South Asian study of 93,000 patients. Out of 72,000 confirmed diagnoses, eczema made up over 30%, well above the combined 20% of bacterial, viral, or fungal infections which are perceived as the prime issue.

Where causes of contact dermatitis have been identified and compared across nations, much the same soaps, detergents, or chemicals have been identified in Asia, Africa, or a range of western countries.

Genetic Influence

Whilst the causes of eczema are not fully understood, the root is in our immune system, an over reaction. There are subtle differences in immune systems across populations but no clear evidence they are significant in this case.

Some research has suggested that darker skin is linked to a stronger immune response to certain skin conditions, although that may not be an advantage for eczema, which is in a sense an immune reaction.

The evolutionary rationale for darker skin is primarily UV protection and thermal regulation. Data on eczema, or dermatitis rates in individual countries does not suggest the colour of a person’s skin makes too much difference.

Diagnosis & Treatment

Eczema can appear different on varying skin colours and experience of this matters for accurate diagnosis. Treatment may need to vary slightly, not least when considering longer term pigmentation issues.

The core approach to eczema, or dermatitis treatment will still apply for all patients. Testing, identifying triggers, understanding your personal and familial history, options for medication, perhaps phototherapy.

The key point is that caring for eczema type conditions is a significant and quite normal part of dermatology for darker skin. Our consultants will be pleased to help, you are welcome to contact us at any time.