Tag: eczema

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How Eczema Looks on Asian Skin: Signs and Treatment Options

Eczema, also known as atopic dermatitis, is one of the most common chronic skin conditions out there. But it doesn’t look the same on everyone. Most of the material out there, like medical textbooks and images, tends to primarily show eczema on lighter skin. This is a huge problem. This lack of representation creates a gap when we are identifying and treating eczema in individuals with darker skin tones. It can be especially hard when trying to identify eczema on those with Asian skin because the inflammation may present as discoloration. Not to mention, eczema is also very common among Asians and Pacific Islanders! In this article, we will explore how eczema looks on Asian skin and its importance to adequately represent all skin tones in dermatology.

So, first things first—what exactly is eczema?

It’s a long-term condition that causes itching, dryness, redness, and rashes. Basically, it happens when the barrier of the skin – the outer layer that helps to keep moisture in and irritants out – is simply not operating properly. Countless factors can play a role in this. These include genetics, a bad immune system, environment (the weather), and stress. In turn, this causes the skin to be susceptible to allergens, microbes, and irritants that induce inflammation. Eczema is not at all contagious, but is often a lifelong condition that tends to flare up in cycles.

Eczema on different skin tones

Inflammation can look quite different depending on your skin type. On light skin, redness can show up bright and obvious; on dark skin, instead, it will look more purple, brown, or gray. Other symptoms — e.g., swelling, dryness, or thickened skin — can potentially be easier to detect than colour changes. So if you think you might have eczema, try looking more into the texture of your symptoms rather than the color. In fact, most clinical images and training focus on lighter skin, so subtle signs of eczema in darker skin, especially early on, can be overlooked.

How might eczema look on Asian skin specifically?

Asian skin has characteristics of both lighter and darker skin, but is also its own unique variation. With flare-ups, redness may appear dusky, violet, or reddish-brown instead of the typical bright red that may usually be seen. With a chronic history of eczema, patients may have thickened, leathery patches angled with skin lines that are more pronounced. The most common change, however, is pigmentation—patches that become darker or lighter and can linger for months. Follicular eczema is also common, that is, itchy small bumps around hair follicles, most often on the arms and torso. Finally, stronger topical steroids or skin-lightening creams may worsen symptoms or mask them, making diagnosis more difficult.

Treatment options for eczema on Asian Skin
To manage eczema on Asian skin, your goal would be to both treat the rash as well as the color changes it can leave behind. Moisturizers and gentle skin care are the first steps, while prescription creams like steroids or non-steroid anti-inflammatory creams can be used to help calm flare-ups. Since Asian skin is more likely to develop dark or light spots after eczema, it’s important to avoid overusing strong steroids or skin-lightening products, which can make things worse. If you’re unsure, a dermatologist who understands different skin tones can help you find the safest treatment plan.

Takeaway

Overall, it is very, very important to identify eczema early on Asian skin. Don’t just be misled by redness. Be sure to consider texture and swelling, and a subtle color change (but again, color changes can be misleading due to differences in melanin!). If you suspect that you have eczema, consult a dermatologist who sees patients across all skin tones. Also, when you make your appointment, be sure to discuss the treatment options that will address both inflammation and pigmentation changes. The more we understand about the way eczema presents across all skin tones, the faster we can help close the gap in dermatologic care and provide a proper treatment that everyone requires and deserves.

References

National Eczema Society. “Skin Pigmentation and Eczema.” National Eczema Society, eczema.org/information-and-advice/living-with-eczema/skin-pigmentation/. Accessed 15 Aug. 2025.

Ruwa, Rashida. “Eczema in Asian Skin: What You Need to Know.” Healthline, 1 Oct. 2024, www.healthline.com/health/eczema-in-asian-skin. Accessed 15 Aug. 2025.

Zhang, J., et al. “Epidemiology and Characterization of Atopic Dermatitis in East Asian Populations: A Systematic Review.” PubMed Central, pmc.ncbi.nlm.nih.gov/articles/PMC8163933/. Accessed 15 Aug. 2025.

Sutter Health. “Atopic Dermatitis (Eczema).” Sutter Health, www.sutterhealth.org/health/atopic-dermatitis-eczema. Accessed 15 Aug. 2025.

WebMD. “Eczema Epidemiology.” WebMD, www.webmd.com/skin-problems-and-treatments/eczema/eczema-epidemiology. Accessed 15 Aug. 2025.

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What Happens During an Eczema Flare-Up? A Scientific Breakdown


Eczema Symptoms | Clovis Dermatology

What is eczema?
Eczema is a common skin condition characterized by inflamed, itchy patches of dry and scaly skin. This chronic condition affects roughly 10% of the US population. These patches result from a combination of environmental triggers and immune system reactions, often with a genetic predisposition. There are several types of eczema, including atopic dermatitis—the most common type—and contact dermatitis, among others. The key difference between atopic dermatitis and contact dermatitis comes down to the underlying cause and immune response. Atopic dermatitis is a chronic condition that can be triggered by both external factors and internal influences, such as stress, but is ultimately caused by genetic and immune system factors. In contrast, contact dermatitis is an acute condition that is directly caused by irritants like soaps or chemicals and can easily be prevented by avoiding said irritants.

Who suffers from atopic dermatitis?
The integration of genetic mutations and a hyperactive immune response in individuals with atopic dermatitis leads to persistent eczema flare-ups. In particular, these individuals have a loss-of-function genetic mutation in their filaggrin gene—one of 70 genes comprising the Epidermal Differentiation Complex—which is crucial for maintaining the epidermis and protecting it from allergens and irritants. This genetic mutation causes the affected individual to produce less filaggrin protein, ultimately resulting in a compromised skin barrier and increased susceptibility to environmental triggers. This single filaggrin defect leads to a cascade of dysfunctions in the body, including reduced natural moisturizing factor levels and a hyperactive immune system.

Filaggrin and eczema – Nursem Skincare
(https://www.nursem.co.uk/pages/filaggrin-and-eczema)

What happens during a flare-up?
An atopic dermatitis flare-up is a multi-step process that begins with a trigger—environmental factors, irritants, allergens, etc. Because the skin barrier of these individuals is compromised and more susceptible to infiltration, allergens and irritants can penetrate more easily. Once the trigger reaches the compromised skin barrier, antigen-presenting cells capture the trigger and carry it over to the local lymph nodes. Lymph nodes are organs that house various immune cells that help coordinate the immune response. T cells – a key type of immune cell – activate and then identify the trigger to initiate the release of cytokines—signaling proteins that—when overproduced—are primarily responsible for the redness and inflammation associated with atopic dermatitis.

How do topical medications alleviate flare-ups?

The complex combination of genetics, environmental triggers, and the immune system makes eczema uncurable, although its symptoms can be mitigated. Topical steroids and inhibitors are commonly used to manage inflammation in conditions like atopic dermatitis. Topical steroids are applied directly to the skin, where they enter cells and bind to receptors in the cytoplasm. This binding triggers the formation of a steroid-receptor complex, which then migrates to the nucleus. In the nucleus, the complex binds to and modifies specific DNA sequences, including the one to reduce the production of inflammatory cytokines. This process helps alleviate redness, swelling, and other symptoms of inflammation.
On the other hand, topical inhibitors reduce inflammation by binding to a protein in T cells, creating a complex that inhibits calcineurin, an enzyme responsible for promoting cytokine transcription and T cell activation. Although these topical treatments yield similar results, their function is very different, so prescription of either should be done by a healthcare professional.

Bibliography

National Center for Biotechnology Information. “Chemical Bonding and Molecular Structure.” NCBI Bookshelf, 2019, https://www.ncbi.nlm.nih.gov/books/NBK538209/.

Wang, Y., et al. “Molecular Insights into Chemical Interactions.” PLOS Computational Biology, vol. 17, no. 2, 2021, e1008623. https://pmc.ncbi.nlm.nih.gov/articles/PMC7880084/.

“—.” American Cancer Society, www.cancer.org/cancer/diagnosis-staging/lymph-nodes-and-cancer.html#:~:text=Lymph%20vessels%20send%20lymph%20fluid,filter%20fluid%20in%20those%20areas.

National Eczema Association. “Eczema Topical Treatments | National Eczema Association.” National Eczema Association, 4 Mar. 2022, nationaleczema.org/eczema/treatment/topicals.