Black Parents’ Guide to Recognizing and Treating Eczema in Babies

Eczema on Black babies may look different than on babies of other races. Where it shows up on their body may depend on their age. You may also need to check with a doctor before using certain treatments.

Eczema, aka atopic dermatitis, is a skin condition that affects roughly 10% of people in their lifetime, according to the National Eczema Association. Most cases develop in childhood.

Generally, eczema causes dry, itchy, or scaly skin. Medical resources often refer to the lesions that appear on the skin from eczema as being “red or pink.” While this may be true of eczema that appears on lighter skin, eczema lesions can look quite different on skin of color, especially on babies and children with darker skin.

Not only can eczema lesions appear darker in people with darker skin tones, but eczema itself can cause different symptoms in People of Color.

Ahead, we’ll explore everything you need to know as a Black parent about eczema in babies with darker skin, including how to recognize and treat eczema in children.

Many of the telltale symptoms of eczema can appear in all skin types. These may include:

• swollen or warm patches of skin
• dry, scaly, itchy skin that oozes
• thick, leathery patches of skin (known as lichenification)

But in babies with darker skin, the affected skin may appear gray, dark brown, or purple rather than red or pink.

Because eczema appears to affect People of Color differently, you might also notice the following symptoms in your child:

• small bumps on the torso or limbs, known as papular eczema
• small bumps on the hair follicles due to follicular eczema
• hypopigmentation or hyperpigmentation of the skin

Age can also influence how eczema affects your skin. Symptoms may be different depending on the age of your child.

0 to 6 months

In young babies, eczema usually affects the face, including the:

Eczema commonly causes infants’ skin to “weep.”

6 to 12 months

In older babies, eczema is common on the elbows and knees often due to irritation from crawling. A yellow crust or bumps that ooze pus may indicate an infection.

Is darker skin more prone to eczema?

Although eczema affects people of every race and ethnicity, the condition appears to be more common in Black people.

According to the National Eczema Association, research has found that Black children have the highest rate of atopic dermatitis. The condition affects roughly 19.3% of Black children versus only 16.1% of white children. Black children may also be 70% more likely to develop atopic dermatitis than white children.

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If you’ve noticed that your baby is showing any of the symptoms of eczema, such as irritated, scaly, or discolored skin, reach out to your child’s pediatrician. They can determine if your child has eczema and refer you to a dermatologist for specialist care if needed.

It’s also important to remember that young children aren’t always able to express when they’re in pain or discomfort.

If your baby is exhibiting any symptoms of discomfort or pain, like crying, wincing, agitation, or even trouble sleeping, reach out to a doctor as soon as possible, even if there are no other visible symptoms.

How to find a culturally competent dermatologist

Culturally competent medical care happens when healthcare professionals provide equally effective care to all patients while being aware of, and respecting, cultural differences such as language, communication, or beliefs.

As the parent of a Black child, it’s essential to have a doctor who’s aware of how eczema affects People of Color, especially children.

If you’re interested in finding a culturally competent dermatologist who specializes in treating People of Color, check out the Black Derm Directory and Skin of Color Society provider databases for specialists near you.

There’s no cure for eczema, but treatment can help reduce symptoms and decrease the likelihood of a flare-up. And while there are differences in how eczema can affect babies with darker skin, treatment is similar for people of different skin colors.

Lifestyle changes

Some lifestyle changes can help reduce your baby’s symptoms and skin irritation. Consider the following:

• Bathe your baby in lukewarm water for 5 to 10 minutes. You can bathe your child daily if you limit baths to 10 minutes. But you usually don’t need to bathe them daily unless they are heavily soiled.
• Moisturize your baby’s skin with thick creams and ointments twice a day, including immediately after bathing.
• Use only gentle fragrance-free cleansers, soaps, and laundry detergents.
• Ensure your baby’s diet doesn’t include foods that can trigger a flare-up.
• Protect your baby’s skin in harsh weather, especially cold, dry winter air.
• Understand and avoid your baby’s eczema flare-up triggers.

Medications

Some over-the-counter (OTC) creams may help ease symptoms. OTC creams often contain either hydrocortisone or colloidal oatmeal. Be sure to check with a doctor before using any cream with hydrocortisone.

In some cases, your baby may require stronger prescription medication. Always be sure to administer the treatment as prescribed. Keep a close eye on any symptoms or side effects to let your baby’s doctor know.

Be sure to keep all medications out of the reach of your child.

Lifestyle changes and medications can help reduce your child’s symptoms and allow their skin to heal. But even with the proper treatment, flare-ups can occur after exposure to certain triggers.

Some of the most common triggers for eczema include:

• dry or irritated skin
• harsh weather
• certain skin products
• food sensitivities
• certain fabrics (especially if washed in harsh detergents)

According to the American Academy of Dermatology Association, other common triggers to look out for in babies include saliva and sweat on the skin.

Does eczema run in families?

Research suggests that certain genes — such as those linked to immunity and the health of the skin barrier — may increase your risk of developing eczema. Because of these potential genetic risk factors, it’s no surprise that children who have a parent with eczema are two to three times more likely to develop the condition.

But newer research also shows that environmental, socioeconomic, and healthcare factors can affect eczema risk.

Living in neighborhoods with high pollution levels and not having access to adequate healthcare services — both of which disproportionately affect BIPOC (Black, Indigenous, and People of Color) communities — may increase your risk of developing eczema.