If you’ve come across images of eczema, they likely feature people with lighter skin tones. However, eczema can affect people of all skin colors and is actually more common in African Americans compared to other racial and ethnic groups, according to the National Eczema Association. Eczema, including facial eczema, can look different and cause distinct symptoms on darker skin tones, such as brown or black skin, which may belong to individuals of various ethnicities, including those of African, Latino, Asian, or Middle Eastern descent.

Members of MyEczemaTeam, the online support network for people with eczema, have discussed differences in their symptoms. “For the African American race, our flares are darker skin reactions or patches,” said one member. “Most doctors are looking for red skin. … I had two or three shades of skin — dark, darker, and some light spots.”

These differences in how facial eczema presents on darker skin can sometimes make it more challenging to receive an accurate diagnosis and proper eczema treatment plan. If you think you might have eczema, it’s essential to seek out a health care provider or dermatologist who is attentive to your concerns and familiar with treating diverse skin tones.

Read on to learn what a facial eczema rash on darker skin looks like and to see pictures of facial eczema on darker skin.

What Does Facial Eczema Look Like on Darker Skin?

Historically, eczema has often been described based on how it appears on lighter skin tones, with terms like “red, itchy, dry skin” being commonly used. However, eczema can look quite different on darker skin tones, such as brown or black skin. These differences can affect how eczema is diagnosed and treated, particularly when health care providers are unfamiliar with its appearance on darker skin.

Differences in Erythema

Erythema, a common symptom of eczema, is usually defined as “reddening of the skin.” However, on darker skin tones, erythema may not appear as bright red as it does on lighter skin. The higher melanin concentration in darker skin can make erythema appear as reddish-brown, purple, grayish, or ashen. For facial eczema, this may result in patches of darker brown, purplish, or gray skin on areas of the face.

Increased Dryness and Itchiness

As compared to lighter skin, darker skin with eczema may be more prone to itching or dryness. A 2024 study found that people with black skin living with eczema had more dry skin and more frequent and severe itchiness. According to the National Eczema Association, Black Americans with eczema may have “more extensive skin dryness” and are more likely to have severe eczema. Itchiness can have a significant impact on daily life, as excessive scratching or rubbing can lead to lichenification (skin thickening). On darker skin, this thickened skin may look different than it does on lighter tones, often becoming darker and rougher in texture.

More Bumps or Nodules

Some studies suggest that people with darker skin tones may be more prone to developing papules (small raised bumps) or inflammation-induced nodules (larger, deeper bumps) during eczema flare-ups. According to the National Eczema Association, Black Americans are more likely to develop papular eczema, which causes small, raised bumps, often on the stomach, legs, and arms.

Increased and Long-Lasting Discoloration

After an eczema flare-up, people with darker skin tones are more likely to experience skin discoloration, where affected areas become darker (hyperpigmentation) or lighter (hypopigmentation) than the surrounding skin. These changes in skin color can last longer in people with darker skin, sometimes making it difficult to conceal the signs of eczema, even after the flare-up has subsided.

The symptoms discussed here are just some of the ways facial eczema may present differently on brown or black skin compared to lighter skin. If you have any signs or symptoms of eczema on your face or anywhere else on your body, talk to a health care provider or dermatologist so you can get an accurate diagnosis and treatment plan.

How To Treat Facial Eczema on Darker Skin

Facial eczema is mostly treated the same way regardless of skin tone, and facial eczema treatment is similar to treatment for eczema on other parts of the body. However, the skin on certain areas of the face, such as around the eyes, may be more sensitive. It’s important to consult a health care provider before applying treatments to these delicate areas.

A combination of methods may be used to manage facial eczema, including:

• Applying hydrating moisturizers
• Identifying and avoiding any eczema triggers
• Using prescription medications

Following a gentle daily skin care routine is essential for treating skin affected by eczema.

Find a Good Moisturizer

Finding a good moisturizer is important for restoring hydration and helping skin heal from eczema. This may be particularly important for individuals with darker skin tones, as they are more prone to dryness and itchiness. Opting for dye-free, fragrance-free makeup and other skin care products is also important to avoid irritating eczema on the face.

If you’re not sure where to start, the National Eczema Association offers a directory of products that meet their standards for being safe for skin with eczema. Sometimes, members of MyEczemaTeam share what’s worked for their facial eczema. One member said, “I get my facial products from the National Eczema Association. I have had very good results with Vichy for face and Vanicream face wash and body lotion.”

Creams and ointments tend to be more hydrating than lotions. Shea butter may also be a good option for a moisturizer. People with eczema should limit showers to 10 minutes and wash their face in cool (not hot) water. Hot water can further dry out the skin and worsen eczema symptoms.

Avoid Triggers

Avoiding triggers can help prevent eczema flare-ups. Common eczema triggers include:

• Allergens like pet dander or dust
• Some laundry detergents and soaps
• Smoke
• Stress
• Changes in the weather, like low humidity and increased dryness
• Some makeup and skin care products

If you’re not sure what triggers your eczema, talk to your health care provider. They can help you determine if there’s anything specific triggering your eczema. You might not be able to discover or avoid all of your triggers, so this is just one aspect of managing your eczema.

Try Medications for Flare-Ups

Medical treatments similar for eczema work equally well on lighter and darker skin. Topical treatments may include:

• Topical corticosteroids
• Nonsteroidal creams like crisaborole (Eucrisa), pimecrolimus (Elidel), and tacrolimus (Protopic)

If your facial eczema is severe and topical treatments don’t work, your health care provider may prescribe systemic medications that target the immune system. These can be taken orally (by mouth) or by injection, and studies have shown that they are equally effective across people of different races, ethnic backgrounds, and skin tones.

Another treatment option is phototherapy (light therapy). Because darker skin contains more natural melanin, which acts as a light filter, people with darker skin may require longer or more intense phototherapy sessions. However, there are no specific phototherapy guidelines based solely on skin color or race.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 53,000 people come together to ask questions, give advice, and share their stories about living with eczema.

How do dryness, itchiness, and other symptoms of eczema flares affect the skin on your face? Have you found any prescription or over-the-counter treatments that work well with your skin tone? Share your experience in the comments below, or start a conversation by posting on your Activities page.