Eczema Resources for Doctors & HCPs
Eczema (also known as atopic dermatitis) can look different in people with skin of color. This can lead to misdiagnosis, under-diagnosis and/or delayed treatment. Healthcare professionals who understand the unique symptoms and cultural factors for eczema in darker skin can greatly improve patient outcomes.
In darker skin tones, eczema patches may look darker, purple, or gray instead of the usual red. Patients may also be more likely to get dark spots or scars after the eczema heals, which can affect their mental health. Knowing these differences is important in providing the right care. It is also key in teaching patients how to manage their condition.
Below are resources and information to help doctors, nurses and healthcare professionals further their understanding of eczema in skin of color. In addition, there are handouts that can be shared with patients in the clinic.
Clinical Care for Eczema Patients of Color
For effective treatment of atopic dermatitis in skin of color, it’s important to understand how it can look different. It’s also important to apply treatments and management strategies that fit each person’s needs. For visual examples of this skin condition, please visit our Image Library.
Providers should consider the following when treating patients with darker skin tones:
Treatment options
Use creams and ointments that work well for the person’s skin type and help prevent dark spots from forming after the eczema heals. In some cases, non-steroid creams, like calcineurin inhibitors, are a better choice for areas where the skin is thin or could scar easily.
Biologics are highly effective for severe cases. However, these can be expensive and not always easy to get, especially for people on a low income. Doctors should work to make sure everyone has a fair chance to access these treatments.
Patient management
Check in with patients regularly to see how the treatment is working and adjust as needed. Engage in culturally respectful, patient-centered communication. Consider language or other unique barriers that might make it harder for patients to get care. Treatment should focus on calming the eczema and also helping with things like dark spots or scars left behind.
How do social and economic factors affect eczema in skin of color?
When treating eczema in skin of color, recognize the broader social and economic context. Factors such as income, insurance coverage, cultural stigma, and health literacy can influence patients. These can impact access to care, treatment follow-through, and the ability to maintain optimal skin health.
Consider these factors when evaluating patients:
Access & Insurance
- Limited coverage. Limited or no insurance coverage, high co-pays, and restricted provider networks can deter patients from seeking timely care or refilling prescriptions.
- Telehealth as a solution. Online doctor visits (via telehealth) can help people who live far away from clinics or have travel challenges. It also helps them see specialists faster and stay on track with their care.
Location & Environment
- Where people live. It’s harder for people in rural areas to find eczema specialists compared to people living in cities. This can affect the ability to attend appointments. It also impacts overall quality of care.
- Transportation barriers. Limited access to reliable transportation, such as not owning a car, lacking public transit, or needing to travel long distances, can make it difficult to attend appointments, pick up prescriptions, or receive specialty care.
- Environmental triggers. Housing conditions or neighborhood environments may expose people to allergens. Living in places with a lot of pollution, dust, mold, or cockroaches can make eczema worse. Exposure to certain fabrics can cause contact dermatitis.
- Food deserts. Some people don’t have grocery stores nearby or can’t afford special foods. This can be a problem if certain foods trigger their eczema.
Socioeconomic & Financial Barriers
- Affording care. Some people with eczema cannot afford to see a specialist or buy products for their skin.
- Workplace exposures. Many service and manual labor jobs like cleaning services, construction, food service or hair salons may involve daily triggers. These can include harsh chemicals, dust or frequent handwashing, which can worsen eczema symptoms.
- Cost of treatments. For uninsured or underinsured people, even basic creams and ointments can be too expensive.
Culture, Diversity & Language
- Representation in healthcare. Patients feel more comfortable and understood when their doctors reflect their background or culture.
- Understanding skin differences. Eczema can present differently in darker skin tones. But not all providers are trained to recognize these nuances.
- Language barriers. Without a shared language, an eczema care plan can be misunderstood. This can result in a one-size-fits-all treatment that does not address individual needs.
- Stigma and mistrust. Historical and ongoing disparities in care have led to mistrust in some communities. This can discourage timely care or participation in research.
Psychosocial Well-Being & Mental Health
- Impact of stigma. Social isolation might make some people with eczema feel embarrassed or left out. This can cause depression, anxiety, and stress.
- Emotional burden. Chronic eczema can take a significant emotional toll on patients. This is especially true if patients have limited access to mental health care and counseling services.
- Mental Health Support. Adding counseling or support groups to eczema care can help a patient’s overall well-being.
Health Literacy & Education
- Understanding care plans. Complex medical terms or unclear instructions can confuse some patients about how to care for their skin.
- Health-literate resources for patients. Providing materials to patients at easy-to-understand literacy levels can make treatment easier to follow. It’s also important to offer resources in multiple languages.
- Provider knowledge of eczema in skin of color. Access to image libraries, along with an understanding of how eczema can present on various skin tones, is crucial for speeding up diagnosis and treatment.
How can doctors and nurses make a difference?
- Help patients get affordable care.
- Offer low-cost treatment options.
- Create or distribute educational materials that are clear, simple, and culturally respectful.
By addressing these challenges, we can improve eczema treatment success rates.
Helpful Resources for Patients
Patients and caregivers may need eczema information to review at home. The resources that doctors provide should be clear, evidence-based and patient-friendly. They should help people better understand what their doctor has told them and involve actionable steps.
Share this website – EczemaInSkinofColor.org – with your patients. Other helpful websites include:
- Allergy & Asthma Network provides medically reviewed, practical articles, videos, webinars and podcasts on eczema. It’s like an “Eczema 101” guide for patients.
- American College of Allergy, Asthma & Immunology (ACAAI) provides an overview of eczema, from diagnosis to treatment. Also available in Spanish.
- The National Eczema Association is another helpful resource for patients.
- The Health Equity in Allergies, Asthma and Immunology webpage outlines health equity by addressing the socioeconomic and systemic factors that drive disparities across diverse populations.
- How Social Determinants of Health Impact Asthma and Eczema Care is a summary of the key findings of the Impact of Social Determinants on the Burden of Asthma and Eczema study from Spring 2020.
- Controlling Your Atopic Dermatitis Tool for Patients – A questionnaire from ACAAI for patients to help initiate shared decision-making for treatment options.
- Webinar: Atopic Dermatitis in Skin of Color
- Eczema Videos and Podcast Series for Patients
- Video about how insurance rejections affect patients
Publications Addressing Atopic Dermatitis in Skin of Color
Below you’ll find a collection of research articles, studies and other publications. These focus on eczema in skin of color. This collection of works aims to:
- Provide clinical insights for recognizing, managing, and preventing eczema flare-ups in diverse communities.
- Highlight evidence-based strategies for accurate diagnosis and effective treatment.
- Explore disparities in access to care and treatment outcomes in skin disease.
