(BPT) - When most people think of eczema, they picture a dry, red, inflamed and itchy rash. But on darker skin tones, eczema can look very different, sometimes appearing purple, gray or dark brown. These differences can lead to a missed diagnosis and delayed treatment.

This not only worsens the symptoms of this common skin condition, but it can also increase the chances of developing additional allergic conditions. Delaying treatment for eczema can take a toll on mental health as well, causing frustration, anxiety, stigma and emotional stress.

With greater awareness and culturally informed care, eczema patients can find relief - for their body, mind and spirit.

Allergy & Asthma Network and the American College of Allergy, Asthma & Immunology (ACAAI) created the website EczemaInSkinofColor.org to help patients and healthcare providers better identify eczema symptoms on skin of color.

What are the unique signs and symptoms of eczema in skin of color?

Eczema (also referred to as atopic dermatitis) affects people of every race and ethnicity. However, research shows that people with skin of color - especially children - are at higher risk of developing eczema and often experience more severe symptoms.

Eczema on black and brown skin often doesn't appear as the typical red rash seen on lighter skin tones. Instead, it might look purplish, ashen gray or darker than the surrounding skin. As a result, many patients and healthcare providers may not identify the skin condition as eczema. They may diagnose it as something else or dismiss it as "just a rash."

Without proper treatment, eczema can cause patches of lighter or darker skin in people with skin of color. (This is known as post-inflammatory hyperpigmentation or hypopigmentation.) It may also cause the skin to thicken over time. These visible changes can be especially distressing for people of color.

How does eczema affect mental health in people with skin of color?

If eczema makes you feel self-conscious, anxious or depressed, you're not alone. The visible nature of the condition, along with the itching, discomfort and social stigma, can lead to feelings of embarrassment or isolation. Over time, this emotional strain can worsen depression, anxiety and stress.

Research presented at the ACAAI annual meeting in 2023 found that 72% of people with eczema reported they had poor mental health for 1-10 days of the previous month. Another study published in the May 2025 issue of Annals of Allergy, Asthma & Immunology found that adults with eczema are two to three times more likely to have depression and anxiety. Yet these mental health needs too often go unaddressed.

For people of color, the emotional burden of living with eczema can be even greater. Barriers such as limited access to affordable or culturally competent healthcare, greater exposure to environmental triggers, and social and economic factors make it harder for many to get effective treatment. These challenges can lead to worse mental health outcomes.

A lack of representation in healthcare, historical and ongoing mistrust of care, and limited medical training on how eczema appears on darker skin tones all contribute to delayed eczema and mental health treatment.

Addressing eczema in skin of color means not only treating the skin but also supporting the whole person.

How can I find support for mental health?

Many resources are available to help you recognize symptoms, access treatment and find support for the emotional challenges that often accompany eczema. When you visit your healthcare provider - ideally an eczema specialist such as an allergist - ask for a referral to a mental health specialist. Addressing both your skin and emotional well-being is an important part of managing eczema and improving your quality of life.

The EczemaInSkinofColor.org website is a comprehensive educational guide with advice on how to talk with your healthcare provider about stress, self-esteem, anxiety and depression related to your skin condition. It includes helpful tips for parents and caregivers of children with eczema, such as creating an "eczema kit" with creams, moisturizers and wipes to bring to school or activities.

You don't have to manage the physical and mental burden of eczema alone. To learn more about how eczema presents on skin of color and find more resources for care and support, visit EczemaInSkinofColor.org.