- Eczema can be tricky to diagnose and complicated to treat, with a profound impact on quality of life.
- Advocates stress the importance of building a good care team and learning your triggers.
- Close relationships and community support can help you manage the stress of eczema.
When Clarissa Lee Fisher was diagnosed with eczema as a child, her parents and doctor agreed that lactose intolerance was probably the root cause.
“I held on to that all of my life until 3 years ago when I got a very serious flare-up, and then I thought, this isn’t just dairy products, this is something else,” Fisher tells Healthline of digging deeper into her condition.
Likewise, after a childhood diagnosis of eczema, Joshua Jung simply carried on with what he understood to be essentially “a skin issue” — one that was never fully understood or managed.
“It was definitely a long time before I grasped what was fundamentally a medical condition,” he recalls to Healthline.
Itchy, dry, irritated skin is common, but for the more than 31 million Americans with eczema, it’s a painful chronic condition that can be difficult to diagnose and treat, especially among People of Color. Atopic dermatitis, the most common form of eczema, impacts 16.5 million.
Disparities in diagnosis exist in part because the inflammatory disease, which may cause scaly patches, blisters, and skin infections, looks different on darker skin — appearing brown, gray or purple versus red or pink on lighter skin.
And doctors may not be aware of this difference due to the underrepresentation of darker skin tones in medical textbooks. Researchers who looked at over 4,000 images in medical textbooks revealed that
“You can go undiagnosed because they don’t see the blotches or patches,” says Cynthea Corfah, a New Orleans-based journalist and activist who’s had eczema since childhood. A dermatologist who was unfamiliar with her case once dismissed her with, “You look pretty fine today.”
But at the time, because of hyperpigmentation caused by eczema, her fingertips and nose were the only parts of her body that hadn’t changed color.
Corfah recently joined a Healthline roundtable of people living with eczema. The panel discussed difficulties in getting diagnosed, treated, and identifying triggers, and the importance of getting the support and encouragement you need.
A knowledge gap persists among doctors even as People of Color face higher risks of eczema, which typically begins in childhood.
A research review found that
Though no one knows the exact cause of eczema, it’s been linked to genetic mutations that impact skin barrier cells and skin immune cells. These mutations are more likely to occur in certain ethnic groups.
La Carmina, a travel and culture journalist from Vancouver, Canada, says that many aunts and nieces on her mother’s side have eczema. “We’d talk about it and share notes about how to treat it,” she says.
As a kid, her eczema was mild. In the last couple of years, it has been harder to treat, and the triggers difficult to pin down. “Is it diet? Lifestyle? Stress?” she asks. “It keeps changing for me.”
Stress can heighten the risk and severity of the disease, as can environmental factors.
There’s no known cure for eczema. Treatment may involve:
- topical remedies
- prescription medication (including steroids)
- lifestyle changes
- avoiding triggers
Everyone’s eczema is different, so there is no one-size-fits-all treatment.
“I’d go to different doctors, and they’d each tell me something different.” — Clarissa Lee Fisher
For Rakhi Roy, MS, RD, an actress-turned-registered-dietitian in Florida who developed eczema at 6 months old, foods are a trigger.
“Doctors told me diet would never do anything for my eczema,” Roy says. But she saw a dietitian for her food allergies. She’s allergic to peas, peanuts, and other legumes, and once she cut them out, her skin did improve.
At her lowest point, the pain was so bad that she was “wearing gloves everywhere — I couldn’t drive or hold a steering wheel, it hurt so bad.”
Roy recommends seeing an allergist for testing. Oral food challenges are the “
- allergens like dust mites and pet hair
- hot showers
- food hypersensitivities
- synthetic fabrics
Joshua Jung, a writer in Montreal, Quebec, has what’s known as the “atopic triad” — eczema, allergy (to nuts), and asthma. He’d tried topical steroids to treat his eczema, but “the withdrawal was a lot worse than my flare-ups,” he says, so he went off steroids and began to focus on triggers. Extreme heat and extreme cold turned out to be key.
Trained in exercise science and kinesiology, Jung ended up leaving the “hot, sweaty” rehabilitation clinic to work from home, where he can better control some of his triggers. But because he lives in Montreal, extreme cold is part and parcel of his year.
Fisher brings her own bedsheets with her when she travels so she can avoid exposure to fragrances and detergents in hotel bedding that might cause a flare. Finding a treatment plan was challenging for Fisher, who grew up thinking her skin issues were from lactose intolerance until a serious flare-up in her twenties sent her looking for answers.
“I’d go to different doctors, and they’d each tell me something different,” she says, including that she was sensitive to soaps, shampoos, cats, pollens, and trees. “Now I pay attention to what affects me the most. I’m listening to my own body.”
“I call myself the bubble girl sometimes because it’s like, what am I not allergic to?” — Cynthea Corfah
Corfah shares this approach. “I feel like I’m the best eczema expert on my own skin,” she says. Though she’s tried light treatment and topical steroids, now she’s focused on tracking her triggers, including allergies to cats, dogs, trees and latex, and a sensitivity to heat.
She avoids nail polish and hair spray, and her partner washes the dishes at home. “I call myself the bubble girl sometimes because it’s like, what am I not allergic to?” she says.
Efforts to reduce exposure to triggers can come with a cost, Corfah says. As an event planner and journalist, her decisions around which jobs to take are affected by her eczema. “Do I really want to cover a wine festival if I’m going to be suffering for it the next day?”
“I can’t find what triggers me,” La Carmina says. Her skin is reactive. “If I get cuts or mosquito bites, my skin goes crazy,” she says. So she avoids chemical-laden cleaning products and takes care to not over-wash or stress her skin.
Often, managing eczema means building in time to tend to the tasks that keep skin calm.
When her eczema was at its worst, Roy says that it would take anywhere from 1 to 2 hours to get out the door in the morning. Fisher sometimes has difficulty just getting out of bed when her skin is extremely dry.
Corfah finds that baths pulled with Epsom salts, tea tree oil, and
“I can’t even put makeup on my skin until I treat it first, so, yeah, it’s time-consuming,” she says. “There are more things to do in the morning if you’re in the middle of a flare-up, or even if just you’re trying to maintain where your skin is at right now,” agrees Jung, who tries to take the time to moisturize after a shower.
“You can’t just get up and go, like you see in the movies. There’s extra skin care steps that you need to integrate into your morning and evening,” he says.
On the plus side, you come out of it as a de facto expert, says La Carmina. “I’m the skin care go-to for all my friends, just because I’ve tried so many moisturizers and I do a lot of research into skin care.”
Understanding and supportive friends and family can go a long way toward making life with eczema more comfortable.
Jung’s partner is supportive of his eczema journey, but it hasn’t always been easy, especially as a man. “It’s just not something you can share with other guys because we have a tendency to minimize struggle,” he says.
“I never had support outside of my family where people took time to understand what I was going through. It was just like, ‘OK, you have bad skin, get over it,’ and I think that’s a universal experience among a lot of guys with eczema.”
While some adults with eczema may find dating challenging, our roundtable participants cited their partners as pillars of support. Corfah notes that she met her partner “while at [her] ugliest.” She added that “you have to surround yourself with genuine people who are able to see past your skin condition and love you through the worst parts.”
“It was just like, ‘OK, you have bad skin, get over it,’ and I think that’s a universal experience among a lot of guys with eczema.” — Joshua Jung
Close relationships can also help you manage the anxiety, depression, and stress that a
“Building a care team is so important because eczema is not just physical, it’s mental,” notes Roy. She recommends having a therapist in addition to a dietitian and a dermatologist for disease management.
“Your happiness doesn’t necessarily hinge on whether you have eczema or not. Making that conscious decision to normalize your condition and talk openly about it can help de-stigmatize everything.”
“Everyone with eczema should get a therapist — that’s where I am now,” says Corfah. “I’m doing the work physically, but I have to do some work mentally because of the lasting effects eczema has had.”
The panelists all agreed that it’s important to recognize the profound impact eczema can have on your life.
Three years after a bad flare that caused Fisher to move to her home state from Washington, D.C., she says that she’s still having difficulties. “I still am so conscious about what I do and what I touch. It’s made me into a complete germaphobe, and it’s so hard.”
She has worked to accept “that this can be lifelong and it’s constantly changing, so you can have ups and downs.”
For Jung, discussions about eczema — like this one — help normalize it. “It lets people know you’re not alone,” he says.
Healthline would like to thank the participants of “Adapting to Eczema: Advice From the Pros” for their involvement:
Rakhi Roy, MS, RD, is an actress-turned-registered-dietitian and holds a Master’s in Dietetics & Nutrition. Her website, Gutskinnutritionist.com, and Instagram are where she covers gut health, food allergies, and supporting the immune system through lifestyle and nutrition. Rakhi also writes, consults, educates, and speaks for health outlets in the medical and wellness spaces like the National Eczema Association, Department of Health, VA Hospital, Food Network, and Cooking Channel SOBE WFF Festival. Follow Rakhi on Instagram and Facebook.
Cynthea Corfah is a New Orleans-based freelance journalist, social media specialist and entrepreneur. In 2017, she founded the women’s wellness and empowerment event turned community Brunch for the Soul. In 2018, Cynthea became the first Black staff writer at 225 Magazine where she writes about everything from local fashion designers to influential community leaders. She has written for various magazines including Essence, New Orleans Magazine, Where Y’at Magazine and 225 Magazine. Follow Cynthea on Instagram, Facebook, and Tiktok.
Joshua Jung is a freelance writer based out of Montreal, Quebec. With a bachelor’s in Exercise Science and Kinesiology, he spent his postgraduate years working in rehab clinics to promote health and fitness in the community, and backpacking the world in his down time. Now, he’s fully combined both passions and writes about all things health and travel, and has appeared in major publications and on podcasts. Visit Joshua’s website here.
La Carmina is an award-winning travel and culture journalist (Time Magazine, AFAR, Business Insider), author of four books, and TV presenter on Travel Channel, Food Network, and Discovery. Her blog specializes in international subculture reports. Her upcoming book, The Little Book of Satanism, will be published this October by Simon and Schuster. Follow La Carmina on Twitter and Instagram.
Clarissa Lee Fisher recently graduated from the University of Edinburgh where she specialized in intersectionality and refugee women studies. Currently she is working remotely on a Congressional campaign in the finance department. She spends her time looking at cat videos to make up for being allergic to them. Curling up with a good book and a cup of tea is her ideal day. As a lifelong sufferer of eczema, she is passionate about educating others about the misconceptions of the illness. Follow Clarissa on Twitter and Instagram.