Crystale Vail Spearman of EYEImagerySave this storySave this story
If you’re a woman of color trying to figure out the best way to deal with your eczema, you can’t do much better than getting insight from Black dermatologists who live with the condition themselves. So we tapped five of them to share how they deal with the itchiness, dryness, and scaliness associated with a condition that tends to cause more persistent and severe symptoms for Black people. Even with access to cutting-edge treatments and top-tier products, these doctors all reached a surprisingly simple conclusion: Knowledge is one of the most powerful tools for managing eczema. But unfortunately there are a lot of misconceptions about the condition that keep people from healing.
“So much of eczema management starts with education, counseling, and understanding. I’m in a unique position to be able to have a complete understanding of my eczema and, as a result, better management of it,” says Onyeka Obioha-Lolagne, MD, owner and founder of Boutik Dermatology in Beverly Hills, California. And the other doctors we spoke with agree. Here are their personal stories of how they learned they had eczema and how they’ve used their expertise to stay one step ahead of it.
Ife J. Rodney, MD
Crystale Vail Spearman of EYEImagery
Medical Director of Eternal Dermatology & Aesthetic Center in Fulton, Maryland, and Founder of BLCK Haircare
You probably can’t tell by looking at me, but I have very dry, eczema-prone skin. During my first pregnancy I noticed dry patches on my skin. They didn’t show up in the classic eczema spots like behind the knees or on the elbows, so for a while I assumed it was something else.
I’ve used topical steroids for my eczema, but dialing in my moisturizing routine has helped me keep flare-ups at bay for longer stretches so I don’t need medication every day. Not keeping up with it just isn’t an option for me. For example, one Saturday night I was really tired, so I put off my usual moisturizing routine. By the time I finally put on lotion, it just sat on top of my skin instead of melting in.
One of the biggest mistakes I see my patients make is not applying enough moisturizer. With eczema, applying lotion once a day won’t cut it—you can feel when your skin is drying out, and that’s your cue to reapply. It’s way easier to top off moisture than to rescue skin that’s already parched. Also, most people only put lotion on key areas like their arms and their legs, but you really need to cover yourself head to toe. I use a full-body method: one to two pumps of La Roche-Posay Lipikar AP+M Triple Repair Body Moisturizer for Dry Skin on each section of my body—feet, lower legs, thighs, butt, hands, forearms, upper arms, back, chest, and tummy—then a thin layer of Vaseline on top. It’s a lot, but I can feel the difference.
Lauren C. Payne, MD
Crystale Vail Spearman of EYEImagery
Owner of Flourish Dermatology and Aesthetics in New Orleans
I went into dermatology because of my experience being diagnosed with eczema when I was four. I knew how much having the skin condition affected my quality of life. As a kid, I was constantly taking antihistamines to manage the itching from my eczema, as well as the seasonal allergies I had, which meant I was constantly nodding off in class. Over time, the dermatologists I saw helped me get my skin under control and feel more confident. That experience made me want to do the same for others who look like me.
I still get dry, itchy patches, mostly on my hands and neck, and I treat those with topical steroids. Once the itch calms down, I’m often left with hyperpigmentation in the same spots. I can develop a dark mark in a day, but it can take six months to fade. My number one trick for this is using mineral-based tinted sunscreen—chemical ones can irritate eczema-prone skin—and reapplying every couple of hours. Your body naturally wants to fade dark spots, but as long as it’s exposed to sunlight and blue light from computer screens and televisions, it’s going to take a lot longer to fade because it’s constantly being triggered. Mineral-based tinted sunscreen contains iron oxide, which blocks the blue light. I really like EltaMD UV Clear Tinted Broad-Spectrum SPF 46, and Neutrogena Purescreen+ Mineral UV Tint Face Liquid Sunscreen.
I’ve also made lifestyle changes to avoid flares. In the summertime, between the sunlight and the heat, my eczema gets triggered a lot, so I minimize the time I spend in the sun and around grass and plants, which are also irritants for me. If someone invites me to a picnic, I’m sitting on a bench or a folding chair. You won’t find me on the ground.
Jeanine B. Downie, MD
Image Dermatology PC
Founder and Director of Image Dermatology PC in Montclair, New Jersey
Getting a proper diagnosis was one of my biggest challenges as a Black woman with eczema. There are multiple types of eczema, and when I was younger, I experienced several that did not present as the classic dry, red patches you often see in people with lighter skin tones. I would get papular atopic dermatitis, which showed up as itchy, flesh-colored bumps on my arms and legs. I also had pityriasis alba, a type that causes lighter patches of skin and is often mistaken for vitiligo. On top of that scratching my eczema led to lichenified patches—thick, rough areas—on my skin.
People would often say, “Oh, this doesn’t look like eczema.” Even before I became a dermatologist, I found myself having to insist that it was. Many of my patients have faced similar difficulties getting accurately diagnosed by other doctors. I was fortunate: My mother, a pediatrician, recognized my eczema when I was a baby. But not everyone has that advantage. And without an accurate diagnosis, it’s impossible to get the treatment you need for healthier skin.
On my worst areas I use a prescription medication called tacrolimus 0.1% ointment, which is a topical immunosuppressant, to treat the eczema and the itch. My top piece of advice is something I follow as well: Wear sunscreen every single day with SPF 30 or higher. Rain or shine, January through December, regardless of your ethnicity, it’s super important because when you have eczema, your skin is very sensitive to the sun. Use moisturizing cleansers and apply hypoallergenic, fragrance-free creams to your skin. For cleansers, I like La Roche-Posay Lipikar AP+ Gentle Foaming Cleansing Oil and Aveeno Calm + Restore Gentle Nourishing Oat Face Cleanser. For creams, I really favor options from Aveeno, La Roche-Posay, and Cetaphil. And if you’re struggling to stop scratching, cut your nails short.
Camille Howard-Verović, DO
Derrick Davis
Owner of Active Dermatology in New York City
When you’re a child with eczema like my daughter, it’s easier for life to pause because you’re itchy. As an adult with eczema, it’s almost impossible. You still have to check things off your to-do list, and the itchiness adds tremendously to your day-to-day anxiety. That’s my biggest challenge: the sometimes-unrelenting discomfort. I always say that if you’re not moisturizing, you’re not properly managing your eczema. I personally spend a lot of time throughout the day monitoring my hands and keeping them moisturized because, as a doctor, I’m constantly washing them, which dries them out. I keep samples of moisturizers everywhere—my coat pockets, my purse—so I’m never without it.
It’s not just what you do, but also how you do it. Cleansing and moisturizing are already part of our daily rituals. I just encourage everyone to do it very intentionally and wisely. It’s best to moisturize when your skin is damp, like after a lukewarm shower. (Hot water is a no-go when you have eczema.) When I lotion up I use moisturizers packed with lipids, emollients, and humectants to keep my skin barrier strong. Eczema tends to weaken that barrier, making it easier for things like allergens and bacteria to get in. That’s why I give myself a little extra TLC at certain times. In the evenings I reach for a heavy moisturizer, and during cold months I use a humidifier to add moisture to the dry air. I also use short-term courses of topical steroids to treat my eczema.
Onyeka Obioha-Lolagne, MD
Idara Ekpoh
Owner and Founder of Boutik Dermatology in Beverly Hills, California
For the past 10-plus years, I’ve been using Dove Original Beauty Bar, Cetaphil Moisturizing Cream, and Eucerin Eczema Relief Cream. For occasional flares, I’ll turn to prescriptions like topical steroids or topical JAK inhibitors, both of which reduce inflammation and itching, but these over-the-counter products are my main skin-care routine. It may not sound exciting, but it’s the gentle routine those with eczema need. Unfortunately, many people don’t know what that really looks like. For example, scrubbing with loofahs and washcloths can make your skin feel cleaner, but it can also unintentionally remove essential lipids and natural protective oils, leaving your skin more inflamed and vulnerable. Using your hands is just fine.
Also, heavily fragranced moisturizers with a lot of botanical ingredients aren’t gentle. They can irritate and thus dry out your skin. If your skin barrier is compromised, even the thickest moisturizer or oil won’t help. Don’t fall into the hype of products that market themselves using buzzwords like “clean,” “natural,” “organic,” or “plant-based.” They may sound better for your skin, but the opposite is often true from a skin-barrier and immunologic standpoint because they’re usually loaded with potential triggers and allergens, such as botanical extracts, essential oils, and maybe even unregulated ingredients. If a product’s packaging says “For Eczema,” you should still comb through the ingredients list to make sure there’s nothing that might irritate your skin, including natural fragrances or botanical oils like bergamot or ylang-ylang.
* Quotes and attributions have been condensed and edited for clarity.
