Scratching eczema patches can lead to changes in the skin, including both hypopigmentation and hyperpigmentation. Some treatment creams can also cause skin discoloration.
Eczema is a common skin condition that causes itchy, dry, irritated lesions. Experts are not sure what exactly causes eczema. However, genetics and environmental factors
Many people feel the urge to scratch the affected skin, which can worsen the irritation that eczema causes. The skin may change color due to scratching, inflammation, and the steroids people can use to treat the condition.
Read on to learn about the link between eczema and skin discoloration, the treatment options, and more.
Eczema lesions, also called atopic dermatitis, can be itchy and uncomfortable. Scratching eczema is a common behavior, but it may lead to changes in the skin’s appearance and texture.
Eczema can cause two types of skin pigment changes: hypopigmentation and hyperpigmentation. Hypopigmentation is a loss of pigment or color, usually presenting in patches that are lighter than a person’s skin tone. Hyperpigmentation, an increase in color, occurs when patches of skin become darker than the surrounding skin.
Both
People with eczema may find these changes in their skin’s appearance distressing, and the condition may affect their quality of life. Even after a person receives treatment for eczema, the skin may not return to its previous color.
During an eczema flare-up, the body releases cytokines. In an effort to protect the body, they cause inflammation.
The cytokines
This reaction leads to increased pigment production.
The darker a person’s skin is, the more melanin they have. Therefore, people with darker skin release more pigment when the reaction occurs.
Eczema looks different depending on a person’s skin color.
On light skin, eczema typically causes inflamed pink or red patches that are dry and itchy. These lesions are harder to detect on dark skin tones and may appear purple, gray, or a darker brown than surrounding skin.
When people with light skin scratch eczema lesions, hyper- and hypopigmentation can occur. Skin pigmentation can progress gradually, and its subtle changes make it hard to detect.
People with dark skin tones may be
Hyperpigmentation
Darker skin patches, or hyperpigmentation, occur as a result of inflammation. This triggers melanocytes to increase melanin synthesis, which is the process of making skin pigment.
The increase in pigment production encourages the transfer of pigment to the epidermis, the top layer of the skin. If a person scratches or rubs their skin, this releases melanin.
Types of hyperpigmentation include:
Post-inflammatory pigmentation
After an eczema flare-up resolves, it can leave behind a darker patch of skin. This is
While it is temporary, it can persist for months and tends to last longer on dark skin tones.
Sunlight also stimulates post-inflammatory pigmentation, so it is advisable to cover affected areas and use sun protection.
Lichenification
If a person rubs and scratches at the affected areas of their skin, the skin can thicken. This may result in lichenification — thick, leathery lesions with visible scratch marks.
These areas of hyperpigmentation may present as gray on dark skin and as dark pink on light skin.
Hypopigmentation
Lighter skin patches, or hypopigmentation, can occur when an eczema flare-up is in the process of resolving.
Eczema hypopigmentation often presents as pityriasis alba, which is low grade eczema marked by light, scaly patches. It usually causes 1–20 rounded or oval patches on the neck, face, upper arms, and shoulders.
Pityriasis alba is more common in dark skin tones and often occurs after a person’s skin has exposure to the sun. Although the scales and dryness may be more apparent during the winter, the actual hypopigmentation is more common during the summer.
The lesions usually resolve within 1 year but may take 2–3 years to disappear.
There is currently no specific treatment for skin pigment changes. However, eczema is treatable in people of all skin tones.
Hyper- and hypopigmentation usually fade and resolve on their own. Using a moisturizing cream or ointment can help address the dryness, and sun protection can prevent patches of hyper- and hypopigmentation from worsening.
If a person’s eczema or pigmentation change does not resolve on its own, a doctor or dermatologist can establish a treatment plan. This may involve oral and topical steroids, nonsteroid creams, and other treatments.
Hyper- and hypopigmentation due to eczema usually resolve on their own.
People who are having difficulty managing their eczema can contact a doctor to receive a diagnosis and establish a treatment plan. Additionally, people who are concerned about patches of hyper- and hypopigmentation may wish to speak with a doctor.
Here are some questions people often ask about eczema.
Can eczema cause white patches on skin?
Pityriasis alba — a low grade type of eczema — can cause white patches. This condition is more common in children and affects around 5% of children globally. Hypopigmentation is more evident on darker skin tones than on lighter ones. It usually disappears after around 1 year but may take 2–3 years to resolve.
Can eczema cause dark skin discoloration?
Eczema is an inflammatory condition that often leaves dark patches of skin when it heals, especially on darker skin tones. The skin cells that affect pigmentation are sensitive to inflammation.
During the post-inflammatory stages, these cells produce extra pigment, leading to lichenification and dark spots. These spots can resemble acne scars and may last weeks to months. They typically go away eventually.
Will eczema skin discoloration from eczema go away?
First, a person needs to treat the eczema. Once the eczema heals, changes in skin color can resolve over time. However, this may take months or years, according to the American Academy of Dermatology.
What is post-inflammatory hypopigmentation from eczema?
Post-inflammatory hypopigmentation appears as lighter skin patches that develop as an eczema flare is improving.
Does hypopigmentation from eczema go away?
Hypopigmentation from eczema typically resolves in 1 year but can take 2–3 years to go away.
Eczema causes dry, itchy, inflamed lesions. When irritated, the skin can develop patches of hyper- or hypopigmentation.
There is currently no specific treatment for hypo- or hyperpigmentation related to eczema, and these conditions usually resolve on their own over time. A person can contact a dermatologist to treat their eczema.