Ask the Ecz-perts: What Can Be Done About Dark Spots Left by Eczema?

Eczema ecz-pert Andrew Alexis, M.D. is Chair of the Department of Dermatology at Mount Sinai St. Luke’s and Mount Sinai West, and Professor of Dermatology at the Icahn School of Medicine at Mount Sinai. As Director of the Skin of Color Center, he is actively involved in advancing patient care, research, and education pertaining to dermatologic disorders that are prevalent in ethnic skin.

Dark spots are a side effect of eczema, or atopic dermatitis, that are often experienced by those with darker skin. An eczema flare-up can leave behind dark spots, or discoloration on dark skin. It‘s an additional challenge for people of color on top of typical eczema symptoms, such as itchiness, rashes, immune system issues and dryness in the skin. Those with lighter skin are less likely to experience this challenge, though some with severe eczema cases could have dark spots.

Why do dark spots form?

After an eczema flare-up, it’s common for dark spots to be left behind, especially for patients with darker skin types. Once the eczema clears, melanin cells in the affected patches of skin experience hypopigmentation, an increase in skin pigmentation production. The pigment forming skin cells in darker skin tones are highly sensitive to inflammation. These inflammatory factors turn on increased pigment production and the post-inflammatory hyperpigmentation causes lichenification and dark spots that can last weeks to months. Sometimes, these dark spots can look similar to acne scars. However, treatment is different for dark spots and eczema scars caused by atopic eczema than for those caused by acne and other skin conditions. It’s important to talk to your healthcare provider about what is causing your dark spots.

How to treat dark spots

The first line of treatment is prevention. When eczema is better controlled, folks will have fewer dark spots. There are a couple home remedies and treatment options to consider, such as an eczema diet and decreasing sun exposure. Try eating anti-inflammatory foods and using sun protection, such as sunscreens and hats, on sunny days. A good skin care routine, including a moisturizer or lotion for dry skin, can also limit the effects of this skin condition.

You can also talk to your dermatologist about medical options, such as topical steroids, to prevent and treat eczema.

Even with the best efforts, you can still get dark spots and skin discoloration. When there are patches of hyperpigmentation, there are some options to treat and eliminate dark spots:

• Topical skin lightening creams that are applied to the affected areas of skin
• Your dermatologist can perform in-office procedures to help, such as superficial chemical peels
• A trained professional can also use laser surgery on the affected area