Atopic dermatitis, a form of eczema, is a common but often overlooked skin condition in people of color, even though it’s often more prevalent, severe, and burdensome in Black and Latino populations.
“Historically, eczema has been characterized by redness, and skin of color has been underrepresented in medical education and public awareness campaigns, which can contribute to delayed recognition and diagnosis,” says
Regine Mathieu, MD, a medical and cosmetic dermatologist in Fresno, California.
Eczema can affect any part of the body, including the hairline and scalp. Managing
scalp eczema can be especially challenging for people with natural or textured hair, because treatment recommendations may affect hair care routines, styling choices, and overall hair health. Yet hair often plays an important role in confidence, cultural identity, and self-expression.
The products, washing schedules, and protective styles that help keep hair healthy might not always align with traditional eczema advice, creating a balancing act between managing symptoms and preserving hair health and appearance.
“Eczema is often overlooked in
skin of color, because it may not present in the way people expect,” says Dr. Mathieu. In darker skin tones, she says,
eczema may appear:
Additional symptoms of scalp eczema, regardless of skin tone, include flaking, itching, scaling, and inflammation, says Mathieu.
Scalp eczema tends to crop up around the hairline and behind the ears, says Mathieu, as well as on parts of the face — especially the eyelids and around the eyes.
Managing scalp eczema can be particularly challenging in darker skin tones. “Traditional treatment recommendations do not always align with diverse hair textures and hair care practices,” says Mathieu. Although topical treatments, medicated shampoos, and frequent washing may help control symptoms, they can also dry out textured hair or disrupt established hair care routines.
Protective styles, such as braids, twists, weaves, and wigs, can sometimes complicate eczema treatment if they make it harder to apply medications, clean the scalp, or remove product buildup, says Mathieu. “That said, I don’t recommend avoiding these styles altogether. For many people, these styles are an important part of maintaining healthy, manageable hair.”
Rather than abandoning the hairstyles or routines that work for you, it’s important to find a dermatologist who can adapt traditional treatment recommendations to your individual hair texture, scalp care needs, and styling preferences, she says.
Your individual scalp eczema care plan should be realistic and culturally appropriate. It may include the following strategies:
- Use gentle hair products. Avoid ingredients in products that irritate your scalp. For example, some — but not all — people find that fragrances trigger eczema, says Mathieu.
- Choose styles wisely. Aim for those that allow for scalp access and minimize buildup, and avoid keeping one style longer than recommended, says Mathieu.
- Talk to your dermatologist. While the treatment for eczema is the same no matter your skin tone, your hair care habits factor into its success. Ask if medicated shampoos or prescription treatments can be helpful for controlling scalp eczema flares. If the answer is yes, discuss the best way to clean your hair or apply them to your scalp while wearing the styles you enjoy.
- Be mindful of what triggers flares. Excessive sweating, stress, and hot, humid, or dry climates are known eczema triggers, so it’s important to take steps to manage them, such as using a humidifier in dry seasons.
“Remember that managing scalp eczema doesn’t mean sacrificing your hair goals,” says Mathieu. “It means finding a routine that supports both.”
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