Everyone who has atopic dermatitis (AD) needs a good treatment plan. But if you have darker skin, you may be more likely to have skin color changes that linger after a flare, making it all the more important to prevent flare-ups in the first place, says Elizabeth Bahar Houshmand, MD, a board-certified dermatologist based in Dallas. Plus, you’ll need to consider hair care, invisible symptoms, and more.
Today, it’s easier than ever to manage atopic dermatitis and maintain your quality of life. “With the current treatments available, we can achieve much better control than was possible even a few years ago,” says Dr. Houshmand.
Asking your dermatologist the right questions can help you understand whether treatment is working, what to expect along the way, and when it may be time to adjust your treatment plan to better meet your needs.
1. How Well Will This Treatment Work for Someone With My Skin Tone?
Plus, many of the newer treatments, such as biologics and targeted oral therapies, work by targeting specific pathways in the immune system that contribute to the disease. These treatments can be effective for people of all skin tones, says Houshmand — something that both studies and real-world evidence have shown.
Finding the right approach may take time, but working closely with your dermatologist can help you gain better atopic dermatitis control and improve your quality of life. “You deserve a treatment plan tailored to your specific skin, lifestyle, and goals,” says Houshmand.
Many organizations have resources that can help you find information about treating the condition and locating a healthcare provider in your area, including:
2. Will Treatment Help Prevent or Fade Dark or Light Spots?
Skin color changes can linger for weeks or even months, especially if you’re having back-to-back flares. “When skin heals from inflammation, it often leaves behind pigment changes, especially in skin of color,” says Houshmand.
Sometimes skin appears darker after a flare; other times skin appears lighter. Once the inflammation is under control, though, the discoloration should gradually begin to fade, says Tanya Evans, MD, a board-certified dermatologist and medical director of the skin cancer program at MemorialCare Saddleback Medical Center in Laguna Hills, California.
In this case, a good defense can be your best offense: Along with regularly moisturizing, wear sunscreen every day (UV exposure can worsen light or dark spots), and control inflammation by following your treatment routine, says Dr. Evans.
If skin discoloration lingers long after the flare, your doctor may recommend treatments such as topical retinoids, azelaic acid, niacinamide, vitamin C, or other pigment-targeting therapies, she says. “We don’t like going to those directly, though,” says Evans, “because these products may dry or irritate the skin, exacerbating inflammation.”
3. Do I Need to Avoid Certain Skin-Care Products Forever?
It’s true that using certain skin-care products can worsen eczema, “especially in people with richly pigmented skin,” says Evans. Alcohol-based products, for example, and those with strong fragrances or exfoliating properties may be too harsh on your skin.
But that doesn’t mean you’re going to be stuck using just one or two products for the rest of your life. “Having eczema doesn’t mean you have to avoid active skin-care ingredients forever,” says Houshmand. “Once your skin is stable and well controlled, you can work with your dermatologist to slowly reintroduce other ingredients.”
Just make sure you ramp up your skin-care routine one product at a time, she adds. This way, you can track any skin reactions that may occur.
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