Eczema and skin colour changes: light patches and dark patches

Q: My daughter has dark skin, and after an eczema flare she is left with very dark patches. Will this ever go away?

A: ESC reached out to paediatrician and eczema expert Dr. Joseph Lam MD to learn more about pigmentation changes that can occur with eczema.

Dr. Lam tells us: “Skin pigment changes – whether lighter spots or darker spots – occur commonly in people with eczema. Patients may be concerned about these darker or lighter spots, and often think they are caused by topical treatments. Usually, this is not the case – it is instead caused by the skin’s response to inflammation. Sometimes we use the analogy of a fire – the eczema flare is like the flaming fire, and the light or dark patches that follow are like the smoldering embers that remain after the flames burn out. When the skin heals and repairs, pigment changes can correct themselves.

For people with a more severe form of the eczema, or for people who have frequent flaring and scratching (which damages the skin), the dark or light patches may be worse and have less of a chance to heal before the next “fire” occurs. The medical terms for these pigment changes are post-inflammatory hyperpigmentation (hyper meaning ‘more’ or ‘excess’) and post-inflammatory hypopigmentation (hypo meaning ‘less’ or ‘under’), and they are not usually permanent but can take up to a year for the normal skin colour to return. Repeated flaring and scratching can also delay healing or cause new pigment problems.”

ESC thanks Dr. Lam MD (FRCPC) for his expertise and ongoing support. If you have any questions or concerns about pigment changes in your skin, speak with your health care provider.