Why Your Eczema Keeps Coming Back – & What Nobody Told You About It

Eczema, or atopic dermatitis, is more than just dry, itchy skin—it’s an inflammatory condition that can be frustrating, painful, and deeply tied to your overall health. And for Black and melanated skin, the journey with eczema comes with unique challenges. If your flare-ups keep returning, no matter how much you moisturize, use prescription creams, or change your diet, you’re not alone.

Most traditional advice on eczema focuses on steroid creams and avoiding common allergens, but there’s more to the story—especially for Black skin. From environmental factors to mental health connections, let’s uncover the hidden truths behind why your eczema keeps returning and what you can do to get long-term relief.

The Hidden Environmental Triggers

If you’ve been battling eczema for years, you’ve likely been told that genetics, allergens, or diet cause flare-ups. While those factors play a role, many overlook environmental triggers that disproportionately affect Black and Brown communities.

1. Air Pollution & Urban Living

Black communities are often located in areas with higher levels of air pollution, thanks to environmental racism and redlining. Research shows that exposure to pollutants like car exhaust, industrial waste, and high ozone levels increases the severity of eczema. These pollutants disrupt your skin barrier and trigger inflammation.

What you can do:

Use an air purifier at home to reduce pollutants.
Keep your windows closed during high-pollution days.
Apply a barrier cream before going outside to shield your skin.

2. Hard Water & Chlorine Exposure

Many U.S. cities have hard water, rich in minerals like calcium and magnesium, that strip moisture from the skin. In addition, tap water often contains chlorine, which irritates sensitive skin.

What you can do:

Install a shower filter to remove chlorine and hard minerals.
Moisturize immediately after showering while your skin is still damp.
Limit long, hot showers, which can worsen dryness.

3. Hidden Irritants in Laundry & Skincare

Even if you’re using “sensitive skin” products, many still contain harsh chemicals that disrupt the skin microbiome and trigger eczema. Common irritants include:

Fragrances & dyes in laundry detergents
Sulfates & parabens in soaps and shampoos
Alcohol-based sanitizers & hand washes

What you can do:

Switch to fragrance-free and hypoallergenic detergents.
Look for skincare labeled “eczema-friendly” or approved by the National Eczema Association.
Wear cotton gloves when handling cleaning products.

How Black Skin Heals Differently from Flare-Ups

Eczema doesn’t just look different on Black and melanated skin—it also heals differently. The mainstream dermatology industry has historically been Eurocentric, meaning that Black skin conditions have been understudied and misdiagnosed for years.

1. Eczema on Black Skin Looks Different

Instead of the typical “red rash” seen on white skin, eczema on Black skin often appears as:

Dark brown, purple, or gray patches
Raised, rough, or ashy areas
Hyperpigmentation (dark spots) after healing

This means that many doctors misdiagnose eczema in Black patients as a fungal infection or another skin disorder.

What you can do:

See a dermatologist specializing in Black skin (or check sites like Skin of Color Society).
Ask for a skin biopsy if your diagnosis seems unclear.

2. Post-Inflammatory Hyperpigmentation (PIH) & Scarring

One of the biggest frustrations for Black eczema sufferers is the dark marks left behind after flare-ups. These dark spots (PIH) can last months or even years if not treated correctly.

What you can do:

Use a niacinamide serum to fade dark spots over time.
Apply sunscreen daily (even on dark skin) to prevent hyperpigmentation from worsening.
Avoid scratching and picking at scabs to prevent deep scars.

Long-Term Management Beyond Steroid Creams

Corticosteroid creams are often the go-to prescription for eczema, but they aren’t a long-term solution. Overusing them can cause skin thinning, steroid withdrawal, and increased sensitivity over time. So, what’s next?

1. Moisturize with the Right Ingredients

Not all moisturizers are created equal. Many lotions contain alcohol and preservatives that make eczema worse over time. Even if your flare-up has calmed down, keeping up with a good moisturizing routine is important. There are a lot of moisturizing products out there, but you can go for either a lotion, cream, ointment, or oil to keep your skin moisturized with:

Shea butter – deeply hydrates and restores skin.
Ceramides – essential for repairing the skin barrier.
Colloidal oatmeal – soothes irritation and inflammation.

Pro tip: Use the “soak and seal” method:

Take a lukewarm bath or shower.
Pat skin slightly damp, then immediately apply moisturizer.
Lock in moisture by layering with an ointment like Vaseline or Aquaphor.

2. Anti-inflammatory diet & Supplements

Eczema isn’t just a skin condition—it’s an inflammatory disease. Certain foods can either help or worsen flare-ups.

Foods to Avoid:
- Dairy (milk, cheese, butter)
- Processed sugars & fried foods
- Gluten & highly processed grains
Foods That Help:
- Omega-3-rich foods (salmon, flaxseeds, walnuts)
- Leafy greens (spinach, kale, collard greens)
- Turmeric & ginger (natural anti-inflammatories)

Some supplements may also help:

Probiotics – to balance gut bacteria and reduce skin inflammation.
Vitamin D – especially for Black people, since melanin reduces absorption from sunlight.
Black seed oil – is known for its skin-healing properties.

3. Wet Wrap Therapy for Severe Flare-Ups

If your eczema is severe and nothing seems to help, wet wrap therapy may provide relief.

How to do it:

Take a warm bath and apply a thick layer of moisturizer.
Dampen a soft cotton shirt or bandages and wrap them over affected areas.
Cover with dry clothing and leave overnight.

This method locks in hydration and helps repair the skin barrier.

The Power of Therapy and Self-Care for Skin Health

Stress is one of the biggest triggers for eczema. Studies show that Black Americans experience higher levels of chronic stress due to systemic racism, financial strain, and daily microaggressions—all of which can lead to inflammation and worsen eczema.

1. Managing Stress for Skin Health

Stress triggers cortisol, a hormone that increases inflammation in the body. High cortisol levels weaken the skin barrier, making it harder to heal from flare-ups.

Ways to reduce stress:

Therapy & Counseling – Talking to a mental health professional can help manage stress-related eczema.
Journaling & Meditation – Helps calm your nervous system.
Spiritual & Community Support – Connecting with your community can provide emotional healing.

2. Getting Enough Sleep

Eczema worsens at night because your skin loses more moisture while you sleep. If itching keeps you up, try:

Silk pillowcases & sheets to reduce friction.
Melatonin supplements to regulate sleep.
Oatmeal or chamomile baths before bed.

Healing Eczema from the Inside Out

If your eczema keeps returning, it’s not just about your lotion or steroid cream but your whole lifestyle. From environmental factors to stress and diet, your skin reflects your overall health.

By taking a holistic approach—moisturizing properly, avoiding hidden irritants, eating anti-inflammatory foods, and prioritizing mental health—you can finally break free from the cycle of constant flare-ups.

Next Steps for Relief: