This failure to recognize the signs of eczema on darker skin is common partly because of medical training. Historically, the representation of melanin-rich skin in dermatology textbooks and clinical image databases has been lacking. Jeanine Downie, MD, a dermatologic surgeon in Montclair, New Jersey, adds that patients of color have also been underrepresented in clinical trials, leaving important gaps in understanding how conditions may present across different populations.
Diagnosing scalp eczema can be especially complicated, in part because it shares symptoms with other skin conditions. One of those conditions is tinea capitis, a fungal infection that Black women are at higher risk of developing. In fact, tinea capitis in Black children is often mistaken for seborrheic dermatitis, since the two conditions can look very similar. As a result, people of color may face delays in getting the correct diagnosis of whichever condition they actually have, which can significantly worsen symptoms either way.
Another factor is that hair-care practices common in the Black community can cause women of color to experience more severe scalp-eczema symptoms, Dr. Woolery-Lloyd says. For example, styling techniques like glue-in extensions can irritate an already inflamed scalp, and layering multiple products, common in textured hair-care routines, increases the likelihood of encountering a trigger ingredient that causes a flare-up.
But all of that doesn’t mean you’re doomed to struggle with an itchy, flaky scalp for the rest of your life. Here is what dermatologists want you to know.
First things first: Identify your triggers
Not every natural hairstyle or styling product plays nicely with an eczema-prone scalp, and being aware of the most common triggers can help you know what to look out for. Remember, though, that the below list isn’t exhaustive. If you’re trying a new product, test it first. Placing a dab behind the ear and leaving it on for 24 to 48 hours can help catch a problem ingredient early.
Fragrances and essential oils
“These are some of the most common triggers for scalp-eczema flares,” says Dr. Negbenebor. Even products marketed as “natural” or “clean” can be irritating, and it’s a misconception that natural ingredients are always safer, she adds. While almost any fragrance or essential oil could do you wrong, depending on your triggers, Tanya Kormeili, MD, a board-certified dermatologist and founder of Derm & Rejuvenation Institute, based in Santa Monica, points to a few known irritants to watch for: tea tree, cinnamon, and rosemary.
Heavy oils and butters
Natural-hair routines can lean hard on oils, and sadly, that may work against you. Purvisha Patel, MD, a board-certified dermatologist in Memphis, says the yeast that often drives seborrheic dermatitis needs warmth and moisture to thrive, and many textured-hair staples, that include thick ingredients like shea butter and cocoa butter, can trap sweat and heat against the scalp, which may worsen the condition, Dr. Negbenebor explains. Switching to a lighter product like SEEN Restore Scalp Serum, which has a National Eczema Association Seal of Acceptance, may help improve your symptoms.
Preservatives and adhesives
The acrylates, latex, or solvents often used in hair-bonding glues can act as potent irritants when applied directly to an already irritated scalp, says Dr. Woolery-Lloyd. Preservatives like methylisothiazolinone, common in water-based products like hair masks, leave-in serums and treatments, and styling products to extend shelf life, can be similarly aggravating.
