Eczema scars are part of a wider category of lasting marks that eczema can leave on your skin. They can be hyperpigmentation in healed areas or actual scars caused by scratching during a flare-up. To find out more about eczema scars, read on!
What causes eczema scars?
Eczema scars are generally the result of the following
1- Pigmentation changes after an eczema flare-up:
Your skin color can have an impact on your symptoms and any persistent scars. It can be easier to spot and diagnose eczema on fair skin, enabling earlier treatment. The symptoms of eczema on darker skin may take longer to recognize. Active eczema flare-ups can worsen over time, leading to more severe symptoms. It may take some time for symptoms to disappear and skin pigmentation to return to its original state
2- Picking at or scratching the skin, which can lead to an open wound and possible infection:
People with eczema tend to scratch more than others. The itching encourages scratching, which causes the skin to react further, worsening eczema symptoms. The result is even more itching, a sequence known as the itch-scratch cycle. If your skin is injured by repetitive scratching, this can lead to pigmentation changes or scarring. Open skin can allow unwanted bacteria to enter your body. The result is an infection that requires antibiotic treatment. Infected skin that takes too long to heal can leave scars.
These skin changes may persist long after the outbreak, but in most cases they eventually disappear. The outer layer of the skin, the epidermis, can usually heal completely. More permanent marks may form if changes occur under the epidermis, but this is unlikely.
What do eczema scars look like?
Eczema scars are usually temporary changes in the color or texture of your skin that last beyond flare-ups. Here are a few examples of eczema scars:
1- Post-inflammatory hyperpigmentation
Eczema inflammation manifests itself differently depending on skin tone:
- Your skin may be pink or red if you have a lighter complexion.
- Your skin may be brown, purple or gray if you have a darker complexion.
These skin changes can last for months after the flare-up. They are more apparent on darker skin.
2- Lichenification
Your skin may also become discolored if your eczema progresses to lichenification, i.e. when your skin becomes thick and rough. This can happen in places where you rub or scratch a lot. Lichenification also makes your skin more pigmented. It can appear dark pink on fair skin and gray on dark skin.
3- Post-inflammatory hypopigmentation
Hypopigmentation is the opposite of hyperpigmentation. Instead of your skin remaining darker after an outbreak, it appears lighter until it has completely healed.
4- Pityriasis alba
Pityriasis alba is a type of hypopigmentation often seen in children and adolescents with dry skin or eczema. It appears as oval, scaly patches that are more visible on darker skin or after sun exposure. The patches do not change color, even if the rest of the skin darkens.
5- Hypertrophic scars and keloids
If your scratching causes a cut in your skin, you may develop a dark, raised scar. These can be hypertrophic or keloid scars, depending on their size. They can be very itchy and require medical treatment. Hypertrophic scars tend to conform to the shape of the wound. Keloid scars are larger than the original wound. They are generally darker in color. These scars are more common in dark-skinned people. African-Americans are 5 to 16 times more likely to develop keloids than Caucasians.
How can eczema scars be treated?
The most important thing you can do to treat eczema scars is to control your flare-ups. The long-term effects of eczema will diminish if you treat symptoms as they occur. To manage symptoms:
- Cover them up: One way to blur your scars with your natural complexion is to cover them with make-up. This is a temporary solution, and it can take some practice to get the right color.
- Darken them: Skin color can be temporarily modified with topical lotions and creams. Sunless tanning lotions contain dihydroxyacetone (DHA). This chemical stimulates melanin production and temporarily darkens the skin when it interacts with the skin’s surface.
- Lighten it up: Scars can be temporarily lightened with whitening creams. These products contain hydroquinone, mercury and glucocorticoids, which limit the skin’s production of melanin.
- Flatten it: Once the wound is closed, apply silicone gel sheets to the affected area. They should be worn for more than 12 hours a day for at least two months.
- Apply scar cream: Over-the-counter or prescription scar creams can make your scars less visible by removing dead skin cells and keeping your skin moisturized.
- Transform your scar: You can permanently change the appearance of your scar by tattooing the affected area. However, you’ll need to take extra precautions. Avoid getting a tattoo during a flare-up, and make sure your skin is well moisturized before your appointment. Consult your dermatologist before getting a tattoo to determine whether it’s an appropriate treatment for you.
- Try laser therapy: If your scars are hyper- or hypo-pigmented, laser therapy can be helpful to change the color of your scar. However, these treatments can be painful and need to be performed several times.
- Consult a surgeon: In some cases, keloid scars can be surgically removed. Although the operation will produce a new scar, it will be much smaller because the skin is stitched back together.
How to prevent eczema scars?
The best way to prevent scarring is to avoid scratching. This can be extremely difficult if you suffer from this intensely itchy condition. However, there are ways to reduce itching and the urge to scratch:
- Add oatmeal to your bath: Take a lukewarm oatmeal bath for 10 to 15 minutes. Pat your skin dry and immediately apply a moisturizer to retain water in your skin.
- Cool your skin: Apply a cool, damp washcloth to the itchy area.
- Pinch the affected area: Gently pinch your skin close to (but not over) the affected area. This may temporarily distract your brain from the itching sensation.
Summary
Eczema can cause persistent skin changes. You may notice changes in your skin color for some time after other symptoms have disappeared. Scars may appear where scratching has broken the skin, or if you’ve developed a bacterial infection. In many cases, these scars fade over time. It’s important to keep eczema symptoms under control to avoid skin changes. Talk to your doctor about how to manage your eczema or if you’re concerned about the possibility of scarring.
