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Have you ever left a doctor’s office feeling less than satisfied with how the appointment went? Like you know something isn’t right with your health, but the doctor either dismissed your concerns or prescribed a frustratingly general solution? Unfortunately, this experience is common when it comes to getting a proper diagnosis for a skin disorder, and especially common for people of color.

According to board-certified dermatologist Diego Ruiz Dasilva, MD, FAAD, who sees more than 100 eczema patients every month and is an expert in treating skin disorders on skin of color, taking an individualized approach to care is essential for getting people of color the diagnosis they need and the care they deserve. “Eczema (atopic dermatitis) presents differently on different skin tones,” he says. “I find I need to take a more nuanced approach with skin of color.”

Dr. Ruiz Dasilva has helped Michael*, one of his patients who has struggled with uncontrolled, moderate to severe eczema for nearly 15 years. Together, they were able to get Michael’s condition under control. Here are three things Dr. Ruiz Dasilva wants everyone to know about diagnosing and treating eczema in people of color.

1. Eczema often looks different on skin of color

For over a decade, Michael saw countless doctors, tried many topical creams and injections, and was misdiagnosed—all while dealing with serious skin discomfort. “My itch was so bad, I used to scratch and it’d just bleed,” he says. “A cold shower would help, but as soon as I got out of the shower, I’d just start scratching again.”

According to Dr. Ruiz Dasilva, Michael’s experience can be common for people of color. “The main frustration I hear from patients of color is that their last provider said, ‘This doesn’t look that bad’ or ‘I don’t see much of a rash, this is just dry skin,’” he says. Patients of color may disproportionately experience misdiagnosis because eczema commonly presents differently in skin of color. Hyperpigmentation, skin-colored bumps that are finely raised, and dry patches that are not quite as red are some of the tell-tale signs of eczema on skin of color, explains Dr. Ruiz Dasilva. On lighter skin tones, the condition tends to have a redder, more raw and oozy appearance. “That’s what some consider more ‘classic’ or ‘evident’ eczema,” he says.

Because of these differences, Dr. Ruiz Dasilva is careful to ask his patients open-ended questions to understand the impact their itch and rash is having on them and the level of discomfort they’re experiencing throughout the day.

2. Living with eczema can be challenging

Before finding the right care, Michael was always self-conscious about his skin’s appearance and his constant need to scratch. “It was a full-time job trying to manage how I was going to take care of my skin,” he explains. One of h