Eczema and How to Better Manage It

Ask around a dinner table at your next cafe outing with your friends and it is very likely that at least one of them is, or will know someone who is, suffering from eczema. That is how prevalent eczema has become in Singapore. In fact, Singapore has one of the highest incidences of eczema in the whole of Asia.

What is eczema/atopic dermatitis?

Eczema is an inflammatory condition that causes itchy and dry skin, often with redness and flaking. It usually affects the face, flexures of the arms and legs, and the neck and hairline regions. It can be irritating, distressing, and socially stressful at times.

It usually starts in childhood and the condition improves as you get older, though you may experience some flare-ups on and off throughout adulthood.

If untreated, there are risks of skin infection setting in and thickening of the affected skin, a condition known as lichenification, which can cause undesirable thickening and darkening of the skin.

What causes eczema?

Many factors are known to cause or worsen eczema. The current belief is that the condition is caused by a combination of factors such as genetics, environmental triggers, stress and the abnormal function of the immune system. Let's look at these factors more closely.

Genetics

Unfortunately, there is a strong genetic predisposition to eczema. This means that if your parents or any of your relatives have eczema or any form of sensitivity (atopy) such as asthma or allergic rhinitis, there is a high chance that you might develop one of these conditions too. It is not known why, but children born to older mothers are more likely to develop eczema.

Allergens

Allergens like dust mites, pet hair, pollen and mould are well-known triggers that can aggravate eczema.

Extremes of temperature and humidity

Extreme fluctuations of temperature and humidity can make your eczema worse, so be prepared with moisturising creams when travelling to different climates.

Irritants

Soap, shampoos, perfume, makeup and even chlorine in swimming pool water can aggravate eczema.

Food

Dairy products, nuts, wheat and soy products have been commonly known to trigger eczema attacks.

Stress

It is very common for patients with eczema to report that their condition worsens during periods of intense stress at work or school. They often find that their eczema improves at the end of an examination period or project deadline.

Hormonal

Female patients might sometimes find their eczema worsening during periods of hormonal changes like during pregnancy or at certain points of their menstrual cycle.

Can my eczema be cured?

As much as we would love to, we have yet to find a cure for eczema. However, with proper treatment, you should be able to keep your eczema well controlled.

How can I keep my eczema under control?

Keep your skin moisturised

The key to managing eczema well is to always moisturise, moisturise, moisturise. When the skin is well moisturised, the skin's defence barrier is well maintained and the chances of it getting irritated is significantly reduced. Use a moisturiser that is fragrance-free and hypoallergenic, and be sure to apply it liberally after showers and before bedtime so that the moisture you lost throughout the day is replenished and the skin has a chance to repair itself well.

Adopt eczema-friendly shower habits

There are several things you will have to watch out for as you shower to prevent your eczema from flaring up.

• Although showering in hot water may temporarily bring respite to the itching, it actually dries out the skin even more, causing a rebound itch and worsening of the eczema. It is best to shower using lukewarm water.
• Use gentle cleansers and shower foams. Soaps that are too harsh will strip the skin of its natural oils and moisture, worsening your skin's condition. Use soap-free products or a gentle cleanser that is meant for sensitive skin.
• Avoid rubbing your skin too hard with a towel as this damages the skin and irritates it further. Instead pat your skin dry gently.
• Moisturise your skin again as soon as it's dry.

Avoid triggers

While you should try to lead as normal a life as possible, it is important to avoid known triggers and aggravators.

Food - Learn to avoid food that, through personal experience, has been known to make your eczema worse.

Sunburn - Try to avoid getting sunburnt. Photodamage to the skin can make an existing eczema condition worse.

Allergens - Avoid exposure to allergens by ensuring that your environment is kept clean and as dust-free as possible.

How will my doctor treat my eczema?

If you suspect you have eczema, see your doctor to get a confirmed diagnosis so that you receive the right treatment.

Any time you have an acute fare-up of your condition, your doctor may prescribe topical steroids. This is often used concomitantly with moisturisers and some anti-allergy medications.

Your doctor may also prescribe antibiotics or anti-fungal treatment where an underlying skin infection is diagnosed.

If your eczema is particularly resistant to treatment or is recurrent, ask your doctor about allergen testing to determine the likely triggers that may be causing your flare-ups.

Remember, do not lose heart if you have eczema. Although frustrating and irritating, it can be very well controlled with the proper treatment and care. Don't suffer silently nor be tormented by the condition. Seek help early and begin taking steps towards your road to recovery.