Eczema, also known as dermatitis, is one of the most common chronic skin disorders in Singapore. It causes the skin to become inflamed or irritated, leading to symptoms such as dryness, redness, and intense itching. These rashes commonly occur on the face, knees, hands, or feet but can affect other areas as well. Treating eczema promptly is crucial to prevent it from adversely affecting one’s quality of life.
Causes of eczema
People with eczema have a defective skin barrier, making their skin more prone to irritants and allergens, and leading to loss of skin moisture. Several factors contribute to the development of this condition:
1) Genetics
Eczema is more likely if one or both parents have it. It is also common to find family members with allergic rhinitis and asthma in patients with eczema.
2) Environmental irritants and allergens
The most common allergen in Singapore is the house dust mite. Other triggers include heat, humidity, sweat, and irritants such as harsh soaps, detergents, and prolonged contact with water.
3) Endogenous factors
Internal factors such as stress, fever, hormonal changes, or lack of sleep can trigger eczema flare-ups.
4) Abnormal bacterial skin colonisation
The skin environment of eczema patients is more easily colonised by harmful bacteria, particularly Staphylococcus aureus (S. aureus), which promotes further skin inflammation and reduces the efficacy of topical treatments.
Common misconceptions about eczema in Singapore
1) Eczema is due to impurity of the blood and can definitely be cured
Eczema is a chronic skin condition linked to a defective skin barrier, not blood impurities. While many patients outgrow their eczema, there is no definitive cure.
2) Eczema is caused by food
While food allergies can trigger eczema, they are less common than believed. Environmental allergens, such as house dust mites, are more likely triggers, especially in older children.
3) Eczema is contagious
Eczema results from the skin barrier’s reaction to the environment and the immune system. It is not contagious, despite its red and progressive appearance.
4) Eczema is due to a lack of hygiene
Eczema is not related to cleanliness. Frequent use of soaps and detergents can actually aggravate the condition by drying out the skin.
Skincare for eczema skin
A good skincare routine is essential for eczema patients, aiming to strengthen the skin’s defective barrier. Key practices include:
- Frequent and regular moisturising
- Avoiding long and hot showers, and keeping bathing time to about 10 minutes
- Gently dabbing the skin dry after a shower instead of rubbing it
- Using mild cleansers and avoiding harsh soaps and products with fragrances
- Reducing harmful bacteria on the skin with gentle antiseptic agents, especially for those with frequent skin infections
During flare-ups, treatment is necessary to prevent worsening inflammation, skin infections, and scarring. Treatment plans depend on the severity of the condition, affected areas, and the patient’s age and general health.
Most common treatments for eczema
1) Prescription creams
Prescription creams are generally categorised into topical steroids or non-steroidal creams like topical calcineurin inhibitors.
Topical steroids work to reduce localised skin inflammation and have to be applied according with your doctor’s instructions.
2) Pro-active therapy
Increasingly, dermatologists are recommending pro-active therapy where treatment is administered even after the rash has subsided. This is done to decrease the residual inflammation in the skin which is not visible (not red) and to maintain the duration of rash-free periods.
3) Oral medications
The common oral medications to treat eczema are over-the-counter antihistamines. They can reduce itching by lowering histamine levels, though they may not be effective for all patients.
4) Wet wrap therapy
This involves applying steroid cream and/or moisturiser and wrapping the skin with a moist open-weave tubular dressing, which helps the rash resolve faster and reduces itching.
5) Photo-therapy
Photo-therapy is the exposure of the affected skin to specific light bands of ultraviolet B and/or ultraviolet A light. It is mostly used for adults with care on the amount of exposure to minimise potential UV damage to the skin.
Don’t let eczema affect your quality of life! Find qualified, experienced, and licensed Singapore dermatologists at Thomson Specialist Skin Centre. Together, we can help manage your skin condition and provide relief for its uncomfortable symptoms.
Dr Tan Hiok Hee
Dermatology (Skin)
Thomson Specialist Skin Centre (Novena Specialist Center)
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