The following article was published on The Straits Times.
While mild symptoms can be resolved with topical creams, don’t wait for severe cases to heal on its own, warns StarMed Specialist Centre’s dermatologist Dr Kok Wai Leong
Most people don’t take skin flare-ups seriously enough. Instead, they often resort to self-diagnosing and self-medicating with over-the-counter topical creams.
While these may provide temporary relief, it’s important that people seek professional help – especially if their flare-ups are persistent or severe – as they could be suffering from eczema.
Atopic eczema, the most common form of eczema, occurs in about 20 per cent of school-going children and 10 per cent of young adults. It is the result of a defective skin barrier that causes increased loss of moisture through the skin, as well as a hypersensitive immune system that overreacts to allergens and environmental factors like heat, sweat, dust or stress.
If left untreated or mistreated, atopic eczema can lead to more serious issues like insomnia or depression. It has even been linked to cardiovascular disease, says Dr Kok Wai Leong, senior consultant in dermatology at StarMed Specialist Centre.
He cites the case of a patient who developed adult-onset eczema triggered by his highly stressful lifestyle as a banker. Convinced that he had food allergies, he did not seek treatment for eczema and instead, went on a vegetarian diet to cut out gluten, seafood and meat – ingredients that he thought were allergens.
After losing a lot of weight and still not seeing any improvement in his skin condition, the patient became socially withdrawn and was eventually diagnosed with clinical depression. It wasn’t until he sought help from Dr Kok and received biologic therapy, an injection under the skin to treat moderate to severe cases of atopic eczema, that he found relief from his condition.
Spot the signs
Dr Kok says that he typically sees a 10 to 15 per cent increase in the number of patients, particularly children, seeking help for eczema flare-ups during the hot and humid months.
Tell-tale signs of eczema include red patches that are very itchy, and if scratched, ooze fluid or bleed. There are other skin condition that may look similar but have subtle differences. For example, hives manifest as transient raised patches, while psoriasis present as thick, white skin patches. Although the latter resembles eczema, the psoriasis rash tends to flake more and occur on areas outside of skin folds, such as the scalp, back and the outer areas of the knees and elbows.
Despite how common the skin condition is, Dr Kok says there are still plenty of misconceptions about eczema. The most prevalent of which includes believing that eczema can heal on its own or be resolved with topical creams.
Says Dr Kok: “I always liken eczema to a fire. When it is mild, it can be put out easily. But if you let the fire fester, it can spread to different parts of your body. Applying a topical cream is like putting out the fire without dealing with the embers. If you wait too long to manage it, permanent damage could occur.”
Managing the condition at home
Depending on the severity of the eczema, a dermatologist might prescribe topical creams (which can be steroid or non-steroid based) for a start. If your condition is more severe, oral medications or biologic therapy, which are new targeted treatment options that help to regulate the immune system, might be recommended.
The most important thing that patients should do after getting a diagnosis for eczema, Dr Kok says, is to be aware of what their triggers are, so as to be able to better manage flare-ups at home.
“For example, if your eczema is triggered by heat and sweat, avoid going outdoors when it’s hot and humid. Pat sweat dry if you’re exercising outdoors, and opt for loose-fitting clothing made with breathable materials such as 100 per cent cotton.”
Switching to a moisturiser and soap formulated for eczema-prone skin is also crucial, as it helps to provide a barrier that prevents water loss and stops external agents like bacteria, viruses and irritants from gaining entry into the skin. It usually contains substances like lipids and ceramides that are building blocks for the skin to promote skin repair.
Want extra relief? Dr Kok recommends popping your moisturiser into the refrigerator to add an extra soothing sensation.
For young patients, he recommends that parents establish a routine for their children to ensure that moisturiser is applied regularly especially after a shower, and keeping fingernails short and teaching children to tap on their skin rather than scratch for itch relief.
While there is no permanent cure for eczema, these home remedies and good habits can help eczema patients manage their flare-ups.
Ultimately, Dr Kok reiterates that eczema sufferers “not treat eczema like a fever or headache, which is something that can be managed with a quick fix”.
He says: “Eczema can be managed. Work with your dermatologist to identify your triggers, come up with a good treatment plan and develop a routine and you will be able to lead a normal life.”
StarMed Specialist Centre’s dermatology clinic provides care and treatment for a range of skin conditions and concerns. Visit https://starmedspecialist.com/specialist/dermatology/ for more information.