Introduction

Eczema is a term that encompasses many inflammatory skin disorders, such as atopic dermatitis, contact dermatitis, photosensitivity dermatitis and seborrhoeic dermatitis. However, when most people mention that they have eczema, they are usually referring to atopic dermatitis. The word “atopy” means the individual has a genetic tendency to be hypersensitive, while “dermatitis” refers to an inflammation of the skin. Most cases of atopic dermatitis manifest in early childhood, and sufferers have an increased chance of developing other atopic diseases such as asthma and allergic rhinitis.

Signs & Symptoms

Atopic dermatitis patients usually have skin that is

  • Sensitive
  • Red and swollen
  • Dry and scaly
  • Itchy
  • Thicker than normal, can look crusty

When to Seek Medical Attention

Eczema is a relatively long-term disease, although most patients’ symptoms improve with age. Majority are able to treat their eczema at home effectively. However, see your healthcare provider if:

  • This is the first time you are getting the rash and have not been diagnosed previously.
  • Your eczema symptoms are severe and affecting your daily activities.
  • There is sign of infection, like pus, red streaks extending from area or a fever.
  • If you are unable to get relief from over-the-counter options.

Causes

The exact cause of eczema is unknown, although there appears to be genetic involvement. However, the condition can be worsened by –

  • Temperature extremities
  • Dry weather
  • Colonisation by microorganisms on the skin
  • Stress
  • Harsh chemicals
  • Allergies
  • Certain food triggers

Lifestyle Modifications

Due to sensitive skin, you should do a patch test for every new skin product. Apply the product on a small patch of skin, and wait for at least 24 hours. Do not use if you notice any skin reactions.

Change your bath products to those suitable for sensitive skin. These include soap, perfume and colourant-free options such as emulsifying ointment. Do not use hot water as this can dry out skin further. Instead, opt for cool or lukewarm baths, and limit bath time to about 5 minutes. Pat skin gently with a towel, and then apply moisturiser within 3 minutes after drying off.

Moisturiser is extremely important to protect and hydrate the skin. Eczema sufferers should moisturize at least twice a day, or more if necessary. Ointments are typically better than creams and lotions for this purpose, although most would complain about its greasy texture. Examples of moisturizers include white soft paraffin and urea.

Look out for any triggers that might be causing the eczema flare-up. Keeping a symptom tracker diary might help.

Practise relaxation techniques as stress can exacerbate eczema. These include meditation and deep breathing techniques.

Keep fingernails short and filed to minimize damage to the skin when scratching. Mittens can be considered in younger children.

Try to minimise perspiring.

Treatment

Coal tar is an over-the-counter option that can help with swelling and itch associated with atopic dermatitis, especially when the skin is thickened. However, it might cause your skin to be more sensitive to the sun, so do your best to keep out of direct sunlight.

Topical corticosteroids can be used to control the eczema flare up. Always use the lowest effective potency for the shortest duration of the time possible. Hydrocortisone and Desonide creams are available from your pharmacy, while the more potent steroids such as Betamethasone are under prescription. If deemed necessary, your doctor might prescribe you a course of oral corticosteroids.

Antihistamines such as diphenhydramine, promethazine, and chlorpheniramine can make you drowsy; hence helping to control the itch at night and giving you get a better sleep. For day-time symptom control, non-drowsy antihistamines such as cetirizine, loratidine or fexofenadine might be helpful.

Bacterial colonisation can happen with atopic dermatitis. See your doctor for antibiotic therapy if necessary.

For eczema that is difficult to control, your doctor might prescribe other medications, such as calcineurin inhibitors or immunosuppressants.

 

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