Atopic eczema

What is atopic eczema?

Atopic eczema is also known as atopic dermatitis. This condition is common and inflammation of the skin causes a dry and itchy rash. It usually starts in infancy and childhood, but can also occur in adults. In infants, the face and outer side of the limbs are affected but during childhood, it usually affects the neck and skin folds. In mild eczema, the rash is red, dry and itchy. If the condition worsens, there may be oozing, crusting and bleeding. The itch can be severe enough to interrupt sleep.

Why do I have eczema?

Genes play an important role as atopic eczema often runs in families. Patients also have a tendency to develop other hypersensitivity disorders such as asthma, allergic rhinitis or hay fever. In atopic eczema, the immune system is altered and overreacts to things such as irritants (eg soaps, fragrances, detergent), and allergens (eg house dust mites, animal dander). In addition, an impaired skin barrier also contributes to dryness and increased penetration of allergens and bacteria/viruses.

Is eczema contagious?

No, it is not infectious and you cannot spread it to other people.

Will my child grow out of eczema?

In general, atopic eczema tends to improve as the child gets older and 50-75% may clear in the teens. However, eczema may still occur on and off at times, even in adulthood. Good skin care and use of appropriate medications is important to minimise these occurrences.

How can I care for my skin?

  1. Try your best to avoid scratching, rubbing and picking your skin. This makes eczema worse and leads to unsightly pigmentation, broken skin and scars. Let us help you with techniques to minimise scratching!
  2. Use gentle non-fragranced soaps instead of harsh irritating soaps and detergents.
  3. Moisturise the skin as frequently as you can, especially during travel to cold and dry climates, or after swimming. Moisturisers do not cause thinning of the skin.
  4. Certain clothing material like cotton are more comfortable for atopic skin and can absorb perspiration well.

Why do I have an eczema flare?

  1. Environmental factors, such as heat, dust, pets and irritants (eg harsh soap)
  2. Dry skin
  3. Being unwell (eg having a cold or flu)
  4. Teething in babies
  5. Skin infections with bacteria or viruses, which may be due to excessive scratching
  6. Food allergens (rare)
  7. Stress

Is it true that certain types of food worsen atopic eczema?

In adults, food allergies causing eczema is uncommon. The prevalence of food allergies is highest in young children less than 3 years old with severe eczema. It may be suspected if eczema is difficult to control or rashes appear after eating a specific food. Common food allergens in children include cow’s milk, hen’s egg, peanut, tree nuts, shellfish, wheat and soy. Tests for food allergies are available, speak to your dermatologist regarding these tests.

I need help to manage my eczema!

Let us work hand in hand with you to improve your skin condition. Most patients are familiar with the use of topical steroids to reduce skin inflammation, but there are many misconceptions present. Your dermatologist will share how to use topical steroids safely and effectively, together with moisturisers, for maximum benefit. Steroid-free topical medications are available and effective, and the doctor will advise you accordingly. In cases of severe eczema, oral medications may be needed. There are biologic medicines such as Dupilumab, speak to us about your suitability for this effective treatment.