Eczema
What Is Eczema?
What Are the Signs and Symptoms of Eczema?
Symptoms of eczema vary according to the type and the age of the person. Signs may start in infancy, with dry and itchy patches affecting the cheeks and scalp. The rashes may be so itchy that they interfere with sleep, and lead to bleeding and infections when constantly scratched.
Most symptoms of eczema develop during childhood (before the age of 5) and may persist up to adolescence and adulthood. It is important to note that no two cases of eczema are alike. The most common signs are:
- Red, inflamed skin across much of the body, including the elbows, knees, nape, neck, ankles, legs, wrists, and buttocks.
- Dry and sensitive skin
- Rough, discoloured, scaly or leathery patches of skin
- Itchy and bumpy rashes
- “Weeping”, oozing or crusting blisters
Why Am I Experiencing Eczema?
The exact cause of eczema is still unknown, but genetic factors are long thought to increase one’s risk of developing it. For instance, a child born to a parent or parents diagnosed with eczema or another atopic disease such as asthma and allergic rhinitis has a greater chance of also developing the skin condition.
Eczema is also believed to be triggered by environmental factors such as:
- Allergens (pollen, dander, dust mites, mould)
- Irritants (soaps, shampoos, detergents, and disinfectants)
- Microbes (viruses, bacteria, fungi)
- Food (egg, dairy products, wheat, gluten, citrus fruits, nuts, and seeds)
- Extreme hot or cold temperatures, and high or low humidity
- Hormonal fluctuations
- Stress
Types of Eczema
Atopic Dermatitis
Contact Dermatitis
Dyshidrotic Eczema
Nummular Eczema
Seborrheic Dermatitis
Stasis Dermatitis
How Is Eczema Diagnosed?
A physical inspection of the affected skin, an assessment of symptoms and a medical history review are often enough for a
Generally, no laboratory tests are necessary to diagnose eczema, though doctors may also order skin tests and blood tests to rule out other skin disorders, as well as determine which substances may be causing the eczema or flare-up of the condition.
What Are the Treatment Options for Eczema?
- Corticosteroids help reduce itchiness and skin inflammation. They are available in the form of a cream, an injection or pills.
- Antibiotics are prescribed if the eczema is secondarily infected by bacteria.
- Antihistamines help manage itch.
- Topical calcineurin inhibitors work by blocking a specific protein in the immune system of the skin that causes inflammation and itch. These include tacrolimus and pimecrolimus. This helps to clear the eczema. Not only do these help to clear the eczema but they also are used as long-term maintenance therapy.
- Oral cyclosporine is an immunosuppressant for the treatment of severe atopic dermatitis.
- Phototherapy such as narrowband ultraviolet B phototherapy is a kind of light treatment that is safe for the treatment of atopic dermatitis. This is available at our clinic.
- Biologics like dupilumab are effective in treating severe atopic dermatitis with minimal side effects. Suitable for standalone use or with topical corticosteroids, and available at our clinic.
- JAK inhibitors are a group of non-steroid oral medicines for patients with moderate to severe atopic dermatitis. These include baricitinib, abrocitinib and upadacitinib. They work in a novel way to block the proteins that stimulate the immune pathway in atopic dermatitis to reduce itch and inflammation. These are available at our clinic.
- Topical PDE4 inhibitor like crisabarole cream is a new class of topical treatment for eczema. It is a non-steroid alternative for eczema and is suitable for use for adults and babies aged 3 months and up.
What Else Can Be Done to Prevent Flare-ups
- Identify and avoid food, chemicals and materials that trigger or worsen symptoms.
- Keep the skin hydrated by applying eczema-friendly lotions and moisturisers.
- Protect any cracked skin or wounds to prevent infections.
- Avoid scratching or touching the affected skin.
- Avoid sudden temperature and humidity fluctuations.
- Reduce stress levels.
FAQs on Eczema
Can eczema be cured?
There is no definitive cure for eczema. However, treatments can help manage its symptoms and improve your quality of life. These treatments range from topical corticosteroids to phototherapy and biologics.
Is eczema an allergy?
No, eczema and allergies are two different conditions. Allergies typically involve a specific immune reaction to allergens, while eczema is a chronic inflammatory skin condition with various triggers beyond allergens.
Is eczema contagious?
No, eczema is not contagious. It is caused by genetics and environmental triggers and often involves a malfunction in the skin's barrier function.
Does eczema hurt?
Yes, eczema usually causes pain, inflammation, and itching, with symptoms varying in severity from person to person.
When should I see a dermatologist?
It is advisable to seek medical advice from a dermatologist if:
- Your symptoms cause discomfort or interfere with daily activities
- Your skin is infected (signs include redness, warmth, swelling, yellowish crust, or pus)
- Self-management methods have not worked
- Symptoms interfere with your sleep
- The affected areas are widespread
- You notice sudden changes in your symptoms
- You experience side effects from over-the-counter treatments
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