Eczema, also known as atopic dermatitis, is a chronic skin disorder characterised by an itchy and dry rash. It is the most prevalent chronic skin disease in children and often shows improvement with age. Approximately 10% of school-aged children in Singapore are affected by eczema1.
Source: 1BMJ Journals
Eczema can arise from a combination of factors, often with a genetic component, implying a family history of eczema or other allergies.
The severity of the condition can be worsened by various individual-specific factors, including environmental temperature changes, irritation from synthetic or woollen clothing, exposure to soaps, animal fur, and emotional stress. Skin affected by eczema is more susceptible to secondary bacterial and viral infections, especially when scratched and broken.
Eczema typically presents as itchy skin that may be dry, red or both, often persisting for months or longer. Commonly affected areas include the fronts of the elbows, back of the knees, neck and face.
While there is no cure for eczema, it may improve over time. Controlling the itch is important for the child's quality of life and sleep, and for preventing complications such as frequent skin infections and lichenification (skin thickening resembling tree bark, which is challenging to reverse).
The main areas of therapy include:
Dry skin is prone to itching and cracking, facilitating allergen penetration and exacerbating eczema. Moisturisers, either prescribed by a doctor or any suitable over-the-counter brands that are alcohol- and scent-free, should be applied to all affected areas, including the face.
Opt for cotton clothing over woollen or synthetic fabrics to avoid skin irritation. Avoid detergents and harsh soaps. If house dust mites are a concern, consult your doctor for methods to reduce them. In cases where eczema begins at one to two years of age, a food allergy may be involved. Please consult a doctor for a thorough evaluation.
Steroid creams, prescribed by the doctor, can effectively reduce skin inflammation. They must be used strictly as directed.
To alleviate itching and promote better sleep, doctors may prescribe topical or systemic anti-itch medications. These are complementary to moisturisers and topical steroids.
In cases where bacteria worsen eczema, antiseptic washes may be helpful. For acute skin infections, topical or oral antibiotics may be prescribed by the doctor.
