Learn about symptoms and causes of eczema, self help treatment options, medication and when to seek medical help.

What is Eczema?

Eczema, commonly known as Atopic Dermatitis, is a skin condition which may continue throughout a person’s life. Eczema symptoms can sometimes get better or sometimes worse, causing red, itchy, dry rash. This skin condition commonly affects children which can begin within the first weeks or months of birth and may carry on into adulthood. Adults may have symptoms of eczema for the first time in their 20s or after the age of 50.

What are the possible causes of this condition?

Eczema is very common in developed countries and city areas. About 20% of school children in Singapore have eczema.   Majority of patients showed improvement of the condition as they become older, but 30-40% may still have eczema symptoms as adults.

There is no exact cause for eczema as the condition can come from a mixture of factors such as the environment you are exposed to, family history of allergies, and/or changes to the immune system.  Feeling stressed may also cause an eczema flare.

What are the symptoms of Eczema?

There are many types of eczema and symptoms may be different from person to person.

However, common symptoms of this condition can include the following:

• Itch
• Small bumps and flaky skin
• Swelling of some areas of the skin
• In mild cases, the skin can appear dry and red 
• In severe cases, skin may appear oozing, crusting or bleeding

Depending on the age of the patient, the areas affected by eczema may be different:

• In babies
  • Scalp
  • Face
  • Sometimes arms, legs and body
• In older children
  • Neck
  • Elbow creases
  • Back of knees
• In adults
  • Areas similar to older children (as above)
  • Face
  • Wrist
  • Hands and forearms

What can I do to treat Eczema?

Treatment for eczema will depend on the severity of the condition, the age of the person, a person’s own preference and the type of eczema involved. Oftentimes, you may need to try a few different products before knowing what would work well for you. 

While there is no cure to eczema, the symptoms you experience can be reduced and maintained with moisturisers, topical and/or oral medications, as well as self-care measures.

Applying moisturisers regularly helps to keep your skin moist, which helps to reduce your signs and symptoms of eczema, and also how often flare ups occur.

There may be oral and/or topical medications which you can consider when managing any eczema flare ups: 

• Oral antihistamines (e.g. cetirizine, desloratadine, fexofenadine, loratadine, chlorpheniramine) may be taken to help relieve itch.
• Topical steroids at the right potency may be used if eczema flares with itch and redness. They should be started when the flares occur and stopped when the flares clear up.

Do discuss with your pharmacist or doctor about the suitability of these medications.

When do I need to see a doctor?

Although eczema can be managed without seeing a doctor, there are times where the condition might be more serious.

If your condition does not get better in 1-2 weeks after self-treatment or gets worse, you should see a doctor. You should also see a doctor if you experience any of the following:

• Signs of infections:
  • Fluid oozing: any fluid coming out from the skin.
  • Yellow crust/ yellowish spots forming on the skin surface.
  • Swelling or soreness of the skin.
  • Fever, shivering.
• Lack of improvement after using any over-the-counter medications for the recommended period of time.
• Eczema flare-ups that disturb your sleep, mood and/or lifestyle.

What else can I do to manage this condition?

 Here are some tips which you may take to manage eczema flare-ups:

1. Knowing and removing any triggers

• Identify your triggers and avoid them as much as possible.
• Trigger factors may include (but not limited to):
  • Changes in temperatures such as overly heated rooms.
  • Sweating/dry environment/surroundings.
  • Feeling stressed or any changes in mood.
  • Coming in contact with chemicals such as perfumes, detergents, cosmetics, dust, sand, smoke.

2. Showering

• Take showers with lukewarm water, not hot water. Hot water strips the natural oils that protect your skin from dryness. Showering with hot water causes your skin to become more dry and worsens your eczema.
• Use shower products that do not contain fragrances or colouring, as these substances may cause irritation to your skin, triggering allergic reactions and eczema flares.
• Limit your showers to no longer than 10 minutes.
• After showering, gently pat your skin dry. Do not rub your skin with your towel.

3. Moisturising

• It is important to apply moisturisers daily, at least two times a day.
• Use moisturisers that do not contain fragrances or colouring.
• Apply moisturisers (preferably creams or ointments) within five minutes after bathing or showering as this helps to retain moisture in your skin better.
• Lotions may be easier to apply than creams due to its higher water content. However, the moisturising effect would be lesser compared to creams and ointments.
• Apply cold compress (towel which is wetted with cold water) and wet dressings or wraps as advised by your healthcare professional.

Disclaimers

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

The content above is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Always speak with your physician, pharmacist or other healthcare professional before taking any medication or supplement, or adopting any treatment for a health problem.