Eczema affects 1 in 10 adults and 1 in 5 kids in Singapore. But what makes eczema all the more alarming is that the number of people diagnosed with the disease is increasing. It is now the top skin condition seen at the National Skin Centre, with 15,000 cases every year. So, what is eczema? Can it be cured? And what’s the cost of living with it?
What is eczema? What are the common eczema symptoms?
Eczema, also known as dermatitis, is actually a group of chronic itchy skin diseases. There are two main types: contact eczema (caused by direct contact with external triggers) and endogenous eczema (the result of conditions within the body).
Most children suffer from atopic eczema, which is a form of endogenous eczema, with many developing it before age 5 – poor things. But most kids’ condition improve as they grow older. However, eczema can still flare up later on.
People who suffer from eczema have a damaged skin barrier making their skin more sensitive to allergens, irritants, bacteria and other external invaders that affect the skin.
The telltale symptoms of eczema are itchy, weepy round patches that eventually become dry and scaly. On babies, they commonly appear on the cheeks and scalp. On kids, neck, elbow, behind the knees, wrists and ankles. For adults, these appear on the face, wrists, hands and forearms, sometimes the legs.
The exact cause of eczema isn’t known, but for many people it’s genetic – they have a family history of it. Because of this genetic predisposition, those who suffer from atopic conditions like asthma or hay fever are also likely to suffer from eczema.
Another risk factor is where you stay – how much exposure you have to urban pollutants that can trigger eczema.
What causes eczema? How do you manage triggers?
Unless you plan to move away to the French countryside, living with urban pollutants is sadly a fact of life that Singaporeans with eczema. But you can find out what exactly you’re sensitive to, and try to manage your exposure to them.
You can get tested for eczema triggers at the National Skin Centre and at private skin clinics. This is done with a skin patch test, a skin prick test or a blood test. The skin patch/prick test is more affordable ($60 or $70 onwards at NSC, $200 onwards at private clinics) while the blood test can go up to $500.
Don’t forget to factor in the consultation cost as well. At the NSC, consultation for Singapore/PRs costs from $36 to $54. For private clinics, expect to pay from $120 to $200 on average.
Many eczema triggers are part of the environment. There are the usual allergens and irritants like smoke, dust mites, pollen, mould and pet fur, which are fairly easily to remove from your environment.
Some people are even triggered by hot or cold weather. Sadly, Singapore’s hot weather can’t really be changed. (You shouldn’t blast the air conditioning as it can worsen dry, itchy skin.) Worse, sweat can be highly irritating as well, so you may need to avoid sweaty exercises.
Another major trigger category is the irritants found in soap, shampoo, detergent and so on. Many of these household products are full of strong fragrances and harsh chemicals; you may want to swap them out for gentler products from online stores like iHerb, Skinshare, NaturaWorks and Love for Earth.
In very young children, food allergies may worsen eczema. (This is not often the case with older children or teens.) Common triggers are dairy, eggs, nuts, soy, wheat/gluten, fish or shellfish.
What are the eczema creams & oral medications available?
What makes eczema unbearable for many is the itch. Some have been known to scratch till they bleed. Even if you don’t scratch it, the blisters can become red and weepy. Then comes the cracking and dryness that can make movement painful.
Because the symptoms are so uncomfortable, treatment involves alleviating the symptoms and healing the damaged skin. The following topical treatments can be applied on your skin:
Steroid creams – These are mid- to high-strength creams that are used for a short time as needed. Apply a cold compress beforehand to help the skin absorb the cream better. You’d usually need a doctor’s prescription for this. Follow the prescription carefully, because improper use (too much for too long) can lead to side effects such as thinning skin, stretch marks and discoloured skin.
Non-steroidal creams – A gentler alternative to soothe the skin, these don’t have the side effects of topical steroids. They work by blocking cells in the immune system that can cause inflammation. You don’t need a prescription as you can find it at retailers like Skinshare Singapore (about $30 a tube).
Moisturisers – Keeping the skin moist and supple is an important way to prevent eczema flare-ups. You can get it at any toiletries store, but choose gentle, unscented brands like QV or Cetaphil.
Topical creams can only do so much for eczema. In many cases, the doctor will also prescribe these common oral medications:
Antihistamines – These block your body’s natural chemical responses to allergens and irritants, which are what make you itch, sneeze and get rashes. You take them for a short period to relieve the itch, especially at night so you can sleep better.
Systemic corticosteroids – When the body encounters allergens and irritants, the immune system is what causes inflammation – red patches and swelling. Orally taken or injected, these suppress the immune system, stopping inflammation.
Antibiotics – Not eczema-specific, but these may be prescribed if there are signs of skin infection.
Are there any cheaper home remedies to treat eczema?
Apart from the standard medically prescribed eczema creams, there’s a plethora of home remedies you can try:
Baking soda – Baking soda has anti-itch properties and can neutralise acids on the skin. Make it into a paste by adding water to a little baking soda. Dab the paste onto the skin where it isn’t broken and leave it to dry. You can buy it at
Oatmeal – Got leftover oatmeal from when you tried to eat healthy? You can use it to soothe your skin too. Grind it into a fine powder and apply on your skin or add it to your bath.
Olive oil – Great for Italian cooking and great for the skin as well. Olive oil helps to restore the skin’s natural smoothness and protects it against UV light.
Coconut oil – It’s not just for dressing salads and cooking. Coconut oil is naturally anti-bacterial and anti-fungal, protecting the skin from infections.
Aloe vera gel – Ever put aloe vera gel on a burn to help it heal? That’s because aloe vera contains hormones that have wound-healing and anti-inflammatory properties.
Finally, if you have the budget, there are pricier exotic creams you can buy online too:
Papaw ointment – Papaw (i.e. papaya) cream is one of those cult skincare products that beauty junkies know about. Supposedly, the enzymes in the fruit remove dry and flaky skin and hydrate it. $23.50 from Pupsik Studio
Emu oil – Yes, this is exactly what it sounds like. This is oil comes from the fat of these flightless birds and is known for its anti-inflammatory property and ability to help your lock in skin moisture. $30 to $68 from Emu Tracks
Argan oil – Extracted from the argan tree, argan oil is high in vitamin E and fatty acid, making it extremely hydrating. $18.90 to $23.90 from Singapore Soap
Kakadu plum ointment – A superfruit rich in Vitamin C, it is also high in anti-oxidants. Vitamin C is an immune-system booster and essential for glowing skin while anti-oxidants protect the skin from the environment. $25 from Skinshare Singapore
What if you have severe eczema? What treatments are there?
For severe cases, these alternative treatment methods are available in Singapore:
Phototherapy or UV therapy – This involves using ultraviolet A and/or B light to calm the inflammation, reduce the itch, increase Vitamin D production, fight bacteria on the skin and heal the rash.
At first, treatment is given 3 times a week. When there is improvement (skin lesions clear), it can be reduced to once a week or once in two weeks. It’s not costly – prices start from $10 per session at the National Skin Centre, and $23.50 to $53.50 at private skin clinics.
Immunomodulators – These are medication that contain an active ingredient that changes the way our immune system works. Some suppress the immune system, some weaken it while others modify the way it works. Since eczema is the result of a dysfunctional immune system which causes inflammation, getting to the root of the problem – the immune system – helps.
In Singapore, pimecrolimus cream (Elidel) and tacrolimus ointment (Protopic) are two topical immunomodulators which have been approved. These are quite pricey and can cost up to $300 online. Nonetheless, given how aggravating the condition can be, some people afflicted with eczema don’t mind paying for relief.
Have you ever dealt with eczema? Share your itch relief tips with us in the comments.