Managing and Caring for Eczema-Prone Skin

Monday, 27.03.2017

Eczema is reported to be the top skin condition in Singapore with new cases every year. With unparalleled medical advancements, skin eczema still remains a non-curable ailment. Skin eczema is not a condition that strikes only in early childhood. Year on year, a sizeable number of adults contract some form of eczema owing to various different factors.

We interviewed Dr Gavin Ong, Medical Director and Consultant at The Skin Specialist, a Singapore Medical Group (SMG) Clinic as he lends his insights into this skin condition and how we can manage it with good routines and the right products.

What is skin eczema?
Skin eczema is a condition characterised by a state of skin that is generally dry and sensitive, and associated with episodes of itchy red rash. It is usually chronic and relapsing. Skin eczema is NOT a skin allergy.

Skin eczema may be present in various forms. The most common forms include atopic eczema (also known as atopic dermatitis), seborrhoeic dermatitis, discoid eczema and, hand & feet eczema. In atopic eczema, the flexural areas (eg. backs of the knees and the insides of the armpits, elbows) are most commonly affected.

What factors trigger eczema flare ups?
The common denominator in eczema flare ups is the further disruption of skin barrier function which is already impaired in sufferers of eczema.

While there could be a multitude of triggers for eczema in different people, they usually fall within either environmental or activity-based causes. Low humidity levels, exposure to pollutants, recurrent illnesses or high stress levels are some of the most common environmental conditions that elicit eczema. Eczema flares can also be caused by habits such as frequent, excessive or prolonged hand wash; scratching and the use of alkaline soaps for washing. 

What is the recommended skin care regimen?
As washing with soap further exacerbates skin dryness, we usually recommend eczema-prone individuals to use moisturising cleansers during wash and rich moisturisers after wash.

Since moisturising is a critical aspect of managing eczema-prone skin, what are the key considerations when chosing a moisturiser?
There is certainly a wide range of moisturising products in the market.

In the case of moisturisers, they can be broadly classified into standard or “moisturisers-plus”.

Standard moisturisers contain the typical ingredients found in majority of the moisturisers suitable for general eczema use.

“Moisturisers-plus” are more premium moisturisers that contain enhanced ingredients which are purportedly helpful in repairing the skin barrier defect in eczema or in reducing some of the distressing symptoms of eczema.

These enhanced ingredients include:

•  Physiological lipids: In eczema skin, the lipid composition of the skin is disrupted. Hence, some moisturizers contain formulations that closely mimic the natural lipids of normal skin. This helps to restore the optimal composition of skin lipids and helps repair the skin's natural moisture barrier.

Ceramides: these are fatty compounds which are important in maintaining the skin barrier, and are lacking  in eczema skin. They are responsible for allowing the top layer of the skin cells to stick together.

•  Palmitoylethanolamine (PEA): this is a compound that has been demonstrated to reduce the inflammatory response in eczema, thereby bringing about relief in itch and inflammation for calmer, less reactive skin.

Most moisturisers for eczema use comes in two main forms: creams and lotions where the former is thicker. Creams are therefore found to be more moisturising and may require less frequent re-applications. They are most suitable for application in targeted areas on the face or between fingers and toes etc.

Lotions are more fluid or “fluid of watery” and are more convenient to use when it comes to applying moisturiser over large body surfaces. They are less moisturising and usually require more frequent reapplications.

Gels in general are not moisturising enough and are not recommended for routine use in the management of eczema.

Most moisturisers formulated for eczema skin are fragrance-free for a good reason.Moisturisers that contain fragrances can prompt an allergic contact dermatitis reaction in some individuals. Always ensure that your moisturiser respects the needs of your sensitive skin by being:

- hypoallergenic (unlikely to cause an allergic reaction),
- non-comedogenic (does not cause blocked pores)
- does not contain and preservatives nor colorants that may trigger sensitivity.

*The information founded is for educational purpose and is not intended to replace the advice of your heath care provider. Discuss with your doctor any questions or concerns you may have. All images used in this material are for illustration purpose only.

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