Health

Published: Sunday May 6, 2012 MYT 12:00:00 AM
Updated: Monday August 5, 2013 MYT 12:05:53 PM

Itchy skin

A survey reveals low awareness of eczema in Malaysia.

ECZEMA is a chronic, inflammatory skin disease marked by intense itching, red rashes, and accompanying skin lesions. It is a common skin condition which afflicts 10-20% of children and 1-3% of adults worldwide, and two in every 10 individuals in Malaysia.

ALthough eczema is a common skin disease, there is still a general lack of awareness about it. In 2011, LEO Pharma conducted a research study among eczema patients and eczema caregivers in Malaysia via The Research Partnership, a global pharmaceutical research company.

Tan Keng Aun, country manager of LEO Pharma said, “We are committed to educating and empowering eczema patients through learning initiatives collaborated with doctors and healthcare providers.”

The study revealed that 75% of eczema patients knew little or nothing about eczema prior to diagnosis, while 15% had never heard of it prior to seeing a healthcare professional.

Similarly, 66% of eczema caregivers knew little or nothing about the illness prior to being exposed to it.

“Many people do not generally know what eczema is, or what it looks like. Without proper knowledge and awareness, there can be a tendency to shrug off the condition, or delay going to the doctor until pain or unbearable discomfort is experienced,” explained consultant dermatologist Dr Suganthi Thevarajah.

The study further showed that there was a gap of around nine months between first experiencing symptoms and getting a diagnosis for the patient.

This means that on average, a patient tends to wait nine months before seeking medical help or treatment.

It is very important to give eczema due medical attention at the onset of symptoms – the most common of which are constant itch, redness, and skin dryness. If untreated, eczema can lead to severe flare-ups, and even, serious infections.

Scratching damages the skin, and allows penetration and colonisation of Staphylococcus aureus bacteria, which is present on the skin of more than 95% of eczema patients. This leaves patients more at risk of dry and brittle skin, which becomes sensitive to chemical impact and entry of irritants and allergens.

When bacteria enter the defective skin barrier damaged by scratching, the secretion of its toxins causes further swelling, intense itching, and infection. Over time, the skin becomes thickened, scaly and crusty.

As eczema is highly visible on the skin, it can also have an emotional, psychological, and social impact on the person suffering from it.

For instance, a flaking rash on the hands or face can make a person feel self-conscious in public, thus making social interactions difficult.

On the other hand, children who have eczema can be subject to bullying and teasing by peers, which can be traumatic for them.

Most patients also feel they have to be constantly vigilant to avoid triggers to their condition, even having to be careful with the clothing or fabric they wear. On average, a patient’s productivity level at work or school also dips by 26% during an eczema flare-up.

The study also revealed how most patients feel about living with eczema: embarrassed about their condition, feel they are constantly reminded of the fact that they have it, exhausted dealing with it, and think controlling it is an impossible task.

As there is no cure for eczema, treatment of the condition may prove to be challenging for many. However, eczema can be successfully managed with the right medical advice, and prescribed medication that can provide fast relief for itchiness and even clearance of lesions.

Treatment options include the following:

Topical steroids

Topical steroids combat inflammation of eczema and help to heal the skin. They are available as ointments, creams or gels, and in different strengths (mild, moderate, potent, etc).

Topical steroid-antibiotic combination cream

When eczema becomes infected, your doctor might recommend a course of antibiotics combined with steroids. This is especially when topical steroids alone don’t work. Using a topical steroid-antibiotic combination may be more effective than changing the type of topical steroids used.

Infected eczema can be treated effectively with a steroid-antibiotic combination cream, which can be applied topically to cracked and broken skin in order to rapidly suppress the itch. It can be used even if there are no obvious signs of infection.

Topical immune-modulators

Topical immune-modulators are available as a cream or ointment, which are applied to the skin to dampen down the immune system and help reduce inflammation.

This kind of treatment should only be used in children older than two years of age, and in exceptional cases where topical steroids do not work.

Topical immune-modulators should never be used in infected eczema. They should only be started by a doctor experienced in the treatment of eczema. The immune-modulators are currently under specific investigations due to the potential risk of skin cancer.

Phototherapy

This employs ultraviolet (UV) radiation for the treatment of moderately severe eczema. It serves to reduce inflammation of the skin. Side effects of phototherapy are similar to prolonged sun exposure and includes itch, redness, tanning of the skin, and the increased risk of skin cancer.

In managing eczema, it is important to adopt a daily skin care routine and eliminate things that make the eczema worse. Exposure to allergens should be kept to a minimum and irritants avoided and substituted. For example, soap can be substituted with an oily or emollient alternative.

References:

1. Atopic Dermatitis: Who Gets and Causes. American Academy of Dermatology. http://www.aad.org/skin-conditions/dermatology-a-to-z/atopic-dermatitis/who-gets-causes/atopic-dermatitis-who-gets-and-causes

2. Atopic Dermatitis / Eczema. Allergy Centre Malaysia. http://www.allergycentre.com.my/atopic.html

3. Thestrup-Pedersen K. Treatment principles of atopic dermatitis. Journal of European Academy of Dermatology and Venereology 2002;16:1–9.

4. Eberlein-Konig B, Schafer T, Huss-Marp,J.Skin surface pH, stratum corneum hydration, trans-epidermal water loss and skin roughness related to atopic eczema and skin dryness in a population of primary school children. ActaDermatoVenereologica, 2000;80:188–91.

5. Leung DY. The role of Staphylococcus aureus in atopic eczema. ActaDermatoVenereologica2008;(S216):21-7.

6. The Psychological Effects of Eczema. http://www.livingwithallergies.org/the-psychological-effects-of-eczema.

Tags / Keywords: Health, Lifestyle, Health, skin care, eczema

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