Understanding eczema


  • Health
  • Sunday, 03 Aug 2003

Dr YLM

I USED to have eczema as a kid, or so my parents told me. Now that I’m an adult, I thought that was all past me. But lately, I noticed a patch at the back of my neck. What is eczema and why is it still plaguing me?  

Eczema is actually a name for a collection of various inflamed skin conditions. The commonest is atopic dermatitis, which is also called atopic eczema.  

The word “atopic” usually has something to do with allergy. Dermatitis means inflammation (‘itis) of the skin (derma). 

It is not only plaguing you alone. Apparently, 10% to 20% of the world’s population are plagued by it.  

 

There are various triggers for eczema.For some,it is the ingestionof foodstuffs like prawns.Others may react to rough and coarseclothing,detergents,soaps,sweating,dust mites,animal salivaand eating meat.

Yeah, but I’m an adult. I thought it was a children’s disease.  

Eczema can be a very chronic condition, which means it can go on and on for a very long time. Sometimes it clears, only to come back again at certain periods.  

You are right. It is a disease of childhood, usually appearing in infancy. Approximately 90% of those who suffer from it develop eczema before the age of five.  

Many children find their eczema clears when they grow up. But 40% to 60% of these children continue to be afflicted through puberty and adulthood, especially if it’s triggered by external factors. 

It also happens in people with a family history of allergy. 

 

What are the triggers?  

Eczema is caused by the body’s own immune system, which is responding abnormally and overactively to certain factors which cause a flare-up. These factors, which are called triggers, vary from person to person. If you have eczema, you have to identify what it is exactly that causes it to flare.  

For some people, it is the ingestion of foodstuffs like prawns. Others may react to rough and coarse clothing, detergents, soaps, sweating, dust mites, animal saliva and eating meat. For some, eczema can even be triggered by a common cold.  

Stress is also sometimes a trigger, so be careful to look out for it. 

 

How will I know it’s eczema and not some other skin  

disease?  

Eczema usually looks like a red, dry patch on your skin that is extremely itchy. A lot of the time, it’s the other way round. Your skin starts itching, and when you scratch it, the red rash appears. It’s something like a chicken and egg situation. 

It can occur on any part of the body. But in children and adults, it is more commonly seen on the face, neck and the inside areas of your elbows, knees and ankles. 

Eczema sometimes can also bubble up and ooze.  

On people who have had it a long time, constant scratching may cause the skin to be leathery, like a turtle. This is called lichenification.  

 

My aunt says people who have eczema will also get asthma. I’m scared. Is this true?  

Apparently, 40% to 60% of people who have eczema can also have respiratory allergies.  

Eczema is associated with asthma and other allergic-type disorders, but it does not cause them.  

A doctor will always ask you for symptoms of asthma when he has diagnosed you as having eczema.  

Okay, so I’m an adult with eczema. What can I do?  

The most important thing anyone will tell you about eczema is: Don’t scratch.  

Okay, I admit that might be difficult sometimes, so a very key component of eczema therapy is to prevent scratching. As dryness exacerbates the itchiness, you are advised to apply lotions or creams to keep your skin moist at all times. It’s best to do this within three minutes directly after bathing in order to “lock in” the moisture.  

Other methods to relieve itching include cold compresses onto the eczema area. Antihistamines can be taken orally, especially to get a good night’s sleep.  

If all this fails, you can use corticosteroid creams and ointments to reduce the inflammation.  

 

Steroids. Don’t they have side effects?  

The ones that are used to apply on the skin do not have so many side effects as the ones you actually ingest. The most common side effect of topical corticosteroids is thinning of the skin. What you can do is limit the amount of time the steroid cream is in contact with your skin. Only apply it on the eczema patches.  

 

I still don’t like steroids. Any other treatments?  

Tar treatment is a useful option, though it’s terribly messy. Phototherapy uses special lights and can be found in some centres. In very resistant cases, a very strong drug called Cyclosporine A can be used. Be careful about this one, it has serious side effects. Some new drugs called topical immuno-modulators (TIMs) have recently been approved for use.  

 

n Dr YLM graduated as a medical doctor, and has been writing for The Star and other magazines for seven years on various subjects such as medicine, health advice, computers and entertainment. 

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