What is eczema?
Atopic dermatitis, colloquially referred to as “eczema”, is a chronic and stubborn skin condition that makes the skin red and itch. It affects about 10% of all Singaporeans, making it one of the most common skin ailments in Singapore, and also one of the most commonly skin conditions for laser treatment in The Clifford Clinic.
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0-2 years old
2-16 years old
Signs and Symptoms
Although most commonly found in young children, eczema can occur at any age and persist well through adulthood. Eczematic people are fairly easy to spot due to their distinct red rashes. Specifically, some of the signs and symptoms include:
- Thick, dry, scaly/flaky skin
- Persistent itch that worsens at night
- Reddish, raw inflamed skin from scratching
- Presence of small red bumps on the skin
- Reddish, brownish or greyish patches of skin especially around the joints, such as the inside of the elbows and the back of the knees
These symptoms can significantly affect the quality of life, as severe eczema can keep patients up at night with the itch, and even cause painful skin infections when the skin is damaged. Also, because eczema symptoms are fairly conspicuous, it may cause confidence and self-esteem issues in the long run.
How / why do eczema occur?
While there is currently no well-defined cause for eczema, most medical research point to genetics as the main reason behind its development. Most eczema patients are born with a hyperactive immune system which interferes with the skin’s natural barrier function. This makes the skin unusually sensitive to environmental stimuli, developing rashes and itching like an allergic reaction. The damaged natural barrier also makes eczema afflicted skin lose moisture faster normal skin, drying out the skin which can worsen the itch.
As the name “atopic dermatitis” suggests, eczema flare-ups are essentially an allergic reaction. The rashes are caused by an inflammatory response of a hyperactive immune system to various triggers. Some of these triggers include:
- Common allergens like pollen, dust mites and pet hair
- Cosmetic products
- Clothing, especially those that contain wool or synthetic fibres
- Temperatures too hot or too cold
- Habitual scratching, further irritating the skin
- Physical or psychological stress
Singapore’s hot and humid weather only further complicates the matter by making flare-ups much more frequent and persistent.
When left untreated, eczema can greatly reduce the quality of life, causing other complications like skin infections or self-esteem issues. However, the condition can be easily controlled with professional medical help.
Eczema patients are one of the most common visitors at The Clifford Clinic, and our doctors have specifically developed the following eczema treatments in Singapore to help address the condition.
Moisturise the skin
The VBeam Laser is our treatment of choice for eczema patients at The Clifford Clinic. The laser is designed to address vascular and autoimmune skin conditions like eczema, psoriasis and several others, with minimal to no side effects.
During treatment, our doctors will deliver precisely controlled pulses of laser energy to the targeted treatment area. This has 2 main effects on the skin:
- It partially suppresses the activity of key immunity system proteins in the skin. This keeps the hyperactive immune system in check, greatly reducing unnecessary inflammatory responses.
- It reduces the blood supply to the inflamed skin tissue by collapsing existing capillaries (tiny blood vessels) and decreasing expression of blood vessel forming proteins.
The combined effects of the above reduce flare-ups by preventing unwanted inflammation, in turn decreasing the formation of the itchy rashes. Most patients who underwent VBeam Laser treatment typically see the first results within the first 2 weeks of treatment, which continued to improve significantly for the next 4 to 6 weeks.
Bellasonic is a form of ultrasound therapy for the skin developed using South Korean technology. It utilises a 1-10MHz Ultrasound applied to the skin to stimulate skin regenerative processes. The ultrasound causes tiny vibrations in the skin, which triggers the activity of key molecules in the skin like Glycosaminoglycans (GAGs) and Heat-Shock Proteins (HSPs) – both of which are important components in the natural regeneration processes of our skin. The increased activity of both GAGs and HSPs boosts hydration and helps restore the natural protective barrier. This prevents the skin from drying out and alleviates further itching and irritation.
Bellasonic treatment typically sees results in several weeks, after 2 or more sessions.
Drugs and medication
Because eczema flare-ups are fundamentally similar to an allergic reaction, certain immunosuppressants such as corticosteroids or antihistamines can effectively alleviate the symptoms and reduce itching. In some cases, antibiotics may also be prescribed to prevent or address skin infections.
Some of the newest drugs that are used to treat eczema include:
- Dupilumab (Dupixent) and Baricitinib
Dupilumab and baricitinib are immunosuppressants, both of which work by suppressing the inflammation reaction of the immune system, reducing the itching and rashes. Dupilumab is administered by an injection under the skin while baricitinib is taken orally. Both drugs are relatively slow-acting and may take several weeks to see noticeable improvement.
- Microbiome cream
Our body, including the skin, is home to many different types of micro-organisms like fungi and bacteria. This is known as our microbiome. While the occasional one may cause infections or is a disease-carrying pathogen, most of these micro-organisms are harmless or even be beneficial to our skin. Microbiome creams work by populating the skin with benign bacteria, preventing their harmful, eczema-triggering counterparts from colonising.
However, oral and topical medication only provides temporary relief, and eczema may relapse after medication is ceased. Moreover, long-term use corticosteroids are usually not-recommended as it can thin out the skin.
At The Clifford Clinic, our doctors usually prescribe oral and topical medication to supplement the VBeam Laser and Bellasonic treatment.
Moisturisation and taking care of the skin
In addition to medication, it is also important for eczema patients to take good care of their skin.
Firstly, it is important to moisturise the skin frequently as eczema afflicted skin dries out more quickly than normal skin, which is one of the main causes of the itch. Moisturising the skin also helps replenish the outermost protective barrier of the skin, reducing sensitivity to eczema triggers.
Also, it can help to have shorter showers/baths and use soap-free body washes. Because the outermost protective layer of the skin consists of naturally secreted oils, regular soap and body washes can remove some of this and cause damage. Normal skin can tolerate this and replace these protective oils relatively quickly, however eczema afflicted skin is not able to do so. Using eczema-friendly body and hand washes, as well as having shorter showers reduces damage to this layer, decreasing the frequency of flare-ups.
Our doctors at The Clifford Clinic have helped patients manage their eczema for over 10 years with their professional skills and experience. If you are bothered by eczema, you are welcome to arrange a consultation with us. Our doctors will assess your condition and customise and individualised treatment regimen most suited for you.