Andrea Piacquadio/Pexels
Cover Consultant dermatologist Dr Ch’ng Chin Chwen for advice on treating and managing eczema (Photo: Andrea Piacquadio/Pexels)
Andrea Piacquadio/Pexels

In honour of World Atopic Eczema Day, we delve into the persistent rash that goes beyond skin-deep

While the severity of eczema varies from person to person, many may not fully grasp the extent of suffering experienced by those with moderate to severe cases. During flare-ups, the incessant scratching not only damages the skin but also disrupts sleep and impacts productivity at work or school. With skin that is raw, cracked and bleeding, bathing becomes a painful ordeal as the water hits open wounds.

Even with constant moisturisation, the skin remains so dry that leaving a trail of flakes becomes the norm. Feelings of low self-esteem and lack of confidence can lead to avoidance of social gatherings or outdoor activities. The stress of managing this condition takes a significant emotional and mental toll, affecting the overall quality of life and making it difficult to feel comfortable in one’s skin.

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Statistics show that eczema affects up to 20 per cent of children and up to 10 per cent of adults worldwide and is associated with a high burden of morbidity and costs to individuals and health services. It results from a combination of genetic and environmental factors, with a higher prevalence in those with a family history. We speak to consultant dermatologist Dr Ch’ng Chin Chwen for advice on treating and managing this condition.

We know that steroids have been the standard treatment for eczema (atopic dermatitis). Are there any recent advancements in treatment or new understandings of its management?

This is a misconception. The go-to treatment for eczema is to identify and reduce/remove the triggering cause, alongside appropriate skincare practices. This has been highlighted in many international guidelines as well as our local Malaysian Clinical Practice Guidelines.

There have been many advancements in eczema treatment. Every day, new understandings and findings are discovered, and new treatment modalities are released. Additionally, many more treatments are in ongoing clinical trials.

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Does diet have any impact on eczema?

The relationship between diet and eczema is complex and can vary from person to person. Generally, a healthy diet with fresh foods may have anti-inflammatory effects and help to reduce itching (rather than processed foods). It’s also important to drink adequate water and have good quality rest and sleep.

Are there specific foods or supplements that eczema sufferers should avoid or include in their diet?

Probiotics may play a role in managing eczema. Research on their effectiveness has yielded mixed results. Some studies suggest that probiotics can help reduce eczema severity, particularly in infants and children, while others show limited or no significant effects. Certain strains of probiotics, such as Lactobacillus rhamnosus GG and Bifidobacterium lactis, have been more frequently studied and may offer some benefit. However, the evidence for probiotic efficacy in adult eczema remains less clear.

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Is there any scientific evidence linking certain diets to improving or worsening eczema?

Evidence on elimination diets is limited and may not be suitable for everyone. A recent systematic review and meta-analysis published in the Journal of Allergy and Clinical Immunology: In Practice in October 2022 looked at 599 patients. The study found a slight improvement in eczema severity, itching and sleeplessness in patients with mild to moderate eczema. However, there is also indirect evidence suggesting that elimination diets might increase the risk of developing IgE-mediated food allergies.

Besides keeping the skin moisturised, what other tips do you have for managing eczema daily?

Avoid very hot and humid environments. After sweating, such as after exercising, take a quick shower if possible. If not, at least wipe down and change into airy, comfortable clothing. When showering, avoid very hot water temperature and use a gentle cleanser instead of harsh soap.

Read more: How working out transforms your skin

What advice do you have to alleviate the urge to scratch?

Try replacing the scratch behaviour with the application of a light moisturiser, a cold pack, a calming mist spray or fanning the area. Treatments such as phototherapy and wet wrapping can also help reduce itching. It’s important to work with your trusted doctor or dermatologist to manage your itch effectively.

How important is a skincare routine in managing eczema, and which “good” ingredients should we look for?

A good skincare routine is the “base” of eczema management throughout all stages and severity levels. It should be maintained even when eczema is under control. For moisturising, good ingredients to look out for include occlusives (e.g. petrolatum), emollients (e.g. ceramides, dimethicone, squalene, stearic acid) and humectants (e.g. hyaluronic acid, glycerin, lactic acid, urea).

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Karolina Kaboompics/Pexels
Above Photo: Karolina Kaboompics/Pexels
Karolina Kaboompics/Pexels

Are there any lifestyle changes that can help reduce the frequency and severity of eczema flare-ups?

Many. Sleep early, rest well, stay well-hydrated, eat a balanced diet, stress management, practice good bathing habits, moisturise regularly, choose appropriate clothing, keep nails short, and try to be in a good environment that is not too hot, humid or dusty.

What is your opinion on products and supplements that claim to help with eczema?

Check the ingredients and [ensure they align with the guidelines mentioned above for effective skincare]. We generally recommend avoiding harsh soaps and using gentle, ideally soap-free, cleansers. Also, avoid skincare products that contain known allergens you are sensitive to, such as certain preservatives or fragrances.

Does taking collagen at night help with skin repair?

Collagen rapidly breaks down in the digestive system, and there is no real evidence that oral collagen intake helps with eczema. However, some studies suggest that certain collagen supplements may somewhat increase skin hydration.

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Above CeraVe contains essential ceramides to lock in moisture and restore the skin barrier

Skin Soothers: These products are here to help soothe and repair dry, damaged skin

CERAVE

Developed with dermatologists and endorsed by the National Eczema Association, CeraVe’s non-comedogenic, oil-free and lightweight formula features a blend of three essential ceramides to lock in moisture and restore the skin barrier. Available at pharmacies.

 

 

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Above Melvory is formulated with superfoods to help restore skin health

MELVORY

Melvory is developed by an Australia-based pharmacist, Elaine Yong, driven by her frustration at seeing her children suffer from itchy and painful skin. Her products are formulated with skin superfoods to help restore skin health. The Manuka Moisturising Baby Butter, enriched with Manuka oil, vitamin F, avocado oil, sea buckthorn oil and rosehip oil, is great for both babies and adults. The creamy, nourishing butter doesn’t leave a greasy residue and has a pleasant vanilla and coconut scent. Order at melvory.com.

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Above Claire Organics uses fresh, high-quality natural ingrediets

CLAIRE ORGANICS

Using fresh, high-quality natural ingredients, founder Louise Chu named the brand after her daughter Claire. Her natural bar soaps and products are designed to protect and nourish the skin, reducing flare-ups and irritation. This Sensitive Skin package includes a Soother Balm, Patchouli Soap, Chamomile Face/Body Mist, Sunscreen Face/Body Cream, Rosehip Face & Body Oil, and Yummy Lips lip balm, all aimed at hydrating and soothing itchiness.

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Elizabeth Soong is the managing editor of Malaysia Tatler. She loves a good laugh, but is serious when it comes to work, and gets a high from dancing, cats purring, plus enjoys musicals or binge-watching a good TV series. Continually inspired by the people she meets, edits and writes about, you're welcome to see what she's up to on her Instagram @lizsoong.