Eczema refers to a category of persistent skin inflammation that is characterised by red, itchy patches.

The root cause of this condition is an over-reactive immune system, said Dr Cheong Wai Kwong, a consultant dermatologist at the Specialist Skin Clinic.

'Eczema is unlike fungal infections as it is not contagious and neither is it caused by external factors,' he said.

Instead, it is in the genes - some people are genetically predisposed to developing eczema. Most will also first experience eczema as a child.

The most common form of eczema in children is atopic dermatitis, which affects the skin at the joints. For adults, itchy patches tend to appear on the palms and soles, said Dr Cheong.

The condition is further classified into mild, moderate or severe cases.

Most people have moderate eczema, where they experience patches of itchy skin. In severe cases, the skin can be scaly, red, raw and 'weepy' from fluid discharge.

'However, the skin is raw mostly because of scratching, as severe eczema is extremely itchy,' said DrCheong. 'Sometimes, the raw skin may lead to bacterial infection.'

Typically, eczema can be worsened by exposure to specific environmental factors like dust, heat and sunlight, although this differs from person to person. Sweat is also a common aggravating factor.

Hence, eczema sufferers in Singapore may fare worse in general due to the tropical climate here.

A study done in 2000 showed that about 20 per cent of Singaporean children aged between seven and 17 had eczema, said Dr Cheong.

'This condition is often frustrating for sufferers and their families because it is chronic - there is no cure for the problem,' he said.

Instead, treatment for eczema involves recognising the factors that aggravate the condition and avoiding these triggers. Topical products and medication are also used to control the inflammation.

This includes moisturisers to counteract the dryness, cortisone tablets and steroid-based creams to reduce inflammation. However, the downside is that steroid creams may thin the skin.

The good news is, there is now a new branch of treatment that includes non-steroid creams and oral medication, said Dr Cheong.

Ultraviolet radiation therapy may be used for patients with severe eczema to reduce the degree of weeping wounds. Other medications that may be prescribed are antihistamine tablets for severe itching and antibiotics for infections.

All in all, eczema can be managed despite its chronic nature.

What may be more distressing are the social and psychological consequences that sufferers face.

Said Dr Cheong: 'There is a limit to the activities that they can participate in, like sports and other outdoor activities. For those who get better, they may experience much anxiety and uncertainty, as they don't know when the eczema will flare up again.'

This article was first published in Mind Your Body, The Straits Times.

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