Managing Eczema: Treatment Options And Self-Care Tips

Eczema is a common skin condition that causes itchy and dry skin that also flakes and develops into rough, thick patches of skin.

A survey in Singapore estimated that 21 per cent of children and 11 per cent of adults suffer from eczema, with half of all sufferers having the skin condition throughout their lives¹. While not contagious, eczema can affect one’s quality of life, as it can be very uncomfortable to live with constantly itching and flaking skin. Damage to the skin caused by eczema also compromises the skin’s barrier function, resulting in a weakened ability to retain moisture and defend against external elements – things that can affect one’s overall well-being.

Treatment options for eczema

While there is no cure for eczema, treatment usually involves managing symptoms. This can be in the form of soothing the itch, using creams to promote skin healing, or avoiding exposure to known triggers. Some of the most common triggers for eczema sufferers in Singapore include dust, physical exercise, and hot weather¹.

Some people are lucky enough to outgrow their eczema in adulthood. But for others who have faced eczema symptoms all their life, managing the condition can be a huge struggle. A variety of treatment options and strategies exist, some of which are described below:

Topical medications

Topical medications are creams that should be applied to affected areas of the skin. Moisturising creams are highly recommended as a staple for persons with eczema, as it helps to soothe the skin and promote moisture retention. These should help with reducing itch and flakiness.

Medicated creams like steroid creams are also commonly used to reduce inflammation and itching in persons with eczema. These could be over-the-counter (e.g. Benadryl, Hydrocortisone) or prescription medications (e.g. Kenalog, Elocon). However, these should be used carefully with the right potency and for short periods of time to avoid the side effects of prolonged steroid usage².

Alternatively, non-steroid classes of medications can also be utilised in the management of eczema and this includes topical calcineurin inhibitors, such as tacrolimus (Protopic™) or pimecrolimus (Elidel™). These are particularly useful for the management of chronic eczema as they do not lead to skin thinning with chronic use. They are, therefore, frequently employed over the facial sites or over the flexural aspects of the limbs. Recently, a newer non-steroid class of topical medication known as a phosphodiesterase-4 inhibitor, such as Crisaborole (Staquis™), has also been used for the management of mild to moderate eczema.

Oral medications

Part of the treatment plan for eczema can include oral medications, which can vary based on how they work to reduce eczema symptoms. Most are classified as immunosuppressants, which suppress the body’s immune reaction to certain triggers that cause eczema flare-ups. One newer type of immune-modulating medication that has shown promising results for eczema management are the JAK inhibitors, which include Abrocitinib (Cibinqo™) and Upadacitinib (Rinvoq®)^3,4.

Some steroids are also available in oral form – but similar to topical steroids, care should be taken not to take them for a prolonged period of time.

Biologic injections

In more recent years, biologic injections have also come to the forefront of the management of various chronic dermatological problems. Dupilumab (Dupixent™) is a monoclonal antibody that blocks interleukin 4 and interleukin 13, which leads to the development of allergic diseases such as eczema and asthma. As such, it helps to control the inflammation that contributes to eczema, but does not suppress your immune system in the way that steroids or other older immunosuppressant drugs like cyclosporine or methotrexate do.

Avoiding eczema triggers

Successful management of eczema includes being aware of one’s triggers and avoiding them where possible. This might mean choosing gentle soaps and cosmetics, using soft cotton clothes and bed sheets, keeping stress levels in check, or avoiding certain foods.

It might help to consult a dermatologist and take an allergy test to determine if any allergies are related to your eczema.

Light therapy

Phototherapy, or light therapy, is a treatment using UV light that helps with reducing itch and inflammation². A special machine is used to transmit either narrowband ultraviolet B (NB-UVB) or ultraviolet A (UVA) light onto affected areas of skin. Phototherapy is usually used when topical medications have already been used and are found to be inadequate.

Conclusion

Eczema may not be curable, but it can be managed to improve one’s quality of life. While it might be a frustrating and long process for some people to find a method that works for them, having a knowledgeable medical professional to guide them through this treatment journey can be highly beneficial.

At our dermatology clinic, MOH-accredited dermatologist Dr Angeline Yong can conduct tests to better understand your eczema condition and recommend treatment plans that are likely to work for you. In the event you have any other skin concerns, we also offer services like mole checks and skin cancer screening in Singapore. Book an appointment to visit us and learn more about how to better manage your skin health.

References

Cheok, S., Yee, F., Song Ma, J. Y., Leow, R., Ho, M. S. L., Yew, Y. W., Tay, Y. K., Rebello, S. A., Luo, N., & Koh, M. J. A. (2018). Prevalence and descriptive epidemiology of atopic dermatitis and its impact on quality of life in Singapore. British Journal of Dermatology, 178(1), 276–277. https://doi.org/10.1111/bjd.15587

Available eczema treatments. National Eczema Association. (n.d.). Retrieved April 13, 2023, from https://nationaleczema.org/eczema/treatment/

Simpson, E. L., Papp, K. A., Blauvelt, A., Chu, C.-Y., Hong, H. C.-ho, Katoh, N., Calimlim, B. M., Thyssen, J. P., Chiou, A. S., Bissonnette, R., Stein Gold, L. F., Wegzyn, C., Hu, X., Liu, M., Liu, J., Tenorio, A. R., Chu, A. D., & Guttman-Yassky, E. (2022). Efficacy and safety of upadacitinib in patients with moderate to severe atopic dermatitis: Analysis of follow-up data from the Measure Up 1 and Measure Up 2 randomized clinical trials. JAMA Dermatology, 158(4), 404–413. https://doi.org/10.1001/jamadermatol.2022.0029

Newsom, M., Bashyam, A. M., Balogh, E. A., Feldman, S. R., & Strowd, L. C. (2020). New and emerging systemic treatments for atopic dermatitis. Drugs, 80(11), 1041–1052. https://doi.org/10.1007/s40265-020-01335-7

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Managing Eczema: Treatment Options And Self-Care Tips