Atopic dermatitis

Atopic dermatitis, otherwise known as eczema, is an extremely common problem. It is a chronic, itchy, dry, sensitive skin condition. In Singapore, it is estimated that 1 in 5 school-going children is affected. While it occurs most frequently in children, it can also manifest in adulthood. The rash usually presents as itchy, dry, scaly red patches and tends to affect areas such as the neck, front of the elbows and back of the knees. Areas affected by eczema are prone to developing infection, and this usually leads to weeping and crusting of the skin.

The exact cause of atopic dermatitis is not known, but it is believed to be a hereditary condition, resulting in an impaired skin barrier, and immunogical dysfunction. In recent years, scientific research has led to the discovery of the “filaggrin” gene mutation as the cause of eczema in many individuals. Many people with atopic dermatitis have asthma or allergic rhinitis, or have family members who also suffer from these problems.

Factors which can worsen atopic dermatitis include: heat, sweat, dust, dry weather, emotional stress, infections and skin irritants( eg harsh soaps, chemicals).

Atopic dermatitis is a treatable condition. Good skin care, in conjunction with certain medications can bring about dramatic improvement in the skin. It is important to use a mild skin cleanser in place of normal soaps, and to moisturize the skin frequently, as this helps to repair the skin barrier. There are various medical treatments available for eczema. They include:

1. Medicated creams ( eg topical steroids, topical calcineurin inhibitors)
2. Phototherapy
3. Oral medications ( immunosuppressants)

It is important to seek advice from an experienced medical professional who can tailor the skin treatment according to the age of the patient and severity and extent of the eczema.