AskMeDoctor! Season 3 Episode 16 - Eczema: Should You Soothe or Manage?

Stop scratching! You have probably heard that a zillion times. However, it is hard to just stop scratching when you are suffering from dry, itchy and irritated skin that results from eczema. Eczema is common in children; however, it can happen to just about anyone including adults. To date, there’s no cure for eczema but there are several treatments and tips that can help to manage the dry, itchy and irritated skin. Today, Dr Adrian Yong from AY Skin Specialist Clinic is here to help us understand and manage eczema and dry skin in children and adults. Q1: Is eczema the same as rash? Image credit: Shutterstock Dr Adrian: Eczema is actually an inflammation of the skin resulting in redness, flaking, and itching. Of course that presents as a rash but there are many different kinds of rashes. To understand eczema, first of all, you need to see the schematic of the skin. The top layer of the skin is known as the epidermis. The deeper layer is called the dermis. What happens very commonly with eczema is when the skin barrier is disrupted and broken. What can disrupt the skin barrier? Image credit: Motherhood Story Dr Adrian: Number one, wrong choice of products. When you have sensitive skin and use something that is too harsh that strips off the oil, or using too much hot water, swimming too often in chlorinated water, and not putting the right products on to maintain the moisture level that the skin requires. Secondly, using products that don’t suit your skin. This causes the white cells and inflammatory cells to go crazy and start attacking the top layer of the skin, leading to skin barrier disruption. So, yes, eczema can produce a rash but not all rashes are eczema. Q2: What causes itchy, dry skin, and eczema? (Types of Eczema) Dr Adrian: Firstly, using products which are drying out because you think that the flaky skin is due to fungal or bacterial infection, using water that is very hot, rubbing your skin excessively or scratching, lead to an insult to the skin barrier which leads to higher moisture evaporation rate from the skin, known as transepidermal water loss. This is called irritant eczema. Image credit: Motherhood Story Secondly, allergic contact eczema, whereby your skin comes into contact with certain things that you may or may not be allergic to. For example, one of the most common things is nickel. When you wear nickel earrings and within one or two days, it got flares up and causing the ear to be very itchy and flaky. Image credit: Motherhood Story Thirdly, atopic eczema which is passed on from parents to kids. This is commonly presented with allergic rhinitis, where you get blocked nose, sneezing from house dust mite allergy, and also asthma. Image credit: Motherhood Story Q3: What can worsen dry, itchy skin conditions or even lead to an eczema flare up? Dr Adrian: When people cannot stop scratching their dry and itchy skin. This is one of the major causes of aggravation of the skin. Image credit: Shutterstock Your nervous system, or the brain and the spinal cord system; is designed to protect you. So when your skin is under attack and there is inflammation, you will feel the itch. When you scratch excessively, there is actually a pleasure centre that makes you feel more pleasant the more you scratch. This will lead to broken, bleeding and pus leaking out of the skin, therefore, leading to worsening skin conditions. Q4: How can we care for itchy, dry skin that could have a positive effect on eczema skin as well? Dr Adrian: Eczema skin is predominantly dry, irritated or sensitive skin. The skin barrier is broken. Inflammation from the deeper layer of the skin. So, what do you do? To stop the inflammation, you need to stop the signal from the white cells in the deeper layer of the skin. The first thing you can do is to put a cold compress on and it actually constricts the blood vessels and reduces the inflammation. Image credit: Shutterstock Secondly, use products which can soothe and reduce the irritation on skin. Thirdly, the use of products with active ingredients and essential fatty acids such as linoleic acid and Echinacea root extract that can actually calm the inflammation down and help the skin to repair itself. One has to also understand the different kinds of moisturisers. You have lotions, creams and ointments. One of the most common questions patients asked if there is any particular brands that one should go for? The answer is there is no one brand that fits everyone and there is no one brand that fits you at all times. If you are in a very dry and cold environment, then ointments will work better. But, if you are in a moderate, in and out of air-conditioning, with a little bit of moisture, cream is just nice. Image credit: Shutterstock Dr Adrian: Next, you should use something with less fragrance and less irritating to the skin as when the product interacts with the sweat under the mask. A lot of chemicals sitting on your skin can cause irritation, leading to eczema which may later require the use of steroid creams and ointments to recover the situation. Long term use of steroids is not beneficial because it can aggravate problems with disrupted skin barriers and therefore, using the right moisturisers and products is essential. Image credit: Shutterstock Q5: Which products can help to manage itchy, dry, and irritated skin? Dr Adrian: Certain moisturisers are passive moisturisers. For example, mineral oils like ointments which just sits on the top of the skin and doesn’t allow the skin to breathe that much. That is very effective for, perhaps, older types of skin which are less inflamed but just dry, that you can lock in the moisture. But not all moisturisers are the same. Ceramides help create a barrier to prevent permeability. This locks moisture into your skin, which helps prevent dryness and irritation. Linoleic acid is actually an essential fatty acid which is a precursor for ceramides. So, when you have linoleic acid around, you can produce more ceramides which can then rebuild the skin barrier. Rebuilding the skin barrier is very important because it then leads to a good barrier level, that doesn’t allow bacteria to come in and to keep things from inside going out. And therefore, minimising the risk of developing allergy to products as well. Advice & Tips From Dr Adrian Image credit: Motherhood Story Don't irritate your skin by rubbing too hard or using the wrong products. No Scratching! If you are in trouble, look for a skin specialist. https://www.youtube.com/watch?vgLcymD85hmY Linola PLUS It is never wrong to try a product like Linola PLUS that contains the two main ingredients that were mentioned above by Dr Adrian - linoleic acid and Echinacea. Linola PLUS offers a cream and lotion that is clinically tested and safe not only for adults but also for infants and toddlers. The unique formulation with essential linoleic acid and a special plant extract from the root of the Echinacea purpurea promotes the regeneration of the natural skin barrier. Image credit: Linola At the same time, it also calms itchy and irritated skin. A daily and long-term use of the Linola PLUS is recommended to alleviate itching and dryness of the skin. The products are clinically proven and free of synthetic fragrances. Use the lotion for large skin areas and the cream for particularly affected skin areas on the body or face. It absorbs quickly and can be used daily. So Mummies, there are a lot tips from Dr Adrian Yong and his insights on our skin. Hopefully, this will ease your worries and don't forget to visit your doctors if you have any problems with your skin! Can't get enough of our experts guidance and advice? Stay tuned with us on AskMeDoctor!There, a bountiful of information that you can get from our experts!

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