You might get occasional red and itchy skin rashes from insect bites, plants like poison ivy, and hives. But sometimes, they’re actually a symptom of atopic dermatitis or atopic eczema.

Atopic dermatitis is a type of chronic eczema. Chronic eczema causes the red skin rashes that itch. These rashes could appear on any areas of the body:

• Elbow skin problems
• Eczema on neck
• Itchy skin rash on neck
• Eczema on legs
• Flaky skin
• Foot eczema
• Rash on elbows
• Eczema on hands
• Eczema on lips
• Eczema on fingers
• Eczema on face
• Eczema on eyelid
• Ear eczema
• Scalp eczema

"The actual cause of atopic dermatitis is unknown. However, it can be caused by a combination of genes, immune system problems and environmental factors.

Some people get atopic eczema with other conditions like allergic rhinitis (sinus that causes your nose to become runny), food allergies and asthma," explained  Dr Phoon Yee Wei, Head and Consultant from Dermatology Service, Department of General Medicine at Sengkang General Hospital (SGH), a member of the SingHealth group. 

If you’re dealing with atopic eczema now, try these two tips to manage your condition long-term and ease the itching and pain.

1) Record and avoid triggers

Irritants like dust and some food can trigger atopic dermatitis (or atopic eczema). Record and avoid your triggers to manage an eczema flare-up better.

How should you record your triggers? Keep a diary to track your eczema flare-ups. In your diary, include:

• Date and time
• Duration of the episode
• Potential triggers: Include the type of clothes you wore, where you went and what you were doing before the flare-up.
• Take photographs of your skin rash to record the intensity and spread.

Share this diary with your doctor when you see them for follow-up appointments. It helps your doctor find out the common triggers or activity patterns that may cause your atopic eczema. 

It will also be useful to keep a record of treatment history – oral and topical medications used to treat previous flares. 

Once you’ve identified your triggers, you can make lifestyle or dietary changes to avoid them. 

Here are 3 common allergens and ways to reduce your trigger exposure. 

a) Pet hair

Pet dander (pet hair) is a common trigger for allergic reactions. If you’re allergic to pet hair and keep furry pets (cats, dogs, hamsters, rabbits), try to reduce your exposure so you don’t get eczema breakouts as often.

• Vacuum your house regularly
  Vacuum your house regularly to get rid of pet shedding and fleas. Use a lint roller or damp cloth to clean fine hairs and dust from your clothes and bedsheets.
  
  
• Declutter
  Too much clutter in your house tends to accumulate more dust and pet hair because there are many cracks and grooves for it to build up in. Decluttering cuts down on the number of surfaces and cracks that trap pet hair. Less clutter also means that it’s easier to clean your house.
  
  
• Don’t sleep with your pet
  As much as you love your pet, sleeping in the same room with them exposes you to more pet hair. Keep them in another room at night and close your bedroom door when you’re sleeping.
  
  If you have allergic family members, restrict pets to one area of the house by setting up a pet room.
  
  
• Use allergen covers
  Put allergen covers on beds, fabric chairs and couches. Allergen covers are special furniture covers that catch and trap pet hair and dust mites. You can wash them clean with warm water and laundry detergent every 6 to 8 weeks.
  
  
• Avoid using carpets at home
  arpets and fluffy rugs are more likely to trap pet hair, and even vacuuming might not remove all of it. So, try to use hard flooring material like laminated wood, linoleum or tiles.
  
  
• Bathe and brush your pets regularly
  Regular baths and brushing remove loose hair, shedding, fleas and dust mites.

b) Pollen and dust

If you’ve ever felt your eczema flare up or get worse after standing in a dusty place, you might be triggered by dust. 
Pollen and dust are common skin irritants and allergens. Some people with eczema get rash flare-ups with allergic rhinitis (sinus) after exposing themselves to pollen and dust. Follow these tips to reduce exposure.

• Ensure proper ventilation at home
  Poor ventilation causes your room to be stuffy. Still air causes dust and other irritants like chemical particles to stay inside the room. They can build up over time in your hair, clothes, and on your furniture, and make you more likely to get eczema.
  
  Ventilation helps remove dust and pollen (airborne allergens) that are floating in the air inside your house. Open up your doors and windows to let fresh air in. Well-ventilated rooms allow regular airflow that carries the airborne allergens out of the room through windows, doors and vents.
  
  
• Use air purifiers
  To keep the air clean, use home air purifiers with HEPA (high-efficiency particulate air) filters. Replace the filters once every month.
  
  For best results, put the air purifiers near your sofa or your bed. Direct the filter at your body or head so it blows clean air towards you.
  
  
• Monitor room humidity levels
  High humidity can encourage mould growth. Mould spores are small particles that can trigger your eczema if you’re allergic to pollen and dust. However, low humidity can also dry out sensitive skin and cause itching. Moderate humidity is the best for your eczema.
  
  How do you check the room humidity? Invest in a household hygrometer to measure humidity levels at home. You can buy a small one online or from a hardware store.
  
  Most houses in Singapore will usually have humidity readings above 50%, given Singapore’s humid weather. You’ll need to buy an electric dehumidifier to lower humidity levels. On the other hand, using the air-conditioner daily dries out the air and your skin. If you use the aircon all day, put a humidifier inside your house to moderate the humidity levels.
  
  
• Take anti-allergy relief medication
  When outside, carry anti-allergy relief medication with you (antihistamine and nasal sprays) in case you get an allergic reaction from breathing in pollen and dust.
   
• Have a shower after coming home
  After coming home, take a shower with gentle soap and water to wash away the irritants from your skin. Next, change your clothes and wash the ones you wore out as soon as possible.

c) Food

Food allergies can happen at the same time as atopic eczema. If you have food allergies or eczema food triggers, follow these tips:

Avoid trigger foods If you’ve identified specific trigger foods, avoid eating them. If you’re still unsure about your food triggers, these are some foods that commonly cause eczema flare-ups: Nuts Milk Wheat-based food Cinnamon Eggs Tomatoes Nightshades (peppers, eggplant) Soy-based products (tofu, soya milk)

You can consult your dermatologist regarding the suitability of a food allergy test.

2) Care for itchy skin

• Take soothing baths
  A soothing bath with a gentle pH neutral cleanser can be the best cure for itchy skin because it helps you relax. The warm water can also reduce the itchy or painful sensation.
  
  
• Moisturise skin frequently
  In addition to showering, you should also moisturise your skin frequently. The best time to put on some moisturiser is after a shower or bath. Apply hydrating lotion or cream to your skin while it’s still damp to trap the moisture in your skin.
  
  Choose skin care products that contain some of these essential ingredients:
  • Oat
  • Shea butter 
  • Aloe Vera 
  • Glycerin 
  • Ceramides 
  • Petrolatum 
  • Petroleum jelly 
  • Hyaluronic acid 
    
    
• Having sensitive skin means you should always take precautions before using new skin products. Do patch testing first by applying a small amount of skincare product to an area of skin.
  
  A moisturiser with more oil hydrates skin and protects it from irritants. How do you tell if the moisturiser has more oil? When you spread it on your skin, these moisturisers usually have an oily or greasy feel.
  
  Lotion is much easier to apply than cream and ointment. But cream and ointment retain moisture better. Ask your pharmacist or doctor for advice on the most suitable moisturiser type.
  
  
• Use anti-itch cream
  Don’t scratch your skin if it itches, as scratches could cause bacterial infection and worsen your eczema symptoms. Use topical anti-inflammatory creams on affected areas instead.
  
  Keep your nails trimmed short and clean, as long nails can trap bacteria underneath, which transfers to your skin when you touch it.
  
  
• Use wet wrap therapy
  At home, you can use 2 two sets of pyjamas. 
  • a) Prepare two sets of pyjamas and a basin of warm water
  • b) Soak one set of pyjamas in a basin of warm water and wring dry. This is to be used as the inner wet layer
  • c) After taking a lukewarm bath, pat your body dry 
  • d) Apply moisturizsers and topical anti-inflammatory creams in a 1:1 ratio to the intended area of wet wrap 
  • e) Put on the inner wet set of pyjamas over the intended area of wet wrap 
  • f) Put on the outer dry set of pyjamas over the wet inner set 
  • g) Leave wet wrap on overnight 
  • h) This can be repeated over 2-3 consecutive nights 
  • i) Topical creams can be applied as per normal over other areas of the body where wet wrap is not performed
     
• Take prescription medications
  To relieve itch and inflammation, take antihistamine oral medications as instructed by your pharmacist or doctor.

Managing eczema flares can be stressful because of the itch, redness, and general discomfort. You may also feel some embarrassment from your skin appearance. These tips could help you manage your flare ups and improve your quality of life with atopic eczema. If you’re unsure about anything, do ask your doctor for advice.

Ref: G25
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