Rash on the eyelids. Cracked, scaly, weeping skin. Itchy fingers. These are all forms of eczema, the common itchy skin condition that can flare up on exposure to anything — from the weather to the environment.

The skin condition affects people at any age. While it cannot be cured, its symptoms — often itchiness and dryness — can be eased with creams, medications and avoiding the so-called triggers.

Heat and hot weather are well-known triggers. “Eczema is definitely one of the big conditions I see in clinic. With the recent hot spell, we’ve had tons of patients coming in for their eczema flaring,” said Dr Shashendra Aponso, AssociateConsultant, Department of Dermatology,Singapore General Hospital (SGH). “There are so many different types of eczema.”

Atopic dermatitis or atopic eczema is typically associated with allergy, tending to afflict people with a sensitive nose, asthma or allergic rhinitis. Said Dr Shashendra: “It can very commonly present when you are young. So you’ll see kids with rashes on their neck and on their skin folds, such as behind their knees. Some outgrow this but, for others, the condition can continue into adulthood.”

At the other end of the age spectrum is asteatotic eczema, which is related to old age. “Elderly patients often get red, itchy and scaly skin on their arms and legs. This is dry skin-related and, sometimes, it can also be a bit weepy,” he said. Associated with older people too is stasis eczema, which develops in those with poor blood flow. They tend to have varicose veins with rash appearing around them. They also display leg swelling, usually in the lower part, and brown pigmentation. “They sometimes look like they are wearing stockings,” said Dr Shashendra.

Stasis eczema can be treated by dealing with the underlying causes — poor blood flow and varicose veins. For the other forms of eczema, avoiding the triggers — heat, dust, dryness, allergens — and using medications like mild steroid cream and antihistamines and moisturising creams usually help keep the eczema symptoms at bay. This is particularly true of contact dermatitis or contact eczema, where the skin comes into contact or is exposed to everyday products, from household cleaners and hand sanitisers to cosmetics and jewellery.

Dr Shashendra cited the case of a patient who had rash on her eyelids but had not used any new cosmetics. The culprit was later found to be her new manicure, a gel acrylic. The acrylate had leeched onto the thin skin around the eyes when she was putting makeup on. More commonly, people who do housework can get irritant eczema from using household detergents, floor cleaners, and the like. “The substance irritates the skin and causes inflammation. So they might get little blisters that look like dots on the sides of the fingers, and even the nails,” said Dr Shashendra. Wearing gloves, reducing the washing, and applying a prescribed mild steroid cream can help bring down the inflammation.

Still, one of the biggest culprits in Singapore is the sun and the heat. “Heat is bad enough, but sweating can worsen eczema. Sweat is an irritant, and it often collects in the folds of the skin, making the skin itch even more than just the heat,” said Dr Shashendra. Wearing tight-fitting gym clothes can trap heat, aggravating eczema symptoms. Bed-bound elderly patients can also suffer from eczema and heat rash because they are lying in bed for long periods of time. “We see it on their back as there’s not a lot of ventilation there. So immediately you change those factors — get them cool, wear breathable fabric, use ice packs sometimes — to help them,” said Dr Shashendra.

While it is tempting to shower often, Dr Shashendra warns against damaging the skin’s natural oil protective barrier. “It’s like washing an oily plate. Using hot water strips the oil from the plate,” he said, adding that keeping to just 15 minutes a day — regardless of the number of showers — is ideal.

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