What Is Eczema According to a Dermatologist

What is eczema? The word “eczema” comes from the Greek word “ekzein”, which means “to boil”. For eczema sufferers, a flare-up can make you feel like your skin is boiling from the inside out.

A 2021 eczema awareness campaign indicated that as many as 20% of Malaysian suffer from this skin condition. Many will continue to experience symptoms even in adulthood. 

Dr Felix Yan Boon Bin, a dermatologist at Sunway Medical Centre answers your questions on this chronic skin condition.

What Is Eczema and What Are Its Symptoms? 

Eczema is characterised by persistently dry, scaly, itchy, red, and inflamed skin. Severe itching can lead to excessive scratching, resulting in blisters and oozing. Lesions appear in sweat-prone areas or where the skin has come into contact with a specific irritant. 

It’s easy to misdiagnose the skin condition as a temporary irritation or contagious infection like scabies. One key characteristic of eczema is that it is chronic. Symptoms come and go depending on triggers.

These symptoms, especially the itching, can get so bad that it causes you to lose sleep. The flaky and scaly red bumps can affect your self-esteem and even lead to depression. 

What Causes Eczema? 

Exposure to skin irritants or allergens like soap, dust, dander, or sweat can cause extrinsic eczema or contact dermatitis. For some people, even heat and humidity can be triggers.

A sensitive and deficient skin barrier causes intrinsic eczema or atopic dermatitis. This makes the skin more prone to dryness, irritation, and inflammation.

People who suffer from intrinsic eczema may also have asthma, hay fever or food allergies, which is related to an over-reactive immune system

What does TCM say about eczema? 

In Traditional Chinese Medicine (TCM), eczema is associated with an internal build-up of pathogenic Dampness, Heat, and Wind. This can be caused by an intrinsically weak and sensitive body constitution. The build-up can also stem from habits such as drinking too much alcohol, overconsumption of rich foods that are fatty, oily or spicy, and stress. 

A compromised Spleen and digestive function cause Dampness to accumulate. Over time this results in poor qi (vital life force) and blood circulation, causing internal Heat and Wind. This build-up manifests as dry, itchy, red, and inflamed skin. 

How Is Eczema Diagnosed? 

A dermatologist will carefully examine your skin and ask you questions about your symptoms. If allergens are suspected, your dermatologist may also do skin patch tests. Blood tests are rare. Consider also seeing a TCM practitioner to complement your clinical diagnosis and treatment. 

How Is Eczema Treated? 

Eczema is treatable though it might not go away completely. With a proper home-care regimen, you can manage it.

First-line treatment focuses on symptom management, which includes: 

• Removal of irritants in cases of eczema caused by external factors. 
• Topical steroids or calcineurin inhibitors to reduce inflammation and itching. 

• Antihistamines to help with severe itching. 
• Moisturisers and ointments to soothe your skin and rebuild its moisture barrier. 
• Biologics (medication derived from living organisms) to regulate your immune system’s over-reaction in severe eczema. 

To prevent attacks: 

• Regularly moisturise to enhance your skin barrier and prevent dryness. 
• Avoid harsh soaps or body washes in favour of mild, moisturising soaps for sensitive skin. 
• Minimise dust in your environment by avoiding dust-prone furniture, as well as vacuuming and changing your bedsheets regularly. 
• Know your triggers, which may even include stress, and manage them properly. 

Herbal and acupuncture therapy for eczema 

Consider combining your regular eczema homecare with a TCM regimen. A recent 2022 systematic data review of 1,946 patients revealed that a combined approach is superior to Western medicine alone.

TCM treats the whole body and focuses on calming the immune system to become less reactive. Your TCM physician will prescribe herbal formulas and acupuncture that are suited to your specific condition.

Qin Zhu Liang Xue is a TCM herbal formulation shown to be effective in calming eczema. This formula contains Chinese skullcap (huang qin, 黄芩) and pearl powder (zhen zhu fen, 珍珠粉), which help remove Dampness and Heat.  

A 2018 review published in the International Journal of Allergy Medications found acupuncture to have similar anti-inflammatory, immune-regulating, and stress-relieving properties. 

Understanding what is eczema and knowing your specific triggers go a long way in helping you manage the condition. With the right regimen, you can prevent future flare-ups.

Want to read more about eczema? Check out this article about first-hand accounts of eczema patients who have been able to treat and live with the condition. 

This is an adaptation of the article “什么是湿疹？”, which first appeared on the Health123 website.