Commentary: Low self-esteem, depression and frequent flare-ups plague growing numbers of eczema sufferers
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Commentary
Commentary: Low cocky-esteem, depression and frequent flare-ups plague growing numbers of eczema sufferers
As a guild, we must overcome the shameful stigma that those who suffer from eczema bear, says dermatologist Dr Joyce Lim.
File photo of a woman displaying a patch of irritated skin on the back of her manus. (Photo: Brett Carlsen/Getty Images/AFP)
17 Feb 2022 06:13AM (Updated: 03 Jul 2022 07:41PM)
SINGAPORE: I met Jamie* when she was 35. She stopped work later on the debilitating rashes from her eczema became unbearable.
Monthly flares left a red scaly rash all over her body and threw her into episodes of intense itches.
In between flares, she suffered from a abiding itch and demand to scratch, on peak of the hurting, bleeding and already intense damage to her skin from frequent scratching.
At work she struggled to complete her work assignments, having to stop working every 10 to 20 minutes to scratch. She besides could non concentrate, exhausted from the bouts of waking upward at night to an overwhelming itch. She took medical leave most every fortnight.
Then there was 13-year-old Samuel*. Cherry-red, scaly rashes that covered his artillery and legs affected his confidence. He entered my clinic with his caput down, avoiding middle contact throughout the appointment. He had no friends equally he avoided socialising at school.
DEBILITATING Status
Those who suffer from this medical scourge have inflamed patches of peel that are itchy, red, cracked, and rough, and blisters sometimes occur. Eczema is particularly common in children just can develop at whatsoever age.
Eczema can be crippling for families with young children. Heart-broken parents helplessly sentinel their children in pain, while exhausted siblings are tuckered from being woken up at nighttime when their brother or sister wakes to episodes of intense itch, crying, crushed by a condition they take niggling control over.
Master school children suffer greatly from the condition. Stress during examination periods can cause more frequent flare-ups. The anxious child - sleep deprived and irritable by morning - may non perform also as hoped, through no fault of their own.
Apart from frequent sleep disturbances and anxiety, eczema exit many sufferers with low cocky-esteem and even depression.
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During their teenage years, several eczema sufferers end up victims of marginalisation or bullying, as their visible skin status confers them an inescapable social stigma. Recreational activities are limited, every bit many tend to avoid sports and outdoor activities, to avoid perspiring and worsening their condition.
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In adults, frequent flare-ups can impair concentration, fuel frequent absenteeism and bear on functioning at work.
A patient once said to me:
Eczema is not just a skin trouble, information technology scarred my life, inside and out. I wouldn't wish it on even my worst enemy.
ECZEMA IN SINGAPORE
The occurrence of eczema in Singapore is ane of the highest in the world. It is the most common pare condition in Singapore. However the occurrence in Main One children has grown over the past 5 years.
This is surprisingly common in avant-garde Asian nations, including Nippon where three in ten infants endure from the condition.
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A combination of genetics, abnormal allowed arrangement functionality, ecology factors and defects in the skin barrier, contribute to its development.
Research suggests that also make clean a living environment may deprive the body of the beneficial bacteria essential for building a strong immune system. When our environs is too clean, the immune system just does not develop the cells needed to fight infections from allergens.
With air-conditioned environments commonplace, the increased amount of time children spend in air-conditioned settings correlates with an increase in occurrence of eczema. Air-conditioners makes a room dry out, sucking up moisture from the skin, precipitating eczema symptoms, and drawing air and allergens from the outside surround into the room.
Conversely, studies have also shown that children exposed to nature, whether through living in the countryside, or by having a pet dog at home, have stronger immune systems and are less likely to suffer from eczema.
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TREATING ECZEMA
Most patients seek assistance just when their eczema worsens but treatments can prevent new outbreaks autonomously from relieving certain symptoms.
A reactive treatment applies emollients with anti-inflammatory topical therapy daily to eczema lesions, stopping just subsequently the lesions subsided or cleared completely. A proactive treatment involves a long-term, intermittent application of anti-inflammatory emollients to previously afflicted areas and unaffected skin.
A proactive treatment is equally, if not more important, every bit it can reduce the occurrence of flares by almost eight times, co-ordinate to studies. And as intervals between flares get longer, at that place is a greater run a risk of a child outgrowing the eczema.
I cannot emphasise how of import information technology is for parents and children to exist educated on practiced skin intendance and to treat eczema early. Not realising that areas of normal looking pare does non mean total recovery has been achieved, many discontinue handling and hope to revert to their pre-eczema routine.
Just caring daily for your skin must be a new manner of life, including taking extra care to utilise fragrance-free and dermatologically-tested moisturisers, on summit of continuing with proactive treatment.
By and large, patients who apply advisable moisturisers find that their peel becomes less irritable. Small doses of antihistamines also help the itch.
Controlling the surroundings, ensuing that there is circulation of natural air for example, or that humidifiers and filters to control external allergens, can as well help.
The adept news is eczema tin can unremarkably exist outgrown, every bit the condition goes into remission when the child grows and their immune system matures, mostly 50 to 60 per cent of those who have had childhood eczema outgrow their status.
All the same, the more severe the condition in babyhood, the higher the risk of the disease continuing into adulthood.
WHAT MORE Tin can Exist Done?
As a society, nosotros must overcome the shameful stigma that those who endure from this condition carry. Eczema patients deserve to live a salubrious and productive life free from discrimination.
Some help to alleviate the condition can motion the needle. Avoiding activities that involve sand, grass and heavily chlorinated water that tin can exacerbate the status will help pre-schoolers with eczema.
In principal school and above, children with eczema should exist seated under fans or near windows for fresh, circulating air. Giving them options to habiliment loose, cotton wool article of clothing (for instance, Concrete Education attire) would likewise go a long way in reducing discomfort, as many school uniforms are made out of synthetic fibers that can trap oestrus.
Education is as well cardinal where the condition is oft seen as "contagious" or a result of someone beingness "dingy".
A 2-year-erstwhile patient of mine, goes to childcare on a daily ground. Initially, the teachers were unsure of how to assistance. However, her mother taught the teachers how to alleviate the child'southward condition by applying moisturisers later showers, keeping her absurd and having her stay away from sand pits.
The teachers eventually learnt that eczema was not contagious and could be managed. They taught the same to the rest of the patient's classmates. Soon after, the other toddlers socialised and played together. The patient now enjoys going to school in spite of her condition.
Master school health educational activity needs to include basic education on skin diseases – since it is most credible in children at this historic period.
As the above example showed, parents and teachers themselves need to exist equipped with cognition on the misconceptions about the condition, the facts, and how they tin help young children in their intendance perform tasks required of them.
In the workplace, having an understanding of the condition tin can go a long way in helping an eczema suffering employee feel supported and remain productive despite the ailments the condition brings.
Flexible hours or work from home options allow patients to create a comfortable piece of work environment that helps manage the condition, for case. Removing dust and allergen traps like heavy defunction and carpets, and regular air-conditioner maintenance are constructive ways to keep the work environment conducive.
When Jamie understood the pathogenesis of eczema, she learnt how to cope with the flare ups, maintain her skin's moisture and improve her overall condition. Happily, Jamie has since returned to work.
One thing both Jamie and Samuel had in common was the mindset that they accept no choice but with this condition for the rest of their lives. They are not the simply ones, as many eczema-sufferers are then used to seeing their pare in rashes they surrender all promise of normalcy.
But there is optimism for those who endure from eczema. With treatment, public pedagogy and support from those effectually them, these patients tin can lead a healthy, productive and stigma-costless life.
*Pseudonyms take been used.
Dr Joyce Lim Teng Ee is a dermatologist in private practice at Joyce Lim Skin and Laser Clinic. She recently spoke at the countdown Asia Derma conference held in Singapore in December 2018.
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