My baby has eczema — help!

It’s a nasty and itchy condition — and quite common in Singapore where 1 in 5 children may have it…


It looks like a rash and your baby is scratching furiously and feeling miserable. So, you bring him to a doctor, only to be told “ah, eczema, it’s quite common here” and you’re given some cream. But what exactly is eczema and why do we get it?

1) Dry, red, itchy rashes

From ancient Greek, “eczema” meant “boil”, explains Dr Tan Siew Kiang a dermatological specialist at Raffles Skin & Aesthetics, “It is used to describe red, dry, itchy skin which can sometimes become weeping, blistered, crusted, scaling and thickened.”

Adds dermatologist Dr Neoh Ching Yin, of Specialist Skin Clinic & Associates, “An inflammation of the skin is sometimes referred to as dermatitis. It affects one in five school-going children; one in 10 persons get it at some point in their lives. It is the most common chronic inflammatory skin condition here.”

2) It runs in the family

Dr Tan says,Eczema tends to run in families, especially in those who have strong family history of atopy.” “Atopy” refers to the inherited tendency to develop allergic reactions such as asthma, sinusitis, rhinitis and eczema. These involve an over-active component of the patient’s immune system ― for instance, a defect in the skin’s barrier allows allergy-causing substances to enter the skin, causing itch and inflammation.

Atopic eczema usually starts in the first few months of life but it may also develop for the first time in adulthood. There are a few sub-types — such as discoid eczema, which usually affects young adults, and old-age eczema, which affects middle-aged or elderly patients,” she says.
Above all, you cannot just “catch” it.

"Eczema affects one in five school-going children; one in 10 persons get it at some point in their lives."

3) It looks bad and did we mention? It ITCHES.  

“The main symptom is itch,” says Dr Tan. In fact, your child is probably constantly scratching and rubbing at the itchy areas, leading to the redness and even swelling in the area, darkening of the skin and causing the body to react by itching more. “Itch can be severe enough to interfere with sleep, causing tiredness and irritability. This can have an enormous impact on the whole family.”

She adds, “Frequent moisturising is the mainstay of treatment as well as the most important treatment for all patients with eczema.” Wash with a gentle soap or bath oil and apply moisturiser several times daily to help the outer layer of the skin function better as a barrier against the environment.

Doctors can also prescribe antihistamines to ease itching.

4) It’s in my baby’s wrists, and the backs of her knees…

Eczema can affect any part of the skin, but the most commonly affected are the neck, wrists, elbows and back of the knees ― in other words, areas where you sweat. In some adults it can spread out along the arms and legs, the face, and the whole body — we saw that in the case of Eu Huiling, reported in the news.

Dr Tan says, “In babies, cheeks, chin and neck are commonly affected because of the milk and saliva from drooling that irritate the skin.”

Other subtypes of eczema presented differently. She describes discoid eczema as “coin-sized rashes on the arms and legs”; follicular eczema (“small, red bumps around the hair follicles”).

“When the eczema is very active, the skin may become moist and weepy. Small water blisters may develop especially on the fingers, hands and feet,” she says.

If you don’t treat a “flare up” (when you aggravate the eczema by things you are allergic to and/or scratching it), your scratching can break your skin, letting in infections that could lead to the development of pus-filled wounds.

5) Is it a Chinese “condition”?

Eczema isn’t restricted to one race, although a local study of 492 patients who visited National Skin Centre from January to June 1994 found that some 83 per cent were Chinese, 7.9 per cent Malays, 5.1 per cent Indians and 4.2 per cent others, notes Dr Tan.

“If we compare to the racial composition of Singapore in the 1990s (77.8 per cent Chinese, 14 per cent Malays, 9.1 per cent Indians, 1.1 per cent Others), eczema is slightly more prevalent in the Chinese population.” But basically, anybody could have eczema.