Eczema is a complex condition that requires treating the symptom (skin flare-ups) and the underlying cause (inflammation). In Singapore it affects up to 1 in 5 children and 1 in 10 adults. Everyone has trigger points and, confusingly, these can change over time and under different circumstances. Eczema needs to be treated holistically, using a variety of healthy habits and skills.
Diet
Enjoy a diet rich in whole or minimally processed foods. Enjoy anti-inflammatory foods including colourful fruits and vegetables. Eat whole grains and legumes. Incorporate herbs (fresh or dried) and spices into your diet, these can help fight inflammation.
Avoid processed and highly processed (packaged) foods. This includes: instant noodles, cakes, boxed breakfast cereals, ‘sugary’ foods and soft drinks including Coca-Cola, 100 Plus and even popular children's' beverages like Milo. Avoid fried foods when possible.
Restaurant, hawker or food court meals, often fried and oil rich, can trigger flare-ups. As can highly spiced foods with hot chili or mala. (this is different from eating meals using gentler spices)
Identify food allergies. These might include dairy, eggs, fish, shellfish, nuts, soya and wheat. Lactose intolerance (from dairy products) affects about 70% of the population.
Avoid alcohol and smoking, vapes or tobacco use.
Understanding what triggers your flare-ups is vital, when do you reach one or more tipping points in your health. Diet is especially complex and requires attention to the detail of what foods and beverages are consumed. Packaged and processed foods, and meals eaten out, are often involved.
Exercise Engage in regular physical activity to improve blood circulation and boost your immune system. Physical activity can also help reduce stress and improve sleep.
Sleep Try to get minimum 7 hours (or more) of quality sleep. Avoid the small screen an hour before sleeping and keep your bedroom as a place for relaxation.
Stress Management Practice stress-reducing techniques like meditation or breath work.
Household Allergens Minimise exposure to allergens by keeping your living environment clean, dust-free. Use hypoallergenic bedding and pillow covers. Be careful when using cleaning products to avoid exposure to your skin.
Clothing Wear soft, breathable fabrics like cotton or bamboo. They allow better air circulation and reduce skin irritation. Avoid potential triggers like synthetic fabrics and wool.
Skincare Use mild, fragrance-free skincare products and keep your skin hydrated by applying a fragrance-free moisturiser to prevent dryness and itchiness. Take short, lukewarm showers or baths, using mild, non-irritating cleansers. Avoid excessive scrubbing or hot water, and pat yourself dry gently with a soft towel.
In hot and humid Singapore, people's triggers can behave differently than under drier conditions. Changes in the external environment are often harder to track and to understand than actions - diet, sleep, exercise - we personally take.
Final Thoughts
Eczema is a complex condition, it is easy to get disheartened and feel negative when flare-ups happen. Try to understand what may have triggered you: diet, stress, changes in the weather and environment around you. Learn to practise self-care and consider keeping a health journal to identify and avoid potential triggers.
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Felicia
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In this article the focus has been on eczema. Achieving skin-health on a day-to-day basis also requires attention to diet and lifestyle.
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Related Studies
Elhage KG, Kranyak A, Jin JQ, Haran K, Spencer RK, Smith PL, Davis MS, Hakimi M, Bhutani T, Liao W. Mendelian Randomization Studies in Atopic Dermatitis: A Systematic Review. J Invest Dermatol. 2024 May;144(5):1022-1037. doi: 10.1016/j.jid.2023.10.016. Epub 2023 Nov 17. PMID: 37977498.
Lax SJ, Van Vogt E, Candy B, Steele L, Reynolds C, Stuart B, Parker R, Axon E, Roberts A, Doyle M, Chu DK, Futamura M, Santer M, Williams HC, Cro S, Drucker AM, Boyle RJ. Topical anti-inflammatory treatments for eczema: network meta-analysis. Cochrane Database Syst Rev. 2024 Aug 6;8(8):CD015064. doi: 10.1002/14651858.CD015064.pub2. PMID: 39105474; PMCID: PMC11301992.
Weimer DS, Demory Beckler M. Underlying Immune Mechanisms Involved in Cow's Milk-Induced Hypersensitivity Reactions Manifesting as Atopic Dermatitis. Cureus. 2022 Aug 2;14(8):e27604. doi: 10.7759/cureus.27604. PMID: 36059314; PMCID: PMC9433788.
De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021 Feb 11;9(2):353. doi: 10.3390/microorganisms9020353. PMID: 33670115; PMCID: PMC7916842.
Ruff SMD, Engebretsen KA, Zachariae C, Johansen JD, Silverberg JI, Egeberg A, Thyssen JP. The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis. Br J Dermatol. 2018 Apr;178(4):879-888. doi: 10.1111/bjd.16147. Epub 2018 Feb 15. PMID: 29172235.
Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015 Aug 3;8:413-21. doi: 10.2147/CCID.S86822. PMID: 26345226; PMCID: PMC4529263.
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