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Conditions We Treat

Eczema

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

What is Eczema?

Eczema, also known as dermatitis, is a common yet complex skin condition that affects both children and adults in Singapore. It causes the skin to become inflamed, itchy and dry, with symptoms that may appear suddenly, fade away and then return. Unlike a one-time rash, eczema often has an ongoing course, with periods of flare-ups and calmer spells.

The condition is not contagious. You cannot “catch” it from someone else, but it can deeply affect sleep, self-confidence and even emotional well-being if it is left unmanaged.

eczema Singapore
Eczema is a common skin condition that is usually triggered by factors such as the climate, frequent handwashing and irritants.

What are the characteristics of Eczema?

Eczema has a few hallmark signs that distinguish it from other rashes. This includes:

  • Itchiness – often intense and sometimes worse at night, leading to scratching and disturbed sleep.
  • Dryness and flaking – the skin feels rough, cracked or scaly.
  • Redness and inflammation – patches of skin may look red, pink or darker than the surrounding skin, depending on the skin tone.
  • Oozing or crusting – in severe eczema, scratching may break the skin, leading to weeping or secondary infection.
  • Thickened or lathery skin – long-standing eczema may cause areas to become thicker (lichenification) due to repeated scratching.

What are the types of Eczema?

Rather than a single condition, eczema is an umbrella term for several related disorders, such as:

TYPES FEATURES
Atopic Dermatitis
  • The most common form of eczema in Singapore.
  • Closely linked to other allergic conditions like asthma and allergic rhinitis.
  • Usually starts in childhood but may persist into adulthood.
Contact Dermatitis
  • Caused by direct exposure to irritants, such as soaps, detergents, cleaning products or allergens, like nickel in jewellery, fragrance or preservatives in skincare.
  • Skin becomes red, itchy and inflamed at the site of contact.
Nummular Eczema (Discoid Eczema)
  • Characterised by round, coin-shaped patches of eczema that may ooze or become crusty.
  • More common in adults and often triggered by dry skin.
Seborrhoeic Dermatitis
  • Affects oily areas such as the scalp, face and chest.
  • Often appears as red, flaky patches or stubborn dandruff.
  • Thought to be linked to an overgrowth of yeast on the skin.
Dyshidrotic Eczema
  • Appears as small, intensely itchy blisters on the hands and feet.
  • Triggered by stress, sweating or exposure to metals like nickel.
Stasis Dermatitis
  • Seen in adults with poor circulation in the legs.
  • Causes redness, swelling and itch around the lower legs and ankles.

Where does Eczema typically develop?

Eczema does not affect the skin randomly. It tends to favour certain areas of the body, depending on age:

  • Infants and babies – the cheeks, scalp, forehead, arms and legs are most commonly involved. Sometimes, the rash spreads to the trunk.
  • Children – eczema often shifts to the skin folds, such as inside the elbows, behind the knees, on the neck, wrists and ankles. Hands are also frequently affected, especially with frequent washing or writing.
  • Adults – hands, eyelids and flexural areas are the common sites. Adults may also experience persistent patches on the face, neck, upper chest and around the eyes. In severe eczema, the condition may affect larger body areas.

What causes Eczema?

The causes arise from a combination of factors, which include but are not limited to:

CAUSES MECHANISM
Skin Barrier Breakdown
  • Healthy skin acts like a protective wall, locking in water while keeping irritants, microbes and allergens out.
  • In eczema, this barrier is weakened, often due to defects in proteins such as filaggrin.
  • As a result, water escapes easily, leaving the skin dry and cracked, while irritants and allergens slip through.
Immune System Overreaction
  • The immune system in eczema-prone individuals is hypersensitive.
  • When the weakened barrier lets in irritants or allergens, the immune cells respond with excess inflammation, causing redness, itching and swelling.
  • This creates a cycle: itch → scratch → further barrier damage → more inflammation
Microbial Imbalance
  • Normal skin has a balance of bacteria and microbes. In eczema, harmful microbes like Staphylococcus aureus often overgrow.
  • These microbes worsen inflammation and trigger flares, making the condition harder to control.

What triggers Eczema?

Even after eczema has developed, certain everyday factors can spark flare-ups or make symptoms worse. These are not the root causes but external sparks that aggravate sensitive skin.

The potential triggers include:

  • Dust and pollutants – exposure to dust, haze or polluted air can worsen skin inflammation.
  • Rapid temperature changes – moving quickly between air-conditioned rooms and outdoor humidity can shock the skin and provoke irritation.
  • Clothing materials – wool, rough fabrics or tight clothing can rub against sensitive skin and worsen itching.
  • Harsh cleansers and skincare products – soaps, bubble baths, fragranced lotions or alcohol-based products strip away natural oils and dry out the skin.

It depends on the condition and its severity. A single session may be enough for smaller acne lesions, but conditions such as keloids, hypertrophic scars or alopecia areata often require several injections spaced four to six weeks apart.

  • Frequent bathing with hot water – long, hot showers dry out the skin and damage its protective oils.
  • Prolonged sweating – physical activity or hot environments lead to sweat build-up, which stings and itches eczema-prone skin.
  • Stress or emotional strain – mental stress does not cause eczema, but can intensify itching, which worsens the scratch-itch cycle.

Who is at risk of Eczema in Singapore?

Although eczema is a common skin condition, certain groups of people are more susceptible to developing it. Some of them are:

  • Family history of eczema, asthma or allergies – genetics play a strong role. If parents carry mutations that affect the skin barrier proteins (filaggrin), their children are more likely to inherit a fragile skin barrier, raising their eczema risk. 
  • Individuals with allergies – conditions like asthma and allergic rhinitis are linked with the same immune system “overreaction” seen in eczema. Having one allergic condition increases the chance of developing another.
  • Infants and children – young skin has a naturally weaker barrier, which loses moisture easily and is more vulnerable to irritants. This makes eczema especially common in the early years.
  • Hot and humid climates – Singapore’s climate encourages sweating, which irritates sensitive skin and worsens the itch-scratch cycle.
  • Urban population – city living exposes people to high levels of dust mites, air pollution and irritants from everyday products. For someone with sensitive skin, these constant exposures push the skin barrier to its limits.
  • Occupational factors – jobs that involve constant washing, use of detergents or handling chemicals strip natural oils from the skin, leaving the barrier weaker and prone to eczema.
types of eczema
There are several types of eczema, each with different characteristics, causes and triggers.

How is Eczema diagnosed in Singapore?

Because eczema can look and feel different from person to person, a careful diagnostic process is essential. At Livingstone Dermatology, we use a step-by-step approach to identify the type, severity and underlying factors contributing to your eczema. That way, the treatment can be precisely tailored to your needs.

Some of the key steps include:

  • Detailed skin and medical history – our dermatologists will begin by asking about when your symptoms first appeared, how they have changed over time and what daily habits may be affecting your skin. They will also discuss family history, as conditions like asthma, hay fever and eczema often run together.
  • Symptom assessment – understanding the nature of your itch, dryness, redness or oozing skin helps us determine not only the severity of your eczema but also how it is affecting your comfort, sleep and overall quality of life.
  • Lifestyle and environmental review – they will explore how your routines, work environment, exposure to dust or pets, bathing habits and even clothing choices may be influencing flare-ups. This helps us identify potential triggers unique to your lifestyle.
  • Dermatological examination – a close assessment of the skin allows us to observe the exact appearance and distribution of eczema. They will look for redness, dryness, thickening or signs of scratching and check whether sensitive areas like the face, folds or hands are affected.
  • Severity evaluation – our dermatologists will assess how widespread the eczema is and how intense the inflammation appears. Sometimes formal scoring systems are used to grade severity, which guides treatment choices.
  • Signs of infection – eczema-prone skin is more vulnerable to bacterial, viral or fungal infections. During the examination, our dermatologists will look for yellow crusts, pus or swelling that may suggest infection requiring treatment.
  • Allergy and additional tests – when eczema appears unusual, stubborn or linked with possible allergens, further investigations may be recommended. This may include:
    • Patch testing helps identify whether substances like metals, fragrances or preservatives are contributing to flare-ups.
    • Skin prick testing may be useful if food or environmental allergies are suspected.
    • Skin swabs or scrapings can check for infection or other conditions that mimic eczema.

How is Eczema treated in Singapore?

The treatment for eczema is aimed at reducing symptoms, promoting skin healing, preventing flares and restoring comfort. We follow a step-up approach, typically starting with gentler measures when possible and increasing treatment intensity if needed.

At Livingstone Dermatology, our dermatologist often designs based on the severity of the condition, such as:

LEVEL OF SEVERITY WHAT WE USUALLY DO
Mild or intermittent eczema
  • Moisturising (emollients) – applied generously and frequently to lock in moisture and repair the skin barrier.
  • Gentle skincare – fragrance-free cleansers, short lukewarm showers and immediate moisturising after bathing.
  • Topical anti-inflammatories – mild corticosteroid creams or non-steroid alternatives (calcineurin inhibitors) for flare-ups.
  • Trigger avoidance – reducing exposure to irritants like harsh soaps, synthetic fabrics or long hot baths.
Moderate or frequent flare-ups
  • Stronger topical treatments – medium-strength corticosteroids or regular use of calcineurin inhibitors under supervision.
  • Wet wrap therapy – dressings soaked in medicated solutions or moisturiser, wrapped around affected areas to soothe and heal.
  • Treatment of infection – topical or oral antibiotics if eczema becomes crusted or oozy.
  • Phototherapy – controlled exposure to narrowband UVB light for widespread or stubborn eczema.
  • Lifestyle adjustments – personal skincare routines and flare-prevention strategies discussed during consultation.
Severe or resistant eczema
  • Systemic medications – immunosuppressants such as cyclosporine, methotrexate or azathioprine are prescribed under close monitoring.
  • Biologic therapies – advanced targeted injections like dupilumab, used when other treatments are not enough.
  • JAK inhibitors – newer oral medications for moderate-to-severe eczema, available under dermatology care.
  • Combination therapy – mixing topical, systemic and lifestyle measures to achieve long-term stability.
  • Ongoing follow-up – regular reviews to adjust treatment, monitor side effects and support quality of life.

Summary

Living with eczema can feel overwhelming, but there is always hope. With the right care, understanding of your skin and a supportive treatment plan, most people can achieve significant relief, fewer flare-ups and much more comfortable skin.

At Livingstone Dermatology, we are committed to partnering with you. Our dermatologists attentively listen to your concerns, adjust treatment along the way and help you rediscover confidence in your skin. Healing may take time, but every small improvement is a step forward.

If you have been suffering from eczema, do not delay treatment any longer. Book a consultation and gain access to a personalised treatment plan to improve your overall skin health.

Frequently Asked Questions

Is eczema contagious?

No, eczema cannot be spread from person to person. It is an inflammatory skin condition caused by a sensitive immune system and skin barrier weakness, not an infection.

The best cream depends on your skin type and severity. For most people, fragrance-free moisturisers are essential, while medicated creams such as corticosteroids or calcineurin inhibitors may be prescribed during flare-ups. Our dermatologist can help recommend the safest and most effective option for your skin.

There is no permanent cure yet, but eczema can be well-controlled with the right treatment and lifestyle adjustments. Many people experience long periods of clear skin with proper care. Children may even outgrow the condition as they get older.

Food is not the root cause of eczema, but in some people, certain foods may worsen symptoms. Common culprits include eggs, cow’s milk, soy, peanuts and shellfish. If a food allergy is suspected, our dermatologists often recommend proper allergy testing before making dietary changes.

Moisturising before bed, keeping the room cool and wearing soft cotton sleepwear may help reduce night-time itching. Using your prescribed anti-inflammatory cream before sleep can also keep flares under control. For persistent problems, speak with our dermatologist for tailored options.

Yes, stress is a common trigger that can intensify the itch-scratch cycle. Managing stress with exercise, relaxation techniques or counselling can complement medical treatment.

When used correctly under medical guidance, steroid creams are safe and effective. Dermatologists prescribe the right strength and duration to minimise side effects and often combine them with moisturisers or non-steroid alternatives for maintenance.

Natural remedies such as oatmeal baths, coconut oil or aloe vera may soothe some symptoms, but they are not a substitute for medical treatment. It is best to discuss these options with our dermatologist before trying them.

Facial skin is delicate, so treatment usually avoids strong steroids. Instead, gentle moisturisers and non-steroid anti-inflammatory creams like calcineurin inhibitors are commonly prescribed.

Both cause red, itchy skin, but they are different conditions. Eczema is linked to a weak skin barrier and allergy-prone immune response, while psoriasis is an autoimmune condition that speeds up skin cell turnover. Our dermatologist can distinguish between the two during consultation.

Yes, many treatments are safe and effective for children, including moisturisers, mild steroid creams and non-steroid options. Our dermatologists always adjust treatment according to age, skin sensitivity and comfort.

Newer therapies such as biologics (such as dupilumab) and JAK inhibitors are available in Singapore for patients with moderate-to-severe eczema who do not respond well to traditional treatment. These targeted medicines can greatly improve the quality of life under specialist care.

Related Services

Paediatric Dermatology
Cosmetic Dermatology

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