What are the difference in the daily life of an eczema patient? Do you wake up in the morning to find flakes all over your bed sheets, mixed with blood? While others enjoy the moment of showering, eczema patients have to muster up the courage to endure the “pain” of getting wet every second? Itchy eczema can make it difficult to sleep at night… Dr. Steven Loo, a specialist in dermatology, suggests that patients should not delay in treating their eczema, whether it is initial or recurrent, and that they should focus on the “eczema triangle” to get rid of the vicious cycle of itchiness and inflammation as soon as possible, so that they can regain a balanced physical and mental life.

Eczema patients’ lives are troubled, physical and mental health should not be ignored

In daily life, some ordinary things may already be difficult challenges for eczema patients! Dr. Loo has consolidated the “experiences” of many eczema patients and pointed out that the most common problems faced by eczema patients are at least the following two.

The first is that the patient’s skin barrier is damaged, causing the skin to lose moisture, resulting in dry, itchy, peeling skin. “In severe cases, there will be piles of dead skin or even blood on the bed sheets after waking up every day, which is very disturbing to patients.

The second is that most patients have an overactive immune system, and whenever the skin is irritated, it will increase the chance of eczema recurrence, and excessive scratching will cause the skin to break down and become inflamed, resulting in a recurring condition that affects the patient’s sleep and emotional health.

Itching, peeling, inflammation, recurrence, vicious cycle

Dr. Loo admitted that the more wounds on the skin of eczema patients, the greater the chance of inflammation, and will make patients more and more reluctant to wash their hands or take a shower, but once the bacteria accumulate on the skin, a vicious cycle will occur, eczema condition gets even more uncontrollable. Therefore, both skin problems and psychological status should be taken care of during the treatment.

According to the Hong Kong Allergy Association, one in five Hong Kong people suffer from eczema at different times. How to deal with the difficult eczema? According to Dr. Loo, it is important to target the “eczema triangle” and provide targeted treatment:

What is the “eczema triangle”? There is a way to solve it

Dr. Steven Loo, a dermatologist, said that there are many factors that cause eczema, but in terms of treatment, as long as the “eczema triangle” is targeted and the right medicine is prescribed, you can get rid of the vicious cycle of eczema as soon as possible and regain the joy of life.

1. Strengthen the skin barrier: many eczema patients face congenital structural problems with the skin stratum corneum, resulting in skin cracks, peeling, so that external allergens such as dust mites, bacteria, etc. easily into the skin, stimulating the immune system to cause inflammation³。
Solution: Dr. Loo pointed out that the most important thing for patients is to protect their skin and they should not be lazy in their daily moisturizing work. For example, you should avoid taking a bath in hot water, because too much hot water will cause the skin to lose oil, and you should apply moisturizing cream as soon as possible after washing your hands or taking a bath to enhance the moisturizing effect.

2. Control inflammation: An overactive immune system produces many inflammatory factors that irritate the skin’s stratum corneum, causing itching and inflammation.
Solution: Dr. Lo emphasized that patients should follow their doctor’s instructions and prescriptions for medication. For medication, there are topical non-steroidal skin treatments, topical steroidal skin treatments, oral medications to regulate the immune system, and biologic treatments, all of which can help control inflammation at different levels.

3. Regulation of microbial and intestinal system imbalance: In recent years, many studies have found that the gut microbiome and the immune system have a close relationship. The intestine can be said to be an important organ of the immune system, 70% of the immune system cells are concentrated in the intestine, gut dysbiosis will lead to abnormal response of the immune system, so a healthy diet is particularly important, including reducing the consumption of processed foods, high-temperature fried foods and reduce the consumption of high-sugar foods, such foods into the intestine will release a large number of inflammatory substances, so that the proportion of bad bacteria increased.

Solution: Dr. Loo suggested that patients with the above problems should eat a variety of different colors of fruits and vegetables, pay attention to sleep and wake up early, do an appropriate amount of stretching and aerobic exercise, and also consider taking the gut microbiome test to understand the situation of the gut dysbiosis, and then under the doctor’s assessment to supplement probiotics, to help regulate the gut microbiome to achieve balance and improve the eczema condition, do not take probiotic supplements indiscriminately, to avoid the opposite.

Do not avoid treatment. Early treatment to regain a balanced life

Dr. Loo said that each eczema patient’s condition is different, so each case needs to be treated by a doctor after diagnosis. He suggested that early use of different medications or treatments to control inflammation, rather than avoiding the fear of disease, and early targeting of the “eczema triangle” to cut off the vicious cycle, will help improve the eczema condition and restore a healthy, balanced life.

References

1. Hong Kong Allergy Association. Retrieved from URL: https://www.allergyhk.org/?page_id=37 Accessed: 15 Oct 2019

2. Chan YT, et al. Hong Kong Med J. 2015; 21:52-60

3. Novak N, et al. J Allergy Clin Immunol. 2003; 112:S128-39

4. Kim H, et al. Asia Pac Allergy. 2012; 2:269-74

5.  Ozkoca D, et al. Clin Dermatol Res Ther. 2019; 2:127

6. Lee SY, et al. Allergy Asthma Immunol Res. 2018; 10:354-62

This article is supported by sanofi-aventis Hong Kong Limited
SAHK.DUP.19.11.0651