Eczema is unfortunately a skincare condition that does not have a cure. But, there are ways to alleviate the itch and keep symptoms at bay. One of the most important ones is choosing the right skin care products. The Asian Parent speaks to Dr Low Kah Tzay, who shares how to pick the most suitable skin care products that can help to relieve symptoms of eczema.
The importance of skin barrier – protection and prevention of moisture loss
The Asian Parent: Dr Low, we understand there is an intrinsic link between damaged skin barrier and dry and itchy skin common in children with eczema. Could you elaborate on this?
Dr Low Kah Tzay: Skin acts as a barrier to prevent external agents such as dust and bacteria from entering the body. At the same time, it acts as a wall to keep body and tissue fluids from leaving the body. The skin barrier is damaged when it cannot perform these functions. Skin barrier can be damaged by several factors, including exposure to strong solvents like soaps, detergents and emulsifiers. A defective skin barrier will lead to increased water loss from the skin. Bacteria and other allergens can then enter through the defective skin barrier and cause allergy and infection in the skin.
TAP: So then, how would a parent know if the child has damaged skin barrier?
Dr Low: One telltale sign is excessively dry skin, or skin that is red, flaky or scaly. Dry skin could then result in itchy and inflamed skin if it is not well managed.
Repair the barrier, stop the dryness and itch
TAP: Is it then possible that using the wrong skin care products can aggravate the skin barrier damage especially in children with eczema conditions?
Dr Low: Frequent washing with soap or detergents with a high pH leads to the formation of an enzyme that breaks down the skin barrier. This results in a damaged skin barrier, which leads to water loss and hence dry skin. In children with eczema conditions, the skin barrier is easily damaged; hence it’s important to select the right skincare products in order not to aggravate the problem. An ideal cleanser should be mild, non-foaming and soap free. It shouldn’t cause a tight feeling after washing and have a neutral pH.
Moisturise at least twice a day
TAP: How will applying moisturisers regularly help exactly? And how often should they be used?
Dr Low: Applying moisturisers regularly will help to treat the damaged skin barrier, which is dry and porous and help keep eczema flares and itching under control. Apply moisturisers at least twice a day and more frequently if your child gets eczema flare ups. Do not shower with hot water. Use only luke warm water for showers.
TAP: What makes an ideal moisturiser for children with eczema?
Dr Low:An ideal moisturiser should contain natural lipids to repair the skin barrier. It should be preferably fragrance free, hypoallergenic and free or low in preservatives. Moisturisers, which mimic the lipid structure of skin, will act as a natural barrier to give longer lasting hydration.
TAP: Is there a “best” time to apply moisturiser?
Dr Low: The best time is to apply moisturiser within five minutes after bathing or showering because when the skin is moist, the moisturiser will be absorbed optimally.
TAP: Are there ingredients in certain moisturisers that can help with reducing inflammation and itch in children with eczema?
Dr Low: Some newer moisturisers contain ingredients that can retain moisture more effectively and reduce inflammation. Some examples are Ceramide and N-Palmitoylethanolamide (PEA). Ceramides are natural skin lipids that can help to restore the skin barrier and to reduce transdermal water loss. N-Palmitoylethanolamide (PEA) is a naturally occurring fatty acid with anti-oxidant properties, which helps reduce inflammation and itch in sensitive skin.
Dr Low Kah Tzay graduated from National University of Singapore (NUS) and obtained his Master in Paediatric Medicine from the Graduate School of Medical Studies in NUS. He joined National University Hospital as a paediatrician in 1997. He was accredited as a Paediatric Specialist by Ministry of Health, Singapore. He spent a year as a Senior Fellow in Monash Medical Centre, Victoria, Australia in 2000 and sub-specialized in the field of Newborn and Developmental Medicine. He became a Fellow of the Academy of Medicine, Singapore in 2000 and an International Fellow, American Academy of Pediatrics in 2003. He is registered with the Singapore Medical Council. Dr Low is now in private practice at Anson International Paediatric & Child Development Clinic.
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Physiogel 'The Essentials of Skin Care' Series
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