Eczema, most commonly referring to atopic dermatitis, is a chronic, relapsing condition that causes the skin to become dry, itchy, and inflamed. It is one of the most common skin conditions in developed countries and city areas, and is particularly prevalent in Singapore, with around one in five school-going children here having eczema. While the majority of children see their symptoms improve as they grow older, three to four in ten will continue to experience eczema symptoms into adulthood.
Eczema is not contagious, and while it cannot currently be cured, it is very manageable with the right combination of skin care, trigger avoidance, and medical treatment when needed. Its appearance can also vary depending on skin tone. On lighter skin, eczema often appears as pink or red patches with bumps and crusting, while on medium to darker skin tones it more commonly appears as dark brown, purple, or grey-toned patches with small, dry bumps, which can sometimes make it less immediately recognisable and lead to delayed diagnosis.
Eczema arises from a combination of two closely linked problems: a weakened skin barrier and an overactive immune response.
Eczema commonly occurs alongside other allergic conditions such as asthma and allergic rhinitis (hay fever).
Atopic Dermatitis
The most common form, and what most people mean by “eczema.” Atopic dermatitis is a chronic, relapsing condition linked to a genetic predisposition toward allergic conditions, typically beginning in childhood, with characteristic patterns of dry, itchy, inflamed skin in specific body areas.
Contact Dermatitis
Occurs when the skin reacts to direct contact with an irritant (irritant contact dermatitis, e.g. harsh soaps or chemicals) or an allergen (allergic contact dermatitis, e.g. nickel or certain fragrances), typically appearing at the site of contact rather than in the classic atopic dermatitis distribution.
Dyshidrotic Eczema
It causes small, intensely itchy blisters, most often on the palms, the sides of the fingers, and the soles of the feet. Can be triggered by stress, sweating, or contact with certain metals.
Nummular Eczema
It presents as distinct, coin-shaped patches of irritated skin, often on the arms, legs, or torso, and can be more resistant to standard moisturising alone.
Seborrhoeic Dermatitis
Affects oil-gland-rich areas such as the scalp, face, and chest, causing flaky, sometimes greasy-looking scaling. Related to, but distinct from, atopic dermatitis.
Symptoms vary from person to person in both severity and appearance, and can flare and settle over time.
Eczema commonly affects certain areas of the body, though this can vary by age:
There is no single cause of eczema. It develops from a combination of genetic predisposition, immune system factors, and environmental exposures, including:
Most eczema flares can be managed at home with the right skin care routine, but certain situations warrant prompt medical assessment rather than continued self-treatment.
A bacterial infection (most often with Staphylococcus aureus) can develop when broken, scratched skin allows bacteria to enter, causing increased redness, warmth, oozing, or crusting beyond the usual appearance of a flare. More seriously, eczema herpeticum is a viral infection of eczema-affected skin caused by the herpes simplex virus, which can spread rapidly and, particularly in young children, cause fever and widespread illness alongside clusters of small, punched-out blisters. It is considered a dermatological emergency requiring prompt antiviral treatment.
Eczema that is significantly affecting sleep, concentration, mood, or daily functioning is also a valid reason to seek medical review — quality of life impact is a real measure of severity, not a secondary concern, and more effective treatment is often available than patients realise.
How Eczema is Diagnosed
Recognise and Reduce Triggers
Care When Showering
Moisturise consistently
