Eczema struggles in Singapore

Having suffered from eczema for close to three decades, Edwin, aged 33, has had to adopt myriad coping habits to manage his condition, while enduring a true test of mental strength. At each stage of his life, from childhood and adolescence to going through National Service and job hunts, his skin condition has managed to creep in and make things exceedingly difficult.

Fellow Singaporeans with eczema, the most common of which is atopic dermatitis, would be able to relate to some of these struggles. But if you’re fortunate enough to have skin that’s not affected by an immunodeficiency, here are some of Edwin’s experiences that shed light on how a skin condition can wreak havoc on someone’s self-esteem and day-to-day life.

What having eczema is like – More than just an itch

Image credit: Edwin Tan

Edwin has battled with atopic dermatitis for “as long as he can remember”, suffering recurring patches of intense itchiness since his early childhood years. These prominent patches would be especially bad behind his elbows and knees, and on his neck. Even in adulthood, he is used to sporting splotches on his face and body, and suffers from frequent cracking and flaking skin.

Besides requiring an immense amount of willpower not to scratch, eczema sufferers also deal with skin that is very dry, red, and prone to oozing when there are wounds.

As you can imagine, this condition is tough for any kid to endure. It didn’t help that Edwin had a handful of classmates who callously mocked his condition. They would imitate his uncontrollable scratching motions and call him hurtful names like monyet (monkey in Malay) while pretending to scratch themselves wildly with flailing arms.

Bullying aside, Edwin couldn’t even get empathy for his condition from some of his teachers – grownups whom he was supposed to trust and look up to. On days where his wounds were particularly severe, he would ask to be excused from P.E., to which some teachers would deny and say that he looks “totally fine”, so he must be “pretending”.

Dealing with eczema in Singapore’s climate

Image credit: Edwin Tan

For those of you who aren’t familiar, sweat is a huge no-no for eczema sufferers. This means living in Singapore, which is near perpetually hot and humid, has the tendency to be a nightmare for those trying to keep their eczema in check.

The cycle goes a little like this:

The sweltering hot weather makes you itchy and uncomfortable. You scratch, creating new wounds and aggravating existing ones.

Heat and humidity lead to salty perspiration, which also intensifies the itchiness. To make matters worse, sweat seeping into your raw wounds causes an excruciating stinging sensation.

When you venture into air-conditioned spaces for some respite from the heat, the coldness makes your skin excessively dry. This makes it prone to irritation and more scratching, and the dryness also means it is more prone to cracking, which spells more pain. 

You might surmise that the clear solution would be to apply moisturiser, but it all goes back to how dastardly humid Singapore is. No matter how well you think your moisturiser is able to be absorbed, a layer of creaminess coating your skin is not fun to deal with in our climate.

How having eczema affects your day-to-day life

That said, Edwin, like many other atopic dermatitis sufferers who proactively tend to their condition, still has the habit of moisturising regularly. It’s come to a point where he has to keep moisturiser ready to go in every single bag he uses, so he doesn’t run the risk of heading out without moisturiser at hand.

Other lifestyle practices – which non-eczema sufferers would never have to worry about – include changing his bedsheets and pillow cases more often when his condition worsens. Although it is a time-consuming hassle, it’s necessary in order to avoid sleeping in sheets stained by his raw and oozing wounds.

While we’re on this topic, Edwin confesses that his skin condition has really taken a toll on his quality of sleep over the years. A “super light sleeper” as it is, his atopic dermatitis prevents him from getting full nights of undisturbed shut-eye.

It’s common for him to wake up in the middle of the night to scratch. And when he doesn’t get enough sleep, his focus for the entire day gets shaken up. 

How a skin condition can create trauma and affect major milestones

To this day, there are plenty of people who still think eczema is “just a rash”, or that you can make the condition go away if you “just stop scratching”. While Edwin is understanding of the fact that these trivialisations stem from a lack of awareness, his experiences go to show that a skin condition can drastically impact one’s life – beyond just appearance and self-esteem.

Image credit: Edwin Tan

One quirk about Edwin is that when he’s invited to someone’s home, he’d either be standing around while others comfortably sat down, or opting to sit on the floor despite the sofa or chairs being available. This conscious preference stems from a traumatising childhood episode, where he was berated by a friend’s parent for staining their sofa with blood from his atopic dermatitis wounds.

So shaken up was Edwin that this incident has stuck with him for over twenty years. Not many people would expect a scolding from their primary school days to stay with them well into adulthood, but neither would they expect their skin to be the cause of failed job applications and wrongful accusations of their integrity.

Image credit: Edwin Tan

Sadly, Edwin was subjected to all of the above. Back in his early twenties, he was denied a job position that he was completely qualified for. He wound up overhearing the discussion between the employers, and the interviewer asserted that the company “doesn’t want someone with skin issues”.

Things weren’t rosy when he was serving National Service, either. During his trainee days, his atopic dermatitis flare-ups would sometimes require him to take medical leave to recover. This led to him being accused of chao keng by some – a term that means to feign illness in order to play hooky.

On days where he had to obtain permission to sit out of physically-demanding training exercises, he was told by some superiors that “if you can’t die from it, it’s not serious enough”.

Learning to live with eczema, even with no permanent cure

For all the fellow eczema sufferers out there, his #1 piece of advice is not to get defeated by it. Personally, he has come this far by drawing inspiration from those plagued by illnesses, but are still able to live their lives to the fullest.

The thing about eczema is that there is no known cure, just ways to alleviate the symptoms and keep nasty flare-ups at bay. Edwin has been through the wringer and sought all kinds of treatment methods, from dermatology specialists to home remedies.

The specialist-prescribed steroids may have tamed his condition for short bursts of time, but the trade-off came in the form of side effects such as thinned, streaky skin and dark scars. He also started developing resistance to the substances, so he knew it wasn’t a sustainable treatment option.

On the natural front, he has been advised by loved ones and strangers alike to try every trick in the book. Herbs, oils, homemade concoctions to slather on your skin – you name it. He was even told to pray during a funeral and rub the incense on his skin once. 

As fate would have it, Edwin began a new atopic dermatitis treatment earlier this year which has been proving helpful thus far. This new treatment limits the immune system’s reactions to environmental triggers, and has been able to give atopic dermatitis patients an alternative to managing their condition.

The results were apparent when he was able to sleep through the night with zero interruption. Everyday tasks which were once painful ordeals have become less daunting and easier to complete, such as taking his daily shower or washing his face.

A consultant dermatologist, Dr Paul Chia, emphasises that every patient is different, and that specialist guidance would be needed to find out exactly which treatment option suits them best. 

Common treatment methods for atopic dermatitis include topical corticosteroids, moisturisers and topical calcineurin inhibitors that are designed to relieve the swelling, itching and redness.

He highlights that consistency is key when it comes to adhering to treatment for atopic dermatitis, and that with greater awareness and newer treatments such as biologic therapy, atopic dermatitis patients can achieve better outcomes. Otherwise, patients run the risk of frequent, unpredictable flare-ups which result in persistent itching, pain and inflammation.

Although the skin condition is likely to stay with Edwin for the rest of his life, he is heartened and “very, very glad” to have finally regained “some semblance of control”, as he puts it. 

He also urges those with eczema not to sit idly by and suffer the effects of this dreadful skin condition: “Go and learn about it, find out how to manage it, and seek treatment.” Even though there is no permanent cure which can rid you of this condition, Edwin assures those in the same boat that “managing it well can give you a better quality of life”.

Speak to your doctor to discover ways in managing your eczema

This post was brought to you by Sanofi.
Cover image credit: Edwin Tan