Eczema is a chronic skin condition that causes redness, inflammation, and intense itching. For many in Hong Kong, it’s a daily challenge, with one in five peopleexperiencing eczema at some point. Children are especially vulnerable, with around 30%affected by eczema, according to a study held in 2019. The condition can disrupt everyday life, leading to discomfort, lack of sleep, and even emotional distress.

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What is Eczema?

Eczema is a group of skin conditions that result in inflammation and irritation. At its core, eczema is linked to a compromised skin barrier, making it less effective at retaining moisture and more susceptible to allergens and irritants. This dysfunction can result in dry, cracked, and itchy skin. There are several types of eczema, but atopic dermatitis is the most common, especially in children and young adults. While eczema isn’t contagious, its symptoms can vary in intensity, often flaring up due to triggers like weather, allergens, surrounding environments, or stress.

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The Causes of Eczema

Eczema is a complex condition influenced by genetic, environmental, and immune system factors. In Hong Kong, the subtropical climate significantly exacerbates eczema symptoms.

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Hong Kong’s Weather and Climate

The climate in Hong Kong, with its sharp contrasts between humid summers and dry winters, significantly affects eczema sufferers. During winter, the air becomes dry, leading to dehydrated skin that can exacerbate eczema. The lack of humidity strips moisture from the skin, making it itchy and prone to cracking. Conversely, excessive sweating in Hong Kong’s sweltering summers can worsen eczema. Sweat can irritate sensitive skin, triggering inflammation and further itching. The heavy rainfall common during the rainy season adds another challenge. High humidity fosters the growth of allergens like mold and dust mites. These allergens can irritate the skin, leading to frequent flare-ups, especially in children with developing skin barriers.

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Allergic Reactions to Substances

Everyday substances can significantly trigger eczema, particularly in urban environments like Hong Kong. With high population density and limited space, homes and workplaces quickly accumulate dust, especially in less-ventilated areas. Dust irritates the skin and carries microscopic particles, such as dust mites and their droppings, which can trigger allergic reactions that worsen eczema symptoms. You should regularly clean indoor environments and use air purifiers.

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During cooler months, woolen fabrics may be a staple in wardrobes, but they also pose a challenge for those who have eczema. The coarse fibers of wool can rub against sensitive skin, leading to further irritation and micro-abrasions that weaken the skin barrier. This makes the skin more susceptible to flare-ups.

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Foods and Diet

Certain foods aggravate eczema symptoms, particularly in individuals with underlying sensitivities. Gluten, a protein found in wheat, barley, and rye, can provoke an inflammatory response in some individuals, especially those with gluten intolerance or sensitivity. This inflammation can manifest as skin irritation for those prone to eczema, leading to flare-ups. The immune system’s reaction to gluten can also cause an overproduction of certain compounds that exacerbate inflammation and make the skin more reactive.

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Soy, a staple in many Asian diets, is another common trigger. It contains specific proteins that can act as allergens, particularly for individuals with a predisposition to food allergies.When consumed, soy can stimulate the immune system, causing a cascade of allergic responses that include itching, redness, and eczema flare-ups. Processed soy products often contain additives or preservatives that might further irritate sensitive individuals.

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It’s important to note that these foods don’t directly cause eczema but act as triggers in individuals predisposed to it. Consulting a healthcare provider or allergist can also provide insights into whether an elimination diet might help manage symptoms.

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Common Areas and Symptoms of Eczema

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Common Areas of Eczema

For individuals with atopic dermatitis, eczema often affects flexural areas of the body, such as the neck, inner surfaces of the elbows, and the backs of the knees. Contact dermatitis is localized to areas exposed to external irritants, such as the hands, when exposed to harsh chemicals. Elderly patients often experience age-related dryness, with eczema commonly appearing on the lower legs.

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Symptoms of Eczema

Eczema manifests in various ways, with its appearance and symptoms often differing between acute and chronic stages. A common hallmark of eczema is red, patchy rashes with undefined edges, which can spread across different body parts. The affected areas often feel warm and tender, with visible inflammation signaling the skin’s heightened immune response.

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In acute eczema, the condition may escalate to the formation of small, fluid-filled blisters. These blisters are prone to breaking open, especially when scratched, exposing raw, sensitive skin beneath. This creates an ideal environment for bacterial infections. Secondary infections can worsen inflammation, prolong healing, and require medical intervention.

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What are the General Care and Treatment Options for Eczema?

While eczema cannot be cured, its symptoms can be managed through medical treatment and careful skin care practices.

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Treatment for Eczema

Medical treatments for eczema aim to reduce inflammation and relieve itching. Topical corticosteroids (applied directly to the skin) are commonly prescribed to control inflammation, while antihistamines can help minimize itching. Moisturizing the skin is essential, and gentle, skin-friendly moisturizers are often recommended.

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General Care

Good skincare habits are vital for managing eczema. Bathing should be limited to short sessions with lukewarm water, as hot water can strip natural oils from the skin. Using hypoallergenic soaps and shampoos can help minimize irritation.

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Pure cotton fabrics are ideal for clothing, as they are breathable and help absorb sweat. Woolen garments, on the other hand, should be avoided, as they can irritate sensitive skin. When doing laundry, use mild detergents and ensure clothes are thoroughly rinsed to remove any residue. Keeping the home environment clean is essential as dust and allergens can worsen eczema, so avoid carpets and fluffy toys, which tend to encourage these irritants.

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Managing Eczema with Confidence and Care

For many in Hong Kong, the struggle with eczema reflects environmental factors, lifestyle choices, and individual sensitivities. From the humid summers and dry winters that test the skin's resilience to everyday allergens found in homes, wardrobes, and diets, managing eczema requires a holistic and informed approach.

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While it cannot be cured, eczema can be effectively managed through medical treatments and lifestyle adjustments. Small, consistent changes—such as choosing breathable fabrics, keeping the home clean, and maintaining a gentle skincare routine—can significantly reduce flare-ups and improve quality of life. Equally important is seeking professional advice to address specific dietary or environmental triggers and tailor treatments that align with individual needs.

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Remarks:

1. Source : Eczema (2021) https://www.redcross.org.hk/sites/redcross/files/media/hcs_files/HE-202104%20ENG.pdf

2. Source : Measuring the quality of life of the families of children with eczema in Hong Kong (2019) https://pmc.ncbi.nlm.nih.gov/articles/PMC6676062/

3. Source : Eczema (2022) https://my.clevelandclinic.org/health/diseases/9998-eczema

4. MFMER (2024). https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279