- Eczema (atopic dermatitis)
- Ichthyosis, Perioral Dermatitis, Psoriasis, and Seborrheic Dermatitis
- Diseases: Diabetes, Thyroid Disease, or Kidney Disease
- Vitamin or mineral deficiency like Vitamin D, Vitamin A, Niacin, Zinc, or Iron
Eczema [Atopic dermatitis (AD)]
Eczema is a chronic inflammatory skin disease that usually starts in early childhood. Eczematous rashes are itchy and able to affect any part of the body especially on skin folds. Children with atopic eczema are at risk of cutaneous infections and is associated with poorer quality of life.2
The treatment of eczema focuses on maximizing skin barrier repair and reducing inflammation. Topical corticosteroids (TCS) are the first-line anti-inflammatory treatment for eczema. Long-term usage of topical corticosteroids may lead to skin barrier defects. Frequent i.e. two or more times daily application of moisturizer improves skin hydration, reduces AD symptoms, flares, and severity, and reduces the amount of topical anti-inflammatory medication needed.2
Moisturisers - what to look for in a moisturiser
Effective management of eczema involves the treatment of a defective skin barrier. Patients with eczema are therefore advised to use moisturizers regularly. Conventional moisturizer consists of three main ingredients: emollients, humectants, and occlusive agents. 2,3
| Class | Mode of action | Biological similarity | Some examples |
| Humectants | Attract and bind water from deeper epidermis to SC.
SC: Sub-cutaneous |
NMF in corneocytes
*NMF: Natural Moisturising Factor |
Urea
Glycerin Alpha hydroxy acids Hyaluronic acid Sorbitol |
| Occlusives | Form a hydrophobic film to retard TEWL of SC
TEWL: Trans Epidermal Water Loss SC: Sub-cutaneous |
Intercellular lipid bilayers
– Ceramide – Cholesterol – Free fatty acids |
Carnauba wax
Lanolin Mineral oils Olive oil Petrolatum |
| Emollients | Smoothens skin by filling the cracks between
desquamating corneocytes |
Natural lipids found on skin and sebum | Colloidal oatmeal
Collagen Glyceryl stearate Isopropyl palmitate Shea butter |
Some of the challenges to treatment in individuals with eczema has been the understanding of the disease, self-management and adherence like frequency of application for various dry skin severity conditions.3 A good reference source to have a better understanding is the Management of Atopic Eczema from the Malaysian Clinical Practice Guidelines that supports the evidence based on managing patients with eczema.4
Please consult your medical professionals for advise
Ref 1. Dry skin: Who gets and causes. American Academy of Dermatology.
https://www.aad.org/public/diseases/a-z/dry-skin-causes
Ref 2. A Review of Moisturizing Additives for Atopic Dermatitis. Vanessa VV et al. Cosmetics 2022, 9, 75. https://doi.org/10.3390/cosmetics9040075
Ref 3. A review on the role of moisturizers for atopic dermatitis. Giam YC et al
Ref 4. Management of atopic eczema. Clinical Practice Guidelines https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Skin