DR. TEO WAN LIN
MBBS (S’PORE), MRCS (EDIN), FAMS (DERMATOLOGY)
Dr. Teo Wan Lin (Zhang Wanlin; Chinese: 张婉琳), is an accredited dermatologist in Singapore and director of TWL Specialist Skin & Laser Centre, specialising in medical and cosmetic dermatology including pediatric dermatology, eczema, acne, and other skin and hair disorders.
What is eczema? Why do I have eczema?
Eczema is a common condition that can affect the young, the middle aged, as well as the elderly. It is synonymous with dermatiti. Dermatitis refers to any condition that involves any barrier dysfunction. The skin barrier is the medical term that helps us to understand the function of the skin to protect the internal organs from the external environment. Skin barrier dysfunction is the result of both genetics, as well as environmental influences. Examples of genetically caused eczema, would be atopic eczema, it’s also related to a condition known as Ichthyosis vulgaris. Both of these run in families, is what we associate with the atopic triad. This involves a constellation of conditions: eczema, which is a sensitive skin condition, allergic rhinitis, which can present with sinus-like symptoms, as well as asthma.
A skin expert on eczema
My child has dry and sensitive skin, do they have eczema?
It is important to understand that eczema, while not being fully curable, as its ultimate root cause is at the genetic level, is fully treatable. Why is this so important? If you have been diagnosed with eczema as a child, it is important to know that the distribution of the eczema rashes is going to be slightly different depending on what age group you are at. Slightly older children will find that eczema affects the flexures of the joints. Younger children may find that they have this at the extensors.
Eczema causes and symptoms, according to a Singapore dermatologist
What causes eczema in babies and toddlers?
It is very common for toddlers, even infants to have a type of eczema we call facial eczema. This is found mainly on the face, around the mouth area. That could actually be due to drooling, or the persistent presence of saliva on the skin. Slightly older children, adolescents and even adults who have a habit of lip smacking where they constantly lick their lips out of habit, may actually induce a form of lip eczema, known as cheilitis. Other areas which are prone to eczema, would be the flexural areas where the skin is thinner. For example, around the eye area, around the mouth, the lips, the neck, the elbows, the knees, the groin. These are areas in contact with the joint folds.
Dry & Sensitive Skin in Singapore
What are the different types of eczema?
Dermatitis can take the form of oily skin. It is somewhat surprising because we all seem to link dermatitis only with dry skin. Dry, flaky, red, sensitive skin, are all common symptoms of eczema. Individuals who suffer from eczema may find that it becomes stinging when in contact with water. Also, when they are exposed to certain cleansers, or cosmetics. However, for oily type of eczema, is a condition known as seborrheic dermatitis.
Seborrheic dermatitis, as its name suggests, is a mix of both dry and oily skin. It occurs first on the scalp, and is due to an imbalance of microorganisms on the scalp, usually due to an excess of a certain yeast, known as malassezia. This affects the scalp balance of bacteria known as microbiome. Subsequently, this results in flaking. Eventually, it can also lead to a certain type of hair loss. Seborrheic dermatitis also occurs on the face, and it’s often misdiagnosed as facial eczema.
The location of the rash is very important, because for seborrheic dermatitis, you will find that it is the hair bearing areas that are affected. For example, the eyebrow area, you can get patchy redness around the nasolabial area, which is the junction between the nose and the lips, and it can also extend to affect the chest area.Another form of dermatitis is perioral dermatitis, that looks a lot like hormonal acne and affects the area around the mouth.
If you have any of these symptoms: stinging, red skin, flaking, a sensation of tightness and dryness, you may have a form of sensitive skin, known as eczema. It is important for you to visit your dermatologist to get a correct diagnosis, as many of these can be effectively treated when diagnosed early.
Dermatologist recommended treatment options for eczema
How do dermatologists treat eczema?
Examples of treatment for eczema would be topicals that contain steroids. Rest assured that an accredited dermatologist will be able to safely prescribe a regimen of topical steroids that are effective for your condition. It’s important to know that we do not advise self medication here. This is because topical steroids can potentially have adverse side effects such as skin thinning, known as steroid atrophy. However, under a dermatologist’s supervision topical steroids are actually highly effective, and essential for the treatment of all types of eczema.
Alternative steroid-like active ingredients would be calcineurin inhibitors. Tacrolimus is an example of a steroid sparing agent. This is what we usually recommend for use on areas such as the eyelids, the eyebrow area. Because, there is a risk of glaucoma when using topical steroids over these areas.
Dermatologist tips on the best moisturizer for eczema
The important rule in eczema treatment is to moisturize. A good moisturizer these days must fulfill certain criteria. A prescription emollient device or PED, is the gold standard for a moisturizer targeting eczema. This means that it must contain a balanced ratio of lipids that mimic your skin barrier, as well as anti inflammatory ingredients that have steroid like effects and these are usually from botanical actives. This is what we use at our Pharmacy, the Multi-Ceram cream is a gold standard type of PED moisturizer. This term was first coined by a pediatric dermatologist, and is now considered the best type of moisturizer for sensitive skin. Antihistamines are also very helpful in the treatment of eczema.
Singapore Dermatologist specialising in eczema treatment
If you have sensitive red skin that gets worse with the change of environment, change of skincare products, or even when you are in contact with water, know that all of these could be signs of dermatitis. There are rare causes of dermatitis, such as cosmetic intolerance syndrome. All this should be fully evaluated by an accredited dermatologist.
Book now for a virtual Tele-Dermatology consultation appointment with Singapore Dermatologist – Dr. Teo Wan Lin. For bookings made after hours, please allow up to the following working day 10am for the appointment booking to be confirmed. You may also contact TWL Specialist Skin & Laser Centre – Email: email@example.com | Phone: +65 9728 6734, for more details regarding the appointment.