Navigating life with atopic dermatitis: A path to better living

At a time when many of her peers were enjoying social gatherings and going on dates, one young woman found herself withdrawing from the idea of romance. 

“My patient often feared that her eczema flare-ups would put off potential partners,” shared Dr Roland Chu, a consultant dermatologist at Loke Skin Clinic. “For people living with atopic dermatitis, intimacy can be challenging due to anxiety about their skin’s appearance and the fear of rejection.” 

AN ITCH THAT TAKES A TOLL

Atopic dermatitis, or atopic eczema, is primarily caused by an unbalanced immune system that leads to inflamed, dry and itchy skin. Scratching to relieve the itch can damage the skin barrier, allowing germs and allergens to enter, which worsens the rash, itching and inflammation, creating a vicious cycle. 

This often leads to visible skin lesions on the body, including the face and scalp, affecting social and emotional well-being and causing self-consciousness. “People dealing with this condition may also experience a decline in their ability to concentrate and perform, particularly since moderate-to-severe atopic dermatitis frequently disrupts sleep,” said Dr Chu. 

As atopic dermatitis can be triggered by factors such as heat and sweat, many patients avoid outdoor activities like picnics or beach outings with friends. Some choose to stay home rather than wear clothing like swimsuits, which reveals their skin lesions. 

Stress further aggravates atopic dermatitis, activating an immune response that intensifies itching and inflammation. During high-stress periods such as preparing for examinations or meeting work deadlines, patients are more likely to experience flare-ups.

Dr Chu explained that common misconceptions about atopic dermatitis can add to one’s challenges. For example, the mistaken belief that it is contagious or brought about by poor hygiene can lead to feelings of shame and self-isolation. Similarly, seeing it as simply a sign of sensitive skin rather than a chronic inflammatory condition can undermine the lived experience, he noted. 

“Neglecting atopic dermatitis may result in a self-perpetuating itch-scratch cycle that worsens the rash and complicates treatment,” warned Dr Chu. “These misconceptions not only increase mental stress but also hinder individuals from receiving the support and treatment required for effective management.” 

In Singapore, atopic dermatitis patients often report taking frequent medical leave, wearing long sleeves even in hot weather and waking up to bedsheets stained with blood and dead skin from scratching. 

These challenges can take a heavy toll on mental health. A local study revealed that individuals with more severe cases of atopic dermatitis experienced higher rates of anxiety and depression. Across Asia, researchers observed that the condition negatively impacts quality of life and psychological well-being, with patients citing social embarrassment and sleep disruptions as key factors. 

INNOVATIVE THERAPIES BRING RELIEF

According to Dr Chu, the most holistic approach to improving quality of life for those grappling with atopic dermatitis is a combination of medical treatment, stress management, a consistent skincare routine and lifestyle adjustments. 

“Atopic dermatitis involves complex immune responses that cannot be effectively controlled with over-the-counter creams or home remedies. Professional treatment targets the chemical signals responsible for inflammation, offering long-term symptom management,” he explained.

Dr Chu added that with a broad range of treatment options, including topical corticosteroids, calcineurin inhibitors (a type of immunosuppressant), systemic medications and phototherapy, medical professionals can personalise treatment plans, monitor for complications and most importantly, provide patients with a renewed sense of hope.

He highlighted biologic therapies, which specifically target the immune pathways responsible for atopic dermatitis inflammation, as a notable breakthrough: “These therapies can result in significant improvement for patients with moderate-to-severe symptoms, offering a favourable safety and efficacy profile for long-term control of the condition.” 

While the chronic and unpredictable nature of atopic dermatitis can leave patients feeling frustrated and helpless, Dr Chu stressed the importance of not letting their diagnosis define them. 

“You may have to live with atopic dermatitis, but you don’t have to struggle with it,” he said. “With the right support and treatment, it’s possible to manage the condition and not let it stand in the way of achieving your goals.” 

Find out more about managing atopic dermatitis.