【Common Diseases】Eczema (Atopic Dermatitis)
A Complete Guide to Eczema Treatment (Hong Kong Edition)
Eczema (Atopic Dermatitis) is a chronic, recurring skin inflammation often associated with itching, dryness, redness, swelling, and scaling. In severe cases, it can ooze, scab, and even crack and bleed. Eczema is a condition associated with a compromised immune system and skin barrier function. While not contagious, it can significantly impact quality of life.
Eczema is a common skin condition in Hong Kong, particularly in children and adults, particularly due to the effects of urban environments, air pollution, hot and humid weather, and stress. According to the Hong Kong Association of Dermatologists, the prevalence of eczema in Hong Kong is as high as 20-30% among children and approximately 10% among adults.
As the editor, I referred to the Hong Kong Hospital Authority, the Department of Health and international dermatology authorities, and listed in detail the causes, treatments, local medical resources and daily care of eczema.
1. Main types of eczema
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Atopic Dermatitis
- The most common, more common in children, and related to genetics, immune system and environmental factors
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Contact Dermatitis
- Allergies or irritations to chemicals, metals, fragrances, etc.
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Seborrheic Dermatitis
- Often appear on the scalp, face, and chest, and are related to sebum secretion and fungi
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Nummular Eczema
- Round, red spots, usually on the extremities
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Dyshidrotic Eczema
- Small blisters on fingers and toes, with severe itching
2. Causes and Risk Factors
The causes of eczema are complex and mainly include:
- Genetic factors (family history of allergies)
- Immune system overreaction
- Defective skin barrier function (easy to lose water, easy to irritate)
- Environmental factors (temperature fluctuations, humidity, pollution)
- Allergens (dust mites, pollen, animal dander)
- Dietary factors (some patients are allergic to milk, eggs, and seafood)
- Stress and mood swings
💡Editor ’s Tip :
Hong Kong's hot and humid climate, alternating with air-conditioning, coupled with air pollution, is particularly unfriendly to eczema patients, and their skin can easily become dry or irritated.
3. Treatment Principles
Eczema cannot be cured , but it can be managed through medication and lifestyle management to reduce the frequency and severity of flare-ups. Treatment goals include:
- Relieve itching and inflammation
- Repair skin barrier
- Preventing infection
- Prolong remission
IV. Drug treatment (doctor’s guidance required)
1. Topical medications
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Topical corticosteroids
- Quickly relieve inflammation and itching, with different levels of intensity (weak → medium → strong)
- Commonly used drugs in Hong Kong include Hydrocortisone (weak), Betamethasone (medium-strong), and Clobetasol (strong)
- Use as directed by a doctor for a short period of time to avoid long-term abuse that may cause skin thinning
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Topical Calcineurin Inhibitors
- Such as Tacrolimus, Pimecrolimus
- Suitable for thinner skin areas such as the face and neck, with fewer side effects
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antibiotic ointment
- Suitable for cases with bacterial infection (Staphylococcus aureus)
2. Oral medication
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Antihistamines
- Relieve itching and help sleep
- Some over-the-counter medicines are available in Hong Kong pharmacies
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antibiotic
- Used for severe infections
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Immunosuppressants (Cyclosporine, Methotrexate)
- For severe and stubborn eczema, prescribed by a specialist
3. Biologics
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Dupilumab
- Significant effect for moderate to severe atopic dermatitis
- Private healthcare is available in Hong Kong, but the cost is high (approximately HK$10,000-$20,000 per month)
5. Daily care (equally important as medication)
- Moisturize : Apply a fragrance-free, mild moisturizer several times a day, especially after showering.
- Gentle cleansing : Avoid using bath products containing soap, alkali, and fragrances
- Keep baths short and warm (avoid overheating)
- Wear pure cotton clothing and avoid wool and chemical fibers
- Avoid scratching : use ice or pat gently
- Control indoor humidity (50%-60%)
- Reduce contact with allergens (dust mites, animal hair, pollen)
- Eat a balanced diet and avoid known food allergens
6. Hong Kong’s Medical Resources and Costs
Dermatology Department of Public Hospital
- Advantages : Low cost (specialist outpatient clinic is about HK$135 per visit)
- Disadvantages : Long waiting time, non-emergency cases may require waiting for several months to a year
Private Dermatology Clinic
- Advantages : Short waiting time, same-day diagnosis and treatment
- Cost : Consultation fee including medication is approximately HK$500-HK$1,200 (depending on medication and treatment plan)
Complementary treatments
- Some eczema patients in Hong Kong will cooperate with Chinese medicine treatment or phototherapy (narrowband UVB), but they must ensure that they are performed by qualified doctors or therapists.
7. Warning signs of acute worsening of eczema
- Rapidly expanding skin redness and swelling
- Increased exudate and pus
- High fever and chills (possibly cellulitis)
- Infants or children with systemic rash accompanied by lethargy and refusal to feed
If any of the above situations occur, seek medical attention immediately to avoid serious infection or complications.
💬Let me tell you :
The key to managing eczema lies not only in medication, but also in daily maintenance and avoiding triggers . Many patients in Hong Kong stop moisturizing after their skin improves, resulting in a rapid relapse before the skin barrier is fully repaired. Another common issue is the fear of using steroid ointments. While short-term use as directed by a doctor is safe, delaying treatment can worsen inflammation and require longer medication.
⚠️ Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.
