Family outings are sometimes unpleasant for Madam Tan, a 50-year-old sales manager, and her 11-year-old daughter.
Many people stare at the girl while some parents even yank their children away.
Once, when Alice (not her real name) was in an air-conditioned playroom at a high-end hotel in Sentosa, a mother insisted on her leaving the room, in case she passed on her skin condition to others.
"There's this swing that is very popular in her school. My daughter told me the good thing is, 'when I go near it, I get it all to myself'," said Madam Tan.
Alice has a severe form of eczema, a skin condition characterised by dry, red and itchy skin. It may look unpleasant but it is not contagious.
"She has either a bad or mild flare-up; her skin is never clear," said Madam Tan. "When it's hot, she scratches, and when she scratches, her skin breaks. This makes her skin prone to bacteria and infections."
Moisturisers are a must for Alice, and used at least four times a day.
When Alice has bad flare-ups, Madam Tan uses steroid cream on her morning and night.
In a very bad flare-up, she has to go to the doctor for oral steroids.
She sometimes uses antihistamines as well - they do not do anything for her eczema, but the medication makes her drowsy so she can sleep, her mother said.
Alice has tried bleach baths, bio-resonance therapy and a host of other treatments.
"I've exhausted all alternatives," said Madam Tan. "I tried traditional Chinese medicine for 11/2 years. She was such a good girl. She would drink all the bitter medicine but it didn't work."
When Alice was in Primary 1, she had bad flare-ups that lasted nine months while she underwent bio-resonance therapy.
"She had to miss school on some days. She would scream and refuse to take a shower because it was so painful for her. Her skin was raw everywhere," said Madam Tan.
This episode ended only when she was put on a course of strong oral steroids.
She is now seeking treatment at KK Women's and Children's Hospital (KKH) and has been put on non-steroidal medication since March to bring the eczema down.
Despite all her challenges, Alice manages to go to school on most days. She also goes to eczema "camps" organised by KKH every six months. Knowing that there are other kids out there with the same condition has helped her cope better. "Eczema is like diabetes. It's how you manage it," she said.
Although eczema is a common condition, many do not completely understand it.
Here are four common misconceptions about eczema.
Eczema can be cured.
Fact: No. In most cases of eczema that is not purely due to external factors, a cure is not something to aim towards, said Dr Derrick Aw, a senior consultant at University Dermatology Clinic, National University Hospital.
"It is control that we strive for."
Steroid creams used for eczema will cause side effects such as thinning of the skin.
Fact: This is true only when steroid creams are used indiscriminately, excessively and incorrectly in an unsupervised, unmonitored manner, said Dr Aw.
"An example of incorrect use is continued daily use even when the eczema has subsided, in an effort to prevent future attacks," he said.
"The correct use is to reduce the frequency of steroid cream application to twice weekly for a few months if prevention is desired."
Topical steroids are often prescribed for flare-ups. They make the skin less itchy and sore.
Eczema is contagious.
Fact: No. Eczema is not contagious so you cannot pass it to others and you cannot catch it from someone else, said the National Eczema Society based in Britain.
Eczema is related to a food allergy.
Fact: This is true only in a small group, and these cases are more often than not, children with very bad eczema, said Dr Aw.
Many choose to self-treat eczema by avoiding certain types of food, but this is not advisable if one's food allergy is not confirmed.
"This may have an impact on a child's growth and development." said Dr Aw.
If one suspects a food allergy, he should consult an allergist who can evaluate and counsel the child and his family, he advised.
This article was first published on Sept 8, 2015.
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