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Is That Itchy Rash Eczema?

Five possible causes of your flaky skin, and how to treat it.

Find out the cause of your peeling skin. By Dawn Chen.

Itchy_Rash_Flaky_Skin_Cause_Ezcema_Dandruff_TSS_Tinea_Dermatitis 

Photo: B. BOISSONNET / BSIP/BSIP/Corbis

Besides being itchy and uncomfortable, patches of dry, flaky skin can also be embarrassing (think flecks of dandruff on your shoulders – eeks!). While the occasional flare-up is common and can usually be treated with over-the-counter moisturiser, there are times when dry skin is more severe and needs medical attention. “If there are blisters, areas of broken skin, pain or pus, see a doctor immediately,” says Dr Rachael Teo, consultant dermatologist at Raffles Skin & Aesthetics Centre

That itch could be… Dandruff

Symptoms Dry, whitish scales that come off the scalp.

Why it happens According to Dr Teo, dandruff is usually a sign of scalp inflammation resulting from a root condition like seborrhoeic dermatitis or scalp psoriasis. Other causes of dandruff are stress and excessive use of harsh styling products.

How to treat dandruff Medicated shampoos and scalp treatments are recommended. Using olive oil to soften the scales before shampooing may also help increase the effectiveness of therapy. 

That itchy rash could be… Eczema

Symptoms Dry, red, scaly patches that are painful and very itchy. Skin may also break and ooze pus.

Why it happens Atopic eczema, the most common type, is caused by many factors, including genes, skin barrier defects and environmental triggers such as heat, says Dr Teo. The condition is usually chronic, so rashes tend to recur.

How to treat eczema Moisturise daily to strengthen the skin barrier. Topical creams and oral anti-itch medication will also help. In more serious cases, phototherapy or controlled exposure to UV light may be used to reduce skin inflammation. 

That itchy rash could be… Contact dermatitis

Symptoms Red, itchy patches with a burning sensation. Skin may also develop blisters or darken.

Why it happens “There are two main types of contact dermatitis – irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD),” explains Dr Teo. The first occurs when irritants damage the skin faster than it can repair itself.

The second is the result of a reaction to an allergen. Frequent hand washers and those with existing skin conditions are at a higher risk of getting contact dermatitis.

How to treat contact dermatitis Avoid potential allergens. Common offenders include harsh soaps, chemical solvents and cosmetics or skin products, including deodorant. For symptomatic relief, your doc might prescribe topical steroid creams, moisturisers and oral medication. If you have developed a bacterial infection, antibiotics will be given. 

That itchy rash could be… Toxic shock syndrome

Symptoms High fever, body chills, fatigue, vomiting and diarrhoea in addition to a red rash.

Why it happens Although rare, peeling skin accompanied by the above might signal toxic shock syndrome (TSS). This serious infection is caused by the bacteria staphylococcus aureus or streptococcus, says Dr Teo. It can happen with prolonged use of high absorbency tampons and contraceptive sponges as these can become breeding grounds for bacteria. Those with open cuts or recent surgery are also at risk of TSS as bacteria can enter the blood stream through the wounds.

How to treat toxic shock syndrome Hospitalisation is usually needed as TSS can be fatal. Antibiotics will be given to fight the infection on top of independent treatments for each symptom. 

That itchy rash could be… Tinea

Symptoms Red, scaly skin and a ring-like rash that usually affects the groin area, armpits and feet.

Why it happens The areas of the body which trap moisture and heat are usually most susceptible to this fungal infection. According to Dr Teo, tinea can be spread via direct contact or through sharing items like towels or shoes with an infected person.

How to treat tinea Mild tinea can be managed with topical anti-fungal creams and lotions. More serious cases may require oral medication.

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