Skin Diseases, Moisturisers & More

Natural Health had an interesting Q & A session with Dr. Koh Chuan Keng, President of the Dermatological Society of Malaysia after his exclusive presentation titled “Sensitive, Compromised Skin: Role of Adjunctive Skincare Products” at Cetaphil new product launch recently.

Q: How prevalent are atopic eczema and atopic dermatitis (dry-skin) cases in Malaysia? What is the current statistic?

A: Prevalence of atopic eczema is around 20%, i.e., 1 in 5 in Malaysia. If you include people with dry and sensitive skin the figure is likely to be higher, closer to about 30%.

Q: What are some of the problems associated with such cases?

A: Some basic problems include:

Physical

• Dry itchy skin patients often cannot focus in school or at work due to the constant itch, having to scratch all the time resulting in poor performance in school and work.

Psychological

• Children may get embarrassed and teased by their classmates making them reluctant to go to school. They feel stigmatised as people frequently misunderstood their problem is due to hygiene and stay away from them.

Economical

• They are least likely to get a well paying job compared to their peers with normal skin, they certainly won’t be on Malaysian Idol or used as a pin-up poster guy or girl.
• The cost of treatment and frequent visits to hospitals impact significantly on the cash flow costing an estimate RM900 to RM3,500 per year.

Q: What are some of the natural remedies for us to take care of ourselves from contracting skin diseases?

A: One can take some natural remedies which may help to reduce sun damage like antioxidants such as vitamin C, eating oranges or cranberries. Omega 3-fish oil capsules may provide some benefits in people with dry skin. Yogurt containing good natural bacteria may be helpful but still need more research.

Q: The risk of Atopic eczema is said to increase due to a “western/clean” style of living and diet. Can you explain briefly on this and what changes can be done to avoid it?

A: Atopic Eczema is more common in industrialised “first world” countries compared to, say rural Africa. In Western countries, it is more common in people who live in the cities than farmers. It is thought that early exposure to dirt and bacteria in our environment may calm down our skin immune system making it less likely to erupt or become oversensitive.

We could all move to live in the countryside but it is not practicable. We can try to avoid allergens which are airborne like dust, pollen(no indoor plants), animal hairs, and carpets. Avoid certain foods like seafood or nuts which can trigger a flare. Stop using soaps, use non-soap cleansers with slightly acidic PH which is kinder to the skin. Soap with its alkaline ph tends to dry the skin and damage the lipid layer on the skin. Moisturise the skin frequently, preferably with specially formulated moisturisers that can help to repair the damaged barrier skin function.

Q: It is said that our skin has natural moisturising factor (NMF). If this is the case, why do we need moisturisers?

A: Our skin do have natural moisturising factors but it is produced less and less as we grow old or if we have a filaggrin gene mutation which results in a reduce filaggrin production. Fillagrin is broken down into filaggrin breakdown products which form part of the natural moistuirising factor (NMF) that helps to keep the skin soft and supple and waterproof.

Q: Being a dermatologist, what would your advice be in choosing an effective moisturiser?

A: An effective moisturiser should not be too greasy, non-comedogenic so that it does not block the pores and have a long lasting effect i.e. last greater than 12 hours. However different skin may find different types of moisturisers suitable to it. People with dry skin may prefer it to be greasier whereas people with acne prone oily skin might prefer a water based light moisturiser.

Q: Based on our observations, many international moisturers are too rich for local climate. Would these moisturisers block the pores or cause acne problems of Malaysian users considering our humid weather condition?

A: Yes, many moisturisers are not suitable for our hot humid climate. They are better for dry winter conditions where the humidity is low. If the moisturiser is too greasy it may clog up or pores resulting in comedones which are early acne which can lead to full blown acne.