Atopic dermatitis (eczema) treatments in Bangladesh by Prof Dr Md Siraj Uddin

Atopic dermatitis is a long-term inflammatory skin condition. It makes the skin barrier weak. Moisture escapes easily, while soap, dust, sweat and other irritants enter the skin more easily.

The result is dry and sensitive skin that becomes itchy or inflamed. Symptoms may settle for some time and then return again. This return of symptoms is called a flare-up.

Bangladesh has long periods of heat, humidity, rain and heavy sweating. Sweat trapped under clothing can irritate sensitive skin. During winter, lower humidity may make the skin much drier. Sudden temperature and humidity changes can also affect eczema symptoms.

Common eczema triggers include:

• Hot weather and heavy sweating
• Dry winter air
• Harsh soap or body wash
• Fragranced skin products
• Detergent left on clothes
• Dust and air pollution
• Wool or rough synthetic fabric
• Frequent handwashing
• Stress and poor sleep
• Scratching the same area
• Skin infection
• Certain workplace chemicals

Food is not the cause of every eczema case. Children should not be placed on a strict elimination diet without medical advice. Unnecessary food restriction may affect nutrition and growth.

There is no single blood test that confirms every case of eczema. Diagnosis mainly depends on the skin examination and the patient’s history. The skin may also be checked for fungal infection, scabies, contact dermatitis, psoriasis or bacterial infection. These conditions can sometimes look like eczema but need different treatment. During the consultation, the doctor may ask:

1. When the itching started
2. Which areas are affected
3. Whether symptoms come and go
4. What makes the rash worse
5. Which creams were used before
6. Whether sleep is disturbed
7. Whether asthma or allergy runs in the family
8. Whether anyone at home has a contagious skin problem

Allergy testing is not required for every patient. It may be considered when the history points to a specific allergy or when usual treatment does not control the symptoms.

Arrange a consultation when the rash keeps returning or does not improve with basic care. Urgent assessment is needed for fever, rapidly spreading redness, significant pain, widespread blisters, or a patient who appears unwell. Seek medical advice if:

• Itching affects sleep or school
• The rash covers a large area
• The face or eyelids are involved
• The skin becomes painful or infected
• A child scratches until the skin bleeds
• Previous creams no longer work
• The diagnosis is uncertain
• Eczema affects work or daily activities
• Strong steroid creams have been used for a long time

Prof Dr Md Siraj Uddin has more than 25 years of experience in dermatology, cosmetology, laser treatment and hair restoration. He has worked as a teacher, department head and practising dermatologist at several recognised medical institutions in Bangladesh.

His professional experience includes serving as Professor and Head of Dermatology at Sylhet Women’s Medical College from 2008 to 2016. He also worked as Associate Professor and Head of Dermatology, and earlier as Assistant Professor of Skin and VD, at Sylhet MAG Osmani Medical College. His qualifications and international training include:

• MBBS — Sylhet Medical College, 1982
• Diploma in Dermatology — Institute of Dermatology, Bangkok, 1996
• Diploma in Dermatology and Venereology (DDV) — BSMMU, Dhaka, 1998
• Fellowship in Dermatosurgery and Laser — Ramathibodi Laser Center, Bangkok, 2006
• Fellowship in Hair Restoration Surgery — Mount Sinai Hospital, New York, 2015–2016

Disclaimer: The information published on this website is provided solely for awareness and educational purposes. It is not intended as a substitute for professional medical advice. Always consult a qualified specialist or physician before making any medical decisions.