Eczema & Topical Steroid Withdrawal – How Does TCM Help?

Updated: Feb 4


For patients suffering from eczema, it can be a painful as well as traumatising condition that greatly affects the overall quality of life and self-esteem. We know personally because one of the founding members of our clinic suffered from eczema since young. He suffered from severe eczema with peeling skin especially at the joints, and skin on his face and back of ears used to come off with his specs whenever he took them off.


If you are a sufferer of eczema and/or topical steroid withdrawal (TSW), you are not alone. According to Straits Times Singapore, about one in ten adults suffer from eczema in Singapore, and for children, the percentage is higher at around 21%, half of eczema sufferers have it for half their lives. Here at Oriental Remedies Group, we aim to help you embark on your road to better manage your eczema and help you #BeTheBestYouCanBe.


What is eczema and how does it occur?

Eczema refers to a group of conditions that causes the skin to become inflamed and irritated. The most common kind of eczema is known as Atopic Dermatitis (AD). Common symptoms and characteristics of affected eczema skin are itchiness, rashes, very dry and flaky skin as well as appearing thickened or even scaly.


Eczema is conventionally believed to occur due to an imbalance in the body’s immune system, in particular, an overactive immune response to substances consumed or applied as well as conditions internally and externally. Triggers include weather, exposure to water, different kinds of foods and so on. What causes flares up in eczema patients varies from one another, so does the intensity of the outbreaks.


A more holistic understanding of eczema is emerging where more people understand the link between gut health and skin issues. Leaky gut may occur due to certain triggers or stressors, which culminates in a microbial imbalance of the gut and ultimately lead to an increase in intestinal permeability. There has been research that has shown a link between skin barrier dysfunction and a compromise of the intestinal permeability barrier in atopic dermatitis.


Other possible pathways that may trigger eczema are environmental toxins like dust, poor liver function, stress-causing adrenal glands imbalance and excessive cortisol production and systemic allergic responses which can begin from the skin i.e. putting creams with food-based ingredients may result in us having systemic allergic reactions to those foods. As eczema can be aggravated by allergens, you may wish to identify these factors and avoid common allergens in food such as chemical additives, dairy products and alcohol.


“There seem to be three major reasons why patients seek alternative medicine for atopic dermatitis: First, we simply don’t yet have a cure for this disease.


Second, we can’t yet clearly explain why this disease occurs. While doctors try hard to describe factors that play a role in atopic dermatitis, such as cytokines and inflammatory cells, we still can’t pinpoint the root of the disease.


Third, the outcomes of conventional atopic dermatitis treatments are not always consistent, and sometimes they are perceived as being unsafe.”

— Peter Lio, M.D



Why does eczema occur in TCM terms? 

Note: All words in Italics refer to the TCM definitions and organ-systems and not the typical definition of the words or anatomy.


In TCM terms, eczema is usually caused by deficiencies in the spleen, kidney and liver, coupled with pathogenic factors of wind, heat and dampness. As per the previous section, where we explained that the onset of eczema could be due to various factors, similarly in TCM, how eczema occurs in patients are vastly different.


Firstly, let’s explore what is the pathogenic factor – Wind. We may not be able to see wind, but like its moving characteristic, this pathogenic factor is often the reason why your eczema rashes are itchy, have sporadic occurrences and appear in different locations. Therefore using herbs with wind-clearing properties will be able to remove this pathogenic factor from our bodies. Wind is related to the liver, which is in turn linked to stress and emotional regulation. Hence, patients tend to observe flare-ups under stress or menstrual cycles. If you suffer from hay fever on top of your eczema or have allergic reactions to pollen, wind is likely a causation factor to your eczema as wind is a spring qi.


In TCM, wind does not travel alone and often brings along heat and/or dampness hand-in-hand. These 2 pathogenic factors could result from internal or external reasons. If you are often exposed to heat or humidity (like Singapore), it is difficult to prevent these pathogenic factors from entering your body. It is advisable to regulate your immunity and body constitution to reduce their impact.


According to TCM principles, the spleen is responsible for converting the food you eat into useful substances like qi and blood that nourishes our body. However, when the spleen is weakened by an imbalanced diet, excessive cold/cooling food or excessive worrying, nutrients are instead transformed into internal dampness, instead of qi and blood. Signs of internal dampness coupled with weakened spleen are presented as lethargy, heavy limbs, brain fog, food coma, sticky or loose stools. Eczema presentation are pus-filled blisters, swollen, often appear at creases of skin and takes a long time to heal.


Internal dampness will generate internal heat when it is accumulated in the body over a prolonged period. Patients who keep late nights, feast on fried/greasy foods tend to accumulate internal heat within the body. This internal heat is similar to chronic inflammation of the skin and presents with red/dusky rashes, cracked skin with flakes, burning sensation, blistering or with infected pus. Accompanied systemic symptoms include thirst, bad breath, constipation, yellow urine, sweat and scared of heat.


Do you know that the liver and kidneys are major organs in our body? Their functions are slightly different from the anatomical organs as TCM sees them with bigger functions.  Liver stores blood and kidney is the source of essence in our body. Many patients do not have good sleep quality or burn the midnight oil, and as we become more hectic and stressed, these unhealthy habits deplete our blood and essence, resulting in skin dryness, itch, skin darkening, changes in nail quality.


Not all eczema conditions have the same root cause so it is best to consult our physicians to get the diagnosis right

Article by Physician Leong Weizhen, with contribution from wellness blogger Eatprayflying.com, Beatrice Liu and Physiotherapist-to-be, Chloe Lee 


Place of Practice: Oriental Remedies Group

Founded since 2013, Oriental Remedies Group has attracted a dedicated team of bilingual (English and Mandarin) physicians with combined more than 50 years of Traditional Chinese Medicine (TCM) experience and certified therapists, with the common goal of providing the best patient care to our patients by combining the best of TCM treatments as well as modern integrative protocols.