We Asked 30 Singaporeans If Eczema Felt Like a Second Job. 27 Said Yes.

Earlier this year I asked our eczema community a simple question. “Does managing your skin feel like a second full-time job?”

Thirty of you answered the full survey. Twenty-seven said yes. Only three said no.

I have lived with eczema for more than twenty years, and I went through topical steroid withdrawal about a decade ago, so I expected most people to answer “yes it feels like a second full-time job”.

What I did not expect was how clearly your answers would describe what that job does to a person. Anyone who has ever held down too many responsibilities at once knows the feeling. It is rarely one task that wears you out. It is all of them, stacked on top of each other, every day, with no end date you can point to. That is what came through in your answers. Not a single hard thing, but the exhaustion of carrying everything at the same time.

About the survey

This was not a clinical study. It was thirty people from our own skinshare.sg community, answering an anonymous form. That is a small, self-selected group, and it hardly speaks for every adult with eczema in Singapore.

But it is an honest look at how we deal with eczema in our lives. These are real people at the end of a long day, telling me things they do not usually say out loud. Where their experience lines up with the published research, I have linked the research so you can check it yourself. Where it points to something the research has not measured yet, I will say that too, because those gaps are part of the story.

Here is what this “second job” costs you.

The years you lose looking for answers

The first thing this job demands is that you become your own clinician.

Of the thirty people who answered, twenty-three had seen three or more doctors or specialists about their skin. Fourteen had seen five or more. That is a lot of waiting rooms for a condition that strangers assume you can fix with one tube of cream.

And seeing the doctors was only the start. You ran your own experiments on yourselves. Sixteen of you changed your environment, your home, your climate, your bedding. Fifteen of you put yourselves through elimination diets. Others did blood tests, patch tests, prick tests, skin scrapes. You were not passive patients. You were doing the work of a whole research team, on your own body, year after year, because the answers were not handed to you.

One respondent put the cost of that below:

“It gets difficult when the people you’re close with assume it’s a ‘you never clean enough’ problem, when in fact I’m very particular about hygiene, and the constant hand washes were what worsened my hand eczema. Only after many years did I finally reach a level of self-advocacy. I knew I had to listen to my own body instead of the next random recommendation.”

NF

Years. That is the part that does not show up anywhere official. There is no Singapore figure for how many doctors an adult sees, or how many years pass, before they find something that holds. Nobody has measured it. Your thirty answers are probably some of the only local data that exists on it.

The routine that never lets up

Then there is the work that happens every single day, whether you feel like it or not.

The cleansing that cannot sting. The moisturiser applied in the right order, often several times. The wraps and the plasters. One of you described it plainly: “putting on plasters and bandages every day, and also food phobia, being very careful of what I eat.”

The research backs up how much time this takes up. A Danish registry study estimated that managing atopic dermatitis takes two to three hours of treatment a day depending on severity. Two to three hours. That is a part-time job on its own, before you have done anything else with your day.

This is the layer where the right products actually save you time and damage (I curate many of these in my shop). A gentle, non-stinging wash instead of soap. Pure emu oil for barrier repair, because its lipids sit close to what skin already recognises. A thick ointment for the cracked patches before they get infected. Done consistently, it is the difference between a routine you can keep up and one that defeats you by mid-week.

The sleep you stop expecting

Eczema does not clock off when you do. It gets louder.

Most of you lose sleep during a flare. Ten of you lose around two hours a night, nine of you lose around four, and a few lose far more. The itch peaks at night, you scratch in your sleep without knowing, and you wake up worse than you went to bed.

That is not a small thing medically. Whole-family sleep disruption is one of the most documented burdens of eczema, and the American Academy of Pediatrics notes that a majority of children with atopic dermatitis have disturbed sleep, with knock-on effects on mood and concentration the next day. Adults are no different. You cannot carry any of the rest of it well on four hours of broken sleep.

The single most useful thing I point people to for the nights is scratch prevention, because you cannot consciously stop something you do while unconscious. Bamboo eczema gloves lock in your moisturiser and put a soft barrier between your nails and your skin, so the nervous system finally gets a chance to settle. For arms and legs there are soft sleeves that do the same job. It will not cure the itch, but it can break the part of the cycle that does the most damage while you sleep.

The hidden bills

Every job has a budget. This one comes out of your own pocket.

Twenty of you spend more than $500 a year managing your skin. Six of you spend up to $5,000. The cost is high, and I have written before about the rising cost of the newest eczema treatments in Singapore, and how a biologic can run to S$1,800 a month with no subsidy.

But that is just what you can count, the creams and the consults and the medicines. It does not count the cost of the unpaid hours, or the work you could not do.

When researchers have tried to put a real price on eczema, that unpaid labour turns out to be most of the bill. A Singapore cost-of-illness study found that informal caregiving, the time families spend on care, made up close to half of the total cost of managing childhood eczema, more than the direct medical bills. In other words, the most expensive part of this condition is the part nobody invoices for.

The mental burden

Fourteen of you feel anxious about a future flare frequently, or every single day, even when your skin is currently clear. Half of you rated the effect on your daily mental wellbeing at eight out of ten or higher. Sixteen of you have felt judged or pitied by strangers. Twenty of you have skipped a social event, a meeting, or a date because you were embarrassed by your skin.

“The longer we have [eczema], the more resilience we build and the less emotionally sensitive we become. That doesn’t make it any less of a burden. It takes up so much mental and emotional bandwidth in the background, just to get to everyone else’s normal that they take for granted. Energy that could be better used elsewhere.”

That is the truest description of the hidden burden I have read, and it came from your responses, not from a journal.

The research is just as stark. A large international review found that adults with eczema are roughly twice as likely to experience anxiety or depression, and significantly more likely to report suicidal thoughts, than people without it. This is not weakness. It is what years of poor sleep, visible difference, and being told to “just stop scratching” more does to a person.

Living with eczema is literally hell on earth. I wouldn’t wish it on my worst enemy.

Darren

If your skin is pulling your mood down to a dark place, that is a real and recognised part of this condition, and it is worth talking to your GP or a mental health professional about, the same way you would talk to a doctor about the rash. If you are in distress and need to talk to someone now, the Samaritans of Singapore (SOS) are reachable at 1-767, any time of day. Reaching out is not separate from treating your eczema. It is part of it.

The toll of caregiving

For some of you, it is not even your own skin you are carrying. You are doing all of this for someone else too.

“Managing my own eczema is painful enough. Imagine I also have to manage my children’s. The itch keeps all of us awake at night, and they are constantly tired in the day, unable to focus on their studies. It is mentally and physically exhausting.”

I hear this from parents in our community constantly, usually mothers, usually exhausted. The research confirms it is not in their heads: a long-term study found that caring for a child with severe eczema measurably raises a mother’s risk of depression. When you are doing all of this for your own skin and your child’s at the same time, on no sleep, the load does not add up. It multiplies.

The role you cannot leave

You do not get a salary. You cannot take leave from it. And there is no resignation letter, because you cannot hand your skin back.

Only fellow sufferers will understand what we go through. I got mine in my fifties and before that didn’t even know what it was. Doctors only know how to treat symptoms. They call it an autoimmune disease but it’s still a mystery to them. So we get the blame.

That is the hidden burden. Not the rash itself, which is the smallest and most visible part, but everything stacked behind it. The waiting rooms, the experiments, the nightly routine, the lost sleep, the money, the constant low hum of worry, and for some of you, the second and third sets of skin you are caring for that are not your own.

This is the reason why I started skinshare.sg years ago. Why I do what I do, and the reason our shop exists, is that a steady, gentle, consistent routine genuinely lightens the daily upkeep and the nights for a lot of people, especially when you start early and keep it up. It will not shrink eczema down to a part-time job overnight. But it can give you back an hour, a night’s sleep, a flare you did not have. Those add up.

If you took the survey, thank you. Your honesty is what made this piece possible. If you have not yet, the Hidden Burden of Adult Eczema survey is still open. The more of us who answer, the harder it becomes for anyone to dismiss this as a minor cosmetic complaint. It is not. It is a job. And it deserves to be counted.