Health · A pharmacist explains
Steroid Cream Works, Then Your Eczema Comes Back Worse? A Singapore Pharmacist Explains What's Happening In Your Gut
By Dr Connie
Pharmacist & Nutritionist · 8 years in practice
It's 3am, and You're Scratching Again
You were scratching before you even knew you were awake. Your palms. The backs of your knees. The inside of your elbows.
Then you see the blood under your nails and the flakes on your bedsheet. Some nights it goes on for 2 hours.
The day isn't much better. Every hand wash burns. Some days you can't even eat with your hands. You wear long sleeves in 32 degrees, and when someone asks about your arm, you say "Allergy lah" and change the topic.
Every day is bad. The only question is how bad.
And you've done everything right. The steroid cream. Moisturiser three times a day. No prawns, no peanuts. TCM, probiotics, maybe even an injection.
Every time, the steroid cream worked. Then you stopped, and your eczema came back. Sometimes worse.
There's a reason it keeps coming back. And it isn't on your skin.
You're Not Imagining It
If this sounds like you, you're far from the only one. Other Singaporeans with eczema put it like this:
✓In their own words
Cream on, skin calms. Cream off, eczema comes back. Round and round. Sian.
It's not your fault. And that loop is your biggest clue.
If steroid cream fixed the cause, your eczema would stay away after you stopped. It doesn't. So the cause must be somewhere the cream can't reach.
What You Already Believe (and the Half Nobody Told You)
"My skin is dry, so I need to moisturise."
You're right. Eczema skin has a weak barrier. But it never gets the chance to heal. The itch makes you scratch, the scratching tears it open, and steroid cream can thin your skin over time, so it tears even more easily.4
So your skin is broken again before it ever heals. Moisturiser patches it from the outside. But as long as the itch keeps coming from underneath, you'll keep scratching it open.
To let your skin heal, you have to calm the inflammation underneath.
"Some foods set my eczema off."
Right again. Seafood, peanuts, dairy, beef. Our form is full of them.
So you cut them out. But for many people, something else starts setting them off, and the list keeps growing.
That's the clue. Food never touches your arm. It goes to your gut. A day or two later, your skin flares. The problem isn't the prawns. It's how hard your body reacts once they reach your gut.
"Heat, sweat and stress make it worse."
True. And in Singapore, you can't escape them.
But look at the person next to you at lunch. Same aircon, same 32 degrees, same laksa.
Their skin stays calm. Yours flares.
Triggers are the same for everyone. How bad your flare gets depends on how hard your immune system reacts.
"There's no cure. I just have to manage it."
"Managing" means calming the same flare again and again.
Steroid cream calms the flare on your skin, fast. Then the next trigger comes, a hot day, a stressful week, a plate of laksa, and the flare starts again.
Steroid cream works on your skin.
It never reaches where your eczema starts.And each time, you need more: stronger steroid cream, more often, on thinner skin.
So where does your eczema start?
Where Eczema Starts: Your Gut
70%
Almost 70% of your immune system lives in your gut.1Your immune system is what turns your skin red, hot and itchy. So when your skin overreacts to everyday things, look at where most of it lives.
- 1
Your gut lining lets food in and keeps everything else out.
- 2
In some people with eczema, researchers found this lining lets through more than it should.2
- 3
The immune system next to it reacts, and can keep reacting. Then heat, sweat, stress or a plate of char kway teow is enough to make your skin flare.
That's why your eczema keeps coming back. Steroid cream calms your skin. It never reaches your gut, where eczema starts.
Speaking as a pharmacist, this is the part most people with eczema were never told. Steroid cream is the right medicine for your skin, and I'll never tell you to stop it on your own. But it was made to work on your skin. It was never meant to reach your gut.
Why it's worst at 3am
Your body makes its own natural steroid, called cortisol. It drops to its lowest around midnight and stays low into the early hours.3
So at 3am, your immune system is still reacting, and your natural steroid is at its lowest. That's when you wake up scratching.
Why it keeps spreading
Eczema is an immune reaction, and your immune system runs through your whole body. That's why it can show up in places it never used to be.
Why it can start later in life
Did yours only start in your 40s, 50s or 60s? On our form, it often began after a big change: giving birth, menopause, an illness, a new medicine, a new home. Changes like these can shift your gut and your immune system, and researchers are still studying how.
What You're Really Hoping For
We ask everyone: "What would make you say it worked?" Almost nobody wrote "perfect skin".
✓"What would make you say it worked?"
For your skin to stay calm on its own, you have to work on your gut. That takes 4 phases.
The 4 Phases, and What We Use for Them
At MakeHealth Easier, we give our eczema customers SpiroPlus. It's 2 small lemon-mint chewables before bed, and each part covers one phase.
Cutting food out only removes a trigger. The food you do eat still has to be broken down, so less of it reaches your gut lining half-digested.
✅ 17 digestive enzymes help break your food down.
A lighter tummy after meals. You may go to the toilet more in the first few weeks. That settles.
Your sinseh might call it "heaty" or "toxins". Here's the plain version. Some bits slip through your gut lining, and left alone, they build up.
✅ Chlorella, a green algae, supports your body's own clearance.
Most people don't notice this one on its own.
In some people with eczema, the gut lining lets more through than it should, so the immune system keeps reacting.
✅ Prebiotic fibre feeds the good bacteria you already have, and they use it to help maintain your gut lining.
The slowest phase. Flares usually come less often by month 2 to 3. That's why it's 90 days.
Steroid cream calms your skin, but the overreaction starts in your gut.
✅ Blue spirulina, standardised to 20% phycocyanin, helps calm an immune system that's working too hard.
Usually felt first. Less itch at night and better sleep, often in month 1.
| Digest | Detox | Repair | Calm | |
|---|---|---|---|---|
| Steroid cream | ✗ | ✗ | ✗ | Skin only |
| Moisturiser | ✗ | ✗ | ✗ | ✗ |
| Antihistamines | ✗ | ✗ | ✗ | Itch only |
| Cutting out food | ✗ | ✗ | ✗ | ✗ |
| Probiotics | ✗ | ✗ | Partly | ✗ |
| SpiroPlus | ✓ | ✓ | ✓ | ✓ |
None of the others covers more than part of one phase. SpiroPlus covers all 4.
Why not just take probiotics? A review of 13 studies found they "probably make little or no difference" to eczema.5 In many people, the new bacteria just pass straight through.6
- ✅ No steroids, so it can't thin your skin.
- ✅ No probiotics. It feeds the bacteria you already have.
- ✅ HSA-Notified and lab-tested by SGS. Ask us on WhatsApp for the report.
What It Looked Like for Them
So does it work for people like you? The first changes are often not on the skin. Many people notice their digestion or their sleep first.
Remember the first quote in this article? That was Roy. On his 3rd bottle, he wrote this:
An itch that came, and didn't turn into a flare.
Real customers, shared with permission. Results vary.
Self-reported. Results vary.
Speaking as a pharmacist: keep using your steroid cream the way your doctor told you. Add SpiroPlus at bedtime. If your skin settles, talk to your doctor before you use less.
And you don't do the 90 days alone. A skin consultant checks in with you on WhatsApp from day 3.
Before You Start
"I've already tried spirulina."
Regular spirulina is green. It takes about 100g of it to make just 5g of blue spirulina. And spirulina is only 1 of the 4 phases. SpiroPlus has all 4 in one chewable.
"2 chewables a night? For eczema I've had for years?"
It doesn't work like a cream, and nothing happens overnight. Your skin takes a month or more to renew, and longer as you get older. That's why it's 90 days, with your skin consultant checking in on day 3, 30, 75 and 90.
"Is it safe for me?"
Adults and kids aged 10 and up can take it. On other medicine, or have other health conditions? Check with your doctor first.
Sensitive stomach? That's why week 1 is just 1 chewable a night. Some people go to the toilet more when they step up to 2. Tell your skin consultant, and they'll adjust your plan.
"It's not cheap."
Moderate to severe eczema can cost S$198 to 403 a month in steroid creams and clinic visits. The 90-Day Reset works out to SGD 2.88 a daySGD 2.63 a day at the 11.11 price, with your skin consultant included. One person on our form was paying "hundreds of dollar per session" at a clinic, every 2 weeks, for 6 months.
Prefer PayNow or Atome? Message us on WhatsApp and we'll set it up.
How the 90 Days Work
- Week 11 chewable a night, before bed. Your skin consultant checks in on day 3.
- From week 22 chewables a night.
- Day 30 and day 75Your skin consultant checks in again. You compare your 90-Day Skin Tracker with week 1.
- Day 90A final check-in, and you look at your pattern together.
Keep using your steroid cream the way your doctor told you, the whole time.
Most people give up on TCM or supplements around month 2, when it feels like nothing is happening. That's exactly when your skin consultant checks in.
What Waiting Costs You
Waiting feels safe. It isn't. Every day you wait, nothing changes in your gut, and your eczema doesn't wait for you to decide.
On our form, people described the same ladder:
- Mild steroid cream
- Stronger steroid cream
- Steroid tablets
- Steroid injections
- Immune-suppressing tablets, or a jab every 2 weeks
That's how moderate eczema turns severe. Itch, pain and blood on your sheets, on repeat.
Every night you wait is another 3am.
Everything You Get With the 90-Day Reset
3 bottles of SpiroPlus (90 days), plus 4 free gifts worth SGD 238:
🎁 WhatsApp Skin Consultation for 90 days (worth SGD 133)Check-ins on day 3, 30, 75 and 90, and private WhatsApp any time.
🎁 Anti-Flare Diet Blueprint (worth SGD 48)What to order at the hawker centre, the kopitiam and the next festive makan.
🎁 90-Day Skin Tracker (worth SGD 32)See the changes week by week, for yourself.
🎁 Free Shipping (worth SGD 25)Processed in 24h, delivered in 2 to 3 working days.
Worth SGD 523. You pay SGD 259, and you save SGD 264 (50%). That's SGD 2.88 a day.Worth SGD 523. 11.11 price: SGD 237. You save SGD 286 (54%). That's SGD 2.63 a day.
The whole routine is 2 chewables at bedtime, alongside your steroid cream.
Want the lab report first, or to pay by PayNow or Atome? Ask us on WhatsApp.
Start tonight, and your skin consultant checks in on day 3.The 11.11 price ends 16 Nov, 11:59pm. After that, it goes back to SGD 259.
Start my 90-Day Reset →You Have Two Choices Now
Choice 1: You close this page.
Tonight, it's the steroid cream again. At 3am, you're awake, scratching, with blood under your nails.
Next month, you stop the steroid cream, and your eczema comes back a little wider and a little angrier.
And if you're honest, you can already feel it starting. The patch that's bigger than it was last year. The steroid cream that used to work in 2 days and now takes a week. The new itchy spot that was never there before.
That's how it started for many people on our form: "From just leg to hand, to body, till my face and neck"
A year from now, it's on your face, where no long sleeves can hide it. Your skin is thin and shiny from years of steroid cream, and it tears when you scratch. Your doctor stops talking about creams and starts talking about tablets, injections and a jab every 2 weeks.
And the nights don't change. Itch. Scratch. Pain. Blood on your sheets. Night after night.
That's the road moderate eczema takes when nothing changes in your gut.
Choice 2: You start the 90 days.
The night your bottles arrive, you take 1 chewable before bed, and you keep your steroid cream.
On day 3, your skin consultant checks in. Every week, you see on your tracker what's changing.
A few weeks in, many people notice it first at night. They sleep through without waking up to scratch.
Or WhatsApp a skin consultant first →
Dr Connie
Pharmacist & Nutritionist
P.S. Now you know why steroid cream never kept your eczema away. It never reaches your gut, where eczema starts. Start my 90-Day Reset →
- Vighi G et al. Allergy and the gastrointestinal system. Clin Exp Immunol. 2008;153 Suppl 1:3-6.
- Pike MG et al. Increased intestinal permeability in atopic eczema. J Invest Dermatol. 1986;86(2):101-4. A small study of 26 children. The gut-skin link is still a young area of research, and much of it comes from lab and small studies.
- Patel T et al. Nocturnal itch: why do we itch at night? Acta Derm Venereol. 2007;87(4):295-8.
- Hengge UR et al. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006;54(1):1-15.
- Makrgeorgou A et al. Probiotics for treating eczema. Cochrane Database Syst Rev. 2018;11:CD006135.
- Zmora N et al. Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell. 2018;174(6):1388-1405.e21.
THIS IS AN ADVERTISEMENT AND NOT A NEWS ARTICLE. Dr Connie works with MakeHealth Easier, which sells SpiroPlus in Singapore.
SpiroPlus is a health supplement, not a medicine. It is not intended to diagnose, treat, cure or prevent any disease. Keep following your doctor's advice, and don't stop any prescribed treatment on your own. Customer quotes are self-reported, and results vary. Privacy Policy