The made-for-Asia itch-relieving cream that’s spreading around world, and the Singapore doctor behind it

Most of us are likely to have experienced the nuisance of an itch: a tiny spot typically triggers an uncontrollable itch that continuously spreads for days as you scratch and scratch some more. It drives you crazy.

Dermatologist Dr Tey Hong-liang, a consultant at Singapore’s National Skin Centre and founder of its Itch Clinic, has had patients who have scratched themselves till their skin was scarred and infected, and resembled that of an elephant’s – rough, thickened and with nodules.

“At some point in our lives all of us will be bothered by itch to some degree; many patients are tormented by it,” Tey tells the Post during a recent visit to his Singapore clinic. “Some patients tell me they can tolerate pain but not itch. There are even patients who say they are contemplating suicide because the symptom is causing them so much pain. The sad thing is we didn’t have any treatment that was good for itch. There was a clear unmet need.”

So Tey decided to devise his own solution – a safe and effective itch-relieving cream that patients would enjoy using. The resulting product, launched in Singapore in April 2015 and now available in Hong Kong, has been so successful the value of its worldwide retail sales is set to reach S$2 million (HK$10.9 million) in its first two years on the market.

Called Suu Balm, the light, non-greasy and highly absorbable moisturising cream was designed for hot and humid Southeast Asian climates, but people in cooler climates such as that in Ireland have also found it a lifesaver for a condition known as winter itch. With cold temperatures, skin often becomes dry, flaky and itchy, and sensitive skin and allergies tend to be aggravated. As Hongkongers begin to bundle up for the season, many could soon begin to experience this winter itch.

Suu Balm is clinically proven to provide rapid itch relief – tests show that nine out of 10 people found relief within five minutes of applying the cream. Tey says the product is suitable for a variety of needs: soothing and repairing skin, especially for sufferers of eczema and psoriasis; preventing dry skin in low-humidity settings; reducing heat and redness after sports; reducing itch from insect bites, and preventing or reducing age-related dry sensitive skin.

There are many causes of itch, cold weather and dry skin being just one of them. Most common is a condition called atopic dermatitis or eczema, which affects about one in five people with inflamed and irritated skin. Itching can also be caused by certain allergens, irritants or environmental factors, such as cosmetics, foods and sunburn; parasites such as flies, mites and bugs; and infections such as chickenpox or thrush. Itching may also be a symptom of certain conditions such as hepatitis, kidney failure, iron deficiency anaemia and some types of cancer.

Tey says Suu Balm works for all causes of itch because the cream targets the “wiring” beneath the skin – the nerves that transmit the itch. “If you [target] the [wiring], it doesn’t matter what is causing the itch,” he says.

The main active ingredient in the cream is menthol, which acts by giving a perceived skin cooling effect (of up to four degrees Celsius), triggering receptors in the nerves of the skin and blocking the transmission of itch signals to the brain. In addition, menthol is a highly lipid soluble and helps move other beneficial ingredients from the surface to the internal layers of the skin without causing irritation.

Tey had experimented with different percentages of menthol, ranging from 1 per cent to 20 per cent, in the cream before settling on 3 per cent, which he says provides effectiveness without side effects such as contact dermatitis.

Another main active ingredient is ceramide, which is crucial in structuring and maintaining the water permeable barrier function of the skin. It supports skin renewal and forms a barrier against moisture loss, protecting and repairing dry, sensitive skin in the long run. Suu Balm contains one of the highest concentrations of ceramides to be found in a mass market moisturiser, Tey says.

The cream does not contain any steroids or parabens, sodium lauryl sulphate/sodium laureth sulphate, heavy metals or phthalates, ingredients that are potentially toxic or allergenic. It is therefore safe for children to use.

Because it does not treat the cause of itch, Tey says the cream is not the final solution for patients. “The cream is buying you time to do repairs in the skin so that the problem doesn’t keep recurring.”

For example, with eczema patients, Suu Balm would buy time for additional anti-inflammatory agents you apply to the affected areas that take a few days to work, Tey explains.

Apart from creams, other ways to prevent scratching is by avoiding spicy foods, alcohol and caffeine, as these can affect your skin’s blood flow, which will only worsen itching. Use a skin-friendly laundry detergent or fabric softener, as some products may have very strong formulations that irritate skin. Regularly wash your linens and make sure that your bed and other furniture are free from nasty bed bugs. Keep your nails short to avoid scratching your skin open. And practise good hygiene: shower regularly and opt for unscented soaps and lotions, which are less likely to irritate skin.

With the support of International Enterprise Singapore and Intellectual Property Intermediary Singapore, Suu Balm has been able to expand from a local innovation into a globally competitive product. It is available in Ireland, China, Thailand, Mongolia and the Philippines, with further expansion to Malaysia and Vietnam planned by the end of 2016, and to Australia, the United Arab Emirates and the UK in 2017.

In Hong Kong, Suu Balm can be bought online from Tmall.HK (http://bit.ly/2fzElPj). It is available in a portable 75ml tube (S$19.90) as well as a 350ml pump dispenser (S$49.90).