Dermatitis is a family of skin conditions that cause red, itchy, dry, cracked, scaly skin. It may also cause blisters that ooze or crust over. The condition has periods of worsening (flare-ups) and remissions.
To treat dermatitis, moisturize your skin 2 to 3 times a day with lotions and ointments. Wash your skin with mild soaps and gentle body washes. Avoid rough or scratchy clothing and irritants.
Symptoms
Dermatitis causes red, irritated and itchy skin that can blister, ooze or flake. It can occur anywhere on the body, but it’s more common in certain areas such as the hands and face. The three most common types of dermatitis are atopic (inherited) eczema, contact dermatitis and seborrheic dermatitis. Your doctor can tell you which type of dermatitis you have by taking a close look at your skin and asking you about your symptoms.
Atopic dermatitis — or eczema — is a long-term, chronic inflammatory skin condition that usually appears in early childhood and continues throughout life. It is itchy, dry and scaly, and the skin can crack, bleed and become infected with the bacteria Staphylococcus aureus (golden staph).
Contact dermatitis occurs when a substance touches the skin and triggers an allergic or irritant reaction. For example, it can be triggered by a plant such as poison ivy or oak, or it can be caused by detergents, jewelry, perfume or food. Allergic dermatitis is also more common in people with certain health conditions such as asthma.
Other rashes that can look like dermatitis include pimples in the case of rosacea, and red spots in the case of seborrheic dermatitis (often called dandruff in adults). If you have dark skin, it may be more difficult to notice changes to your complexion.
Diagnosis
Your doctor will take a close look at the affected skin, looking for classic signs of dermatitis like redness, dryness, itching and scaly patches. They will also ask about your symptoms and when they started. They will also want to know if anything seems to make them worse or better. This information can help pinpoint the cause of your dermatitis. For example, if your rash is caused by exposure to certain chemicals or allergens, it can be identified with patch testing, in which small amounts of different substances are placed on the skin for a few days to see if a reaction occurs.
Your dermatitis may be triggered by specific plants or metals, such as poison ivy and oak. Or it can be caused by everyday products, like soaps, detergents and jewelry, as well as foods and emotional stress. It can also be caused by underlying health problems, such as diabetes and rheumatoid arthritis.
Some types of dermatitis can be diagnosed by taking a sample of the affected skin and using special tests to look for bacteria or other particles under a microscope. This is called a skin biopsy and it can be performed in your doctor’s office. It is important to avoid scratching your rash because this can lead to infection and scarring. Also, scratching can cause your rash to spread and get bigger.
Treatment
There’s no cure for most types of dermatitis, but treatments can help manage symptoms. Moisturizing creams help hydrate and restore the skin barrier. Some topical medications, like calcineurin inhibitors or phosphatidieterase-4 inhibitors decrease inflammation. Other medications include corticosteroid creams and ointments, which decrease itching and swelling, and PUVA (psoralens UVA and ultraviolet B). Antihistamines may be used to suppress the itch of eczema. Other medications are available as injections or pills. These include pimecrolimus, tacrolimus, a retinoid called acitretin or ruxolitinib, which blocks functions of the immune system that affect dermatitis.
There are many different types of dermatitis, but the most common is atopic dermatitis, or eczema. People who have a history of hay fever or asthma are more likely to develop it, as well as those with certain health conditions, such as a problem with the immune system.
Other types of dermatitis include contact dermatitis, which causes a rash after direct exposure to something that irritates the skin, such as poison ivy or everyday items like soaps, lotions and jewelry. There’s also dyshidrotic eczema, which is characterized by blisters on the palms of hands and soles of feet, neurodermatitis, which causes itching on the head, forearms, wrists or lower legs, follicular dermatitis, which results in thickened bumps around hair follicles, and stasis dermatitis, which is caused by circulatory problems.
Prevention
The key to preventing dermatitis is to avoid contact with the substance that triggers it. If you can figure out what causes it (for example, the rash on your hands gets worse when you clean with certain chemicals or wear that wool sweater), you can stop it from getting worse. A rash caused by contact with allergens — such as poison ivy, perfume or nickel jewelry — will clear up when you stop coming into contact with the allergen. Having a family history of eczema, allergies or hay fever increases your chances of developing this skin problem. The condition can also be worsened by stress, poor diet and a genetic predisposition.
Keep the skin moist by applying ointments, creams or lotions 2 to 3 times a day. Use mild soaps or bathing products and a humidifier in your home. Try not to scratch the rash because it may become infected and the itch will only get worse. If your fingernails are long, trim them so you don’t injure yourself when scratching.
People with this condition should always wear cotton clothing and apply a cold compress to the affected area for relief from itching. They should also be aware that this is a lifelong disease and will flare up throughout their lives, usually when triggered by seasonal changes or irritants. Some people find that they outgrow atopic dermatitis; others have it for their entire lives, even into old age.