Dermatitis

Dermatitis is a general term that describes an inflammation of the skin. There are different types of dermatitis, including seborrheic dermatitis and atopic dermatitis (eczema). Although the disorder can have many causes and occur in many forms, it usually involves swollen, reddened and itchy skin.
Dermatitis is a common condition that usually isn't life-threatening or contagious. But, it can make you feel uncomfortable and self-conscious. A combination of self-care steps and medications can help you treat dermatitis.

Each type of dermatitis has distinct signs and symptoms. Common signs and symptoms include:

Redness
Swelling
Itching
Skin lesions

Types of dermatitis, include:

Contact dermatitis-> a rash that results from either repeated contact with irritants or contact with allergy-producing substances, such as poison ivy
Neurodermatitis-> a chronic itchy skin condition localized to certain areas of the skin
Seborrheic dermatitis-> a common scalp and facial condition that often causes dandruff
Stasis dermatitis-> a skin condition that's caused by a buildup of fluid under the skin of the legs
Atopic dermatitis-> more commonly known as just eczema or atopic eczema, a chronic itchy rash that tends to come and go
Perioral dermatitis-> a bumpy rash around the mouth

When to see a doctor
See your doctor if:
You're so uncomfortable that you're losing sleep or are distracted from your daily routines
Your skin becomes painful
You suspect your skin is infected
You've tried self-care steps without success

A number of health conditions, allergies, genetic factors, physical and mental stressors, and irritants can cause dermatitis.
Contact dermatitis
This condition results from direct contact with one of many irritants or allergens.

Common irritants include:

Laundry soap
Skin soaps or detergents
Cleaning products

Possible allergens include:

Rubber
Metals, such as nickel; jewelry
Perfume and fragrances
Cosmetics
Weeds, such as poison ivy
Neomycin and bacitracin, common ingredients in topical antibiotic creams

It takes a greater amount of contact with an irritant over a longer time to cause dermatitis than it takes for an allergen. Once you're sensitized to an allergen, just brief exposure to a small amount of it can cause dermatitis. Once you develop sensitivity to an allergen, you typically have it for life.

Neurodermatitis
Also known as lichen simplex chronicus, this type of dermatitis typically develops when something has created an itchy sensation in a specific area of your skin. This irritation may lead you to rub or scratch your skin repeatedly in that area. Common locations include the ankle, wrist, outer forearm or arm, and the back of your neck.

Possible underlying factors include:

Dry skin
Chronic irritation
Eczema

Seborrheic dermatitis
This condition causes a red rash with yellowish and somewhat "oily" scales, usually on the scalp and sometimes on the face, especially around the ears and nose. It's common in people with oily skin or hair, and it may come and go depending on the season of the year. It's likely that hereditary factors play a role in this condition.

Possible underlying factors include:

Physical stress
Neurological conditions, such as Parkinson's disease

In infants, this disorder is known as cradle cap.

Stasis dermatitis
Stasis dermatitis can occur when fluid accumulates in the tissues just beneath the skin — typically on your lower legs — due to a sluggish return of blood from the leg veins back to the heart. The extra fluid interferes with your blood's ability to nourish your skin and places extra pressure against your skin from underneath.

Possible underlying factors include:

Varicose veins
Obesity, often extreme
Other chronic conditions or recurrent infections that affect circulation in your legs, such as pregnancy or deep vein thrombosis

Atopic dermatitis
This condition often occurs with allergies and frequently runs in families in which members have asthma, hay fever or eczema. It usually begins in infancy and may vary in severity during childhood and adolescence. It tends to become less of a problem in adulthood, unless you're exposed to allergens or irritants in the workplace.

Possible underlying factors include a combination of:

Dry, irritable skin
A malfunction in the body's immune system
A genetic tendency for allergic conditions such as asthma, hay fever or eczema

Stress can exacerbate atopic dermatitis, but it doesn't cause it.

Perioral dermatitis
This type of dermatitis may be a form of the skin disorder rosacea, adult acne or seborrheic dermatitis, involving the skin around the mouth or nose.

Possible underlying factors include:

Makeup
Moisturizers
Topical corticosteroids


Complications

Infection. The open sores and fissures that can occur with dermatitis may become infected with bacteria, such as staphylococci, as well as viruses and fungi.
Cellulitis. If you notice red streaks on your skin, you may have cellulitis, a bacterial infection of tissues under the skin. Cellulitis appears as intensely inflamed skin that's swollen, red, tender and warm to the touch, with spreading, indistinct margins. Cellulitis that occurs in someone whose immune system is compromised is potentially life-threatening. See your doctor as soon as possible if you think you have cellulitis.

Scarring and changes in skin color are other potential complications from dermatitis.

Your doctor may diagnose dermatitis after talking to you about your signs and symptoms and examining your skin.

Patch testing
In the case of contact dermatitis, your doctor may conduct patch testing on your skin to see which substances inflame your skin. In this test, your doctor applies small amounts of various substances to your skin under an adhesive covering. During return visits over the next several days, your doctor examines your skin to see if you've had a reaction to any of the substances. This type of testing is most useful for determining if you have specific contact allergies.


Treatments and drugs

Dermatitis treatment varies, depending on the cause. Using corticosteroid creams, applying wet compresses and avoiding irritants are the cornerstones of most dermatitis treatment plans. To minimize side effects, such as thin skin, and to increase effectiveness, topical corticosteroids are generally used only short term until rashes are under control.

For some types of dermatitis, nonsteroidal medications may help relieve signs and symptoms. And for all types of dermatitis, occasional use of over-the-counter oral antihistamines can reduce itching.
Contact dermatitis
Treatment consists primarily of identifying the cause of the rash and then avoiding it.

Treatment options include:

Creams containing hydrocortisone
Other, stronger steroidal creams
Cool, wet compresses on the affected area

Neurodermatitis
Getting you to stop scratching and to avoid further aggravating your skin are the treatment objectives.

Treatment options include:

Covering the affected area to prevent you from scratching it
Hydrocortisone and similar lotions and creams
Wet compresses
In some cases, antidepressants or anti-anxiety medications

In addition, counseling can help you learn how your emotions and behaviors can fuel — or prevent — itching and scratching.

Seborrheic dermatitis
Medicated shampoos are usually the first treatment choice.

Treatment options include:

Warm mineral or olive oil to remove scales
Shampoos that contain tar, salicylic acid or ketoconazole as the active ingredient
Topical hydrocortisone creams and lotions

Stasis dermatitis
Treatment consists of correcting the condition that causes fluid to accumulate in your legs or ankles for extended periods.

Treatment options include:

Wearing elastic support hose
Having varicose vein surgery
Using wet dressings to soften the thickened yet fragile skin and to control infection

Atopic dermatitis
In addition to relieving redness and itching, treatments for this condition are aimed at healing infection-prone cracks in your skin.

Treatment options include:

Hydrocortisone-containing lotions
Wet dressings with mildly astringent properties
Immunosuppressant topical medications, such as tacrolimus (Protopic) and pimecrolimus (Elidel)

In addition, light therapy, which involves exposing your skin to controlled amounts of natural or artificial light, may be used to help prevent recurrences of atopic dermatitis.

Perioral dermatitis
In general, doctors try to avoid treating this condition with strong corticosteroids. When these potent medications are stopped, perioral dermatitis may return and even worsen.

Treatment options include:

The oral antibiotic tetracycline, sometimes taken for several months
A mild corticosteroid cream


Alternative medicine

A number of natural options have been studied as possible treatments for dermatitis. Although none are as potent as steroid medications, natural approaches generally aren't associated with the same risk of side effects.

You may wish to talk with your doctor about natural therapies for dermatitis, including:

Oral treatment

Probiotics. Some research has shown that certain strains of lactobacillus may improve the symptoms of atopic dermatitis in children younger than 13. Further studies are needed to establish its benefits for a broader age range.

Topical treatment

Rice bran. Topical application of rice bran broth seems to help reduce atopic dermatitis.
Bovine cartilage. Applying a cream that has 5 percent bovine cartilage seems to help contact dermatitis caused by poison ivy.
Vitamin B-12. Preliminary research showed that applying topical vitamin B-12 to treat atopic dermatitis was superior to a placebo, though in some cases, it aggravated the condition.


Prevention

Preventing contact dermatitis requires a twofold approach of avoiding the triggers that cause it — such as poison ivy or harsh soaps — as well as taking gentle care of your skin.

Common triggers
Try to identify and avoid triggers that worsen the inflammation, such as:

Rapid changes of temperature
Sweating
Stress
Direct contact with wool products, such as rugs, bedding and clothes
Harsh soaps and detergents

If you must handle products that irritate your skin, wear nonlatex gloves.

Skin care
Avoiding dry skin may be one factor in helping you prevent future bouts of dermatitis. These tips can help you minimize the drying effects of bathing on your skin:

Bathe less frequently. Most people who are prone to dermatitis don't need to bathe daily. Try going a day or two without a shower or bath. When you do bathe, limit yourself to 15 to 20 minutes, and use warm, rather than hot, water.
Use only mild soaps. Choose mild soaps, such as Cetaphil, Dove or Keri, which clean without excessively removing natural oils. Deodorant and antibacterial soaps may be more drying to your skin. Use soap only on your face, underarms, genital areas, hands and feet. Use clear water elsewhere.
Dry yourself carefully. Brush your skin rapidly with the palms of your hands, or gently pat your skin dry with a towel after bathing.
Moisturize your skin. Seal in moisture, while your skin is still damp, with an oil or cream. Pay special attention to your legs, arms, back and the sides of your body. If your skin is already dry, consider using a lubricating cream made for dry skin, such as Eucerin.