Dermatitis is a general term that describes an inflammation of the skin. Although dermatitis can have many causes and occurs in many forms, this disorder usually involves an itchy rash on swollen, reddened skin.
Skin affected by dermatitis may blister, ooze, develop a crust or flake off. Examples of dermatitis include atopic dermatitis (eczema), dandruff, and rashes caused by contact with poison ivy or certain metals.
Dermatitis is a common condition that usually isn't life-threatening or contagious. Even so, 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 may look a little different and may tend to occur on different parts of your body. The most common types of dermatitis include:
- Atopic dermatitis (eczema). Usually beginning in infancy, this red, itchy rash most commonly occurs where the skin flexes — inside the elbows, behind the knees and the front of the neck. When scratched, the rash can leak fluid and crust over.
- Contact dermatitis. This rash occurs on areas of the body that have come into contact with substances that either irritate the skin or cause an allergic reaction, such as poison ivy. The rash may burn, sting or itch. Blisters may develop.
- 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 a common cause of dandruff. In infants, this disorder is known as cradle cap.
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 and irritants can cause different types of dermatitis:
- Atopic dermatitis (eczema). This condition often occurs with allergies and frequently occurs in families in which members have asthma, hay fever or eczema.
- Contact dermatitis. This condition results from direct contact with one of many irritants or allergens — such as poison ivy; jewelry containing nickel; and certain cleaning products, perfumes and cosmetics.
- Seborrheic dermatitis. This condition is common in people with oily skin or hair, and it may come and go depending on the season. It's likely that hereditary factors play a role in this condition.
A number of factors can increase your risk of developing certain types of dermatitis. Examples include:
- Age. Dermatitis can occur at any age, but atopic dermatitis (eczema) usually begins in infancy.
- Allergies and asthma. People who have a personal or family history of hay fever or asthma are more likely to develop atopic dermatitis.
- Occupation. Jobs that put you in contact with certain metals, solvents or cleaning supplies increase your risk of contact dermatitis.
Scratching the itchy rash associated with dermatitis can cause open sores, which may become infected. These skin infections can spread and may, very rarely, become life-threatening.
Preparing for your appointment
You'll probably first bring your concerns to the attention of your family doctor. He or she might refer you to a doctor who specializes in the diagnosis and treatment of skin conditions (dermatologist).
Here's some information to help you get ready for your appointment, and know what to expect from your doctor.
What you can do
Before your appointment, you might want to write a list of answers to the following questions:
- What are your symptoms and when did they start?
- Does anything seem to trigger your symptoms?
- What medications are you currently taking, including those you take by mouth as well as creams or ointments that you apply to your skin?
- Do you have a family history of allergies or asthma?
- What treatments have you tried so far? Have any treatments helped?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:
- Do your symptoms come and go, or are they fairly constant?
- How often do you shower or bathe?
- What products do you use on your skin, including soaps, lotions and cosmetics?
- What household cleaning products do you use?
- Are you exposed to any possible irritants from your job or hobbies?
- How much do your symptoms affect your quality of life, including your ability to sleep?
Tests and diagnosis
Your doctor may diagnose dermatitis after talking to you about your signs and symptoms and examining your skin.
In the case of contact dermatitis, your doctor might 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. Light therapy, which involves exposing your skin to controlled amounts of natural or artificial light, also may be used in some cases.
Lifestyle and home remedies
These steps can help you manage dermatitis:
- Use nonprescription anti-itch products. Over-the-counter hydrocortisone cream or calamine lotion can temporarily relieve itching. Oral antihistamines, such as diphenhydramine (Benadryl, others), may be helpful if itching is severe.
- Apply cool, wet compresses. Covering the affected area with bandages and dressings can help protect your skin and prevent scratching.
- Take a comfortably cool bath. Sprinkle your bath water with baking soda, uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that's made for the bathtub.
- Avoid scratching. Cover the itchy area with a dressing, if you can't keep from scratching it. Trim nails and wear gloves at night.
- Wear cotton clothing. Smooth-textured cotton clothing can help you avoid irritating the affected area.
- Choose mild laundry detergent. Because your clothes, sheets and towels touch your skin, choose mild laundry products that are unscented. Avoid fabric softeners.
A number of natural options have been studied as possible treatments for dermatitis, including:
- 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.
- 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.
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 that 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.
- Dry yourself carefully. Whisk water off your skin with the palms of your hands. Gently pat your skin dry with a towel after bathing.
- Moisturize your skin. While your skin is still damp, seal in moisture with an oil or cream. Pay special attention to your legs, arms, back and the sides of your body.