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updated December 08, 2011


Filed under: Beauty & Plastic Surgery
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.

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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

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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.

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

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  • 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.

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If you have signs and symptoms of dermatitis, make an appointment with your doctor. He or she may 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

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. Also list any irritants or triggers that seem to cause your symptoms.
  • Write down your key medical information, including other conditions for which you've been treated and any prescription or over-the-counter medications you're taking, including vitamins and supplements. Also note whether you or anyone in your family has a history of allergies or asthma.
  • List possible sources of skin irritation, such as dust and chemicals used on your job or as part of hobby work. Also note the types of soaps, shampoos, cosmetics and detergents you use.
  • Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask your doctor about dermatitis. If any additional questions occur to you during your visit, don't hesitate to ask.

  • What is the most likely cause of my signs and symptoms?
  • Are there any other possible causes?
  • What tests are needed to make a diagnosis?
  • What treatment options are available for this condition?
  • What are the most common triggers for my type of dermatitis?
  • What self-care steps are likely to improve my symptoms?
  • What products or ingredients should I avoid?
  • Do you have any written materials about this condition that I can bring home? Can you recommend any websites?

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:

  • When did you first develop these signs and symptoms?
  • Does anything in particular seem to trigger your symptoms?
  • 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?
  • What treatments have you tried so far? Have any treatments helped?
  • Have you been diagnosed with any other medical conditions, including skin conditions?
  • What medications are you currently taking, including those you take by mouth as well as creams or ointments that you apply to your skin (topical treatments)?
  • Do you have a family history of allergies or asthma?

What you can do in the meantime
In the time leading up to your appointment, try these tips to help manage your dermatitis.

  • Resist the urge to scratch itchy areas on your skin. Breaking the itch-scratch cycle is a key part of healing dermatitis.
  • Try a nonprescription topical cream that contains at least 1 percent hydrocortisone. It may provide some relief.
  • Consider taking a nonprescription oral antihistamine, such as diphenhydramine (Benadryl, others) to reduce itching. Antihistamines can cause significant drowsiness, so be sure to read the label and use a nondrowsy formula during the day.
  • Avoid products that seem to trigger your rash and protect yourself from contact with them. Wearing nonlatex gloves while washing dishes, shampooing your hair or handling other products that irritate your skin may help. In addition, try to shower or bathe only once every day or two, using warm water and mild soaps.

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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.

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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

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

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These steps can help you manage dermatitis:

  • Apply an anti-itch cream or calamine lotion to the affected area. A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve itching. A nonprescription oral antihistamine, 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 (Aveeno, others).
  • Avoid scratching whenever possible. Cover the itchy area with a dressing, if you can't keep from scratching it. Trim nails and wear gloves at night.
  • Wear smooth-textured cotton clothing. This will help you avoid irritating the affected area.
  • Use a mild, unscented laundry detergent when washing clothes, towels and bedding. Avoid using fabric softeners.

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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.

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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.

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