Dermatitis

Overview

What is dermatitis and what does it look like?

“Dermatitis” is a word used to describe a number of skin irritations and rashes caused by genetics, an overactive immune system, infections, allergies, irritating substances and more. Common symptoms include dry skin, redness and itchiness.

In the word “dermatitis,” “derm” means “skin” and “itis” means “inflammation.” The word as a whole means “inflammation of the skin.” The rashes range from mild to severe and can cause a variety of problems, depending on their cause.

Dermatitis causes no serious harm to your body. It is not contagious, and it does not mean that your skin is unclean or infected. There are treatment methods and medications that can manage your symptoms.

What are the types of dermatitis?

The types of dermatitis include, but are not limited to:

See the “Causes and Symptoms” section for more details about the types of dermatitis.

Who gets dermatitis?

Anyone – young and old – can get dermatitis. Some examples include:

  • Your baby can get cradle cap and diaper rash.
  • Atopic dermatitis (eczema) usually begins in childhood, but anyone at any age can get it.
  • Anyone can get contact dermatitis as it just involves skin to substance contact.
  • Individuals with celiac disease are prone to dermatitis herpetiformis.

There are several factors that put you at risk of getting dermatitis. Some examples include:

Atopic dermatitis risk factors include:

  • A family history of dermatitis, hay fever or asthma.
  • Being female.
  • Being African-American.

Contact dermatitis risk factors include:

  • If you work around chemicals such as in a factory, restaurant or garden.

Periorificial dermatitis risk factors include:

  • Being female.
  • Being ages 15 to 45.

Dyshidrotic dermatitis risk factors include:

  • If you sweat a lot.
  • Prolonged exposed to water and/or irritants.
  • If you live in a warmer climate.

What’s the first sign of dermatitis?

Itchiness and redness are commonly the first signs of dermatitis.

Where does dermatitis form on the body?

The location of your dermatitis depends on the type. For example, atopic dermatitis can appear anywhere on your skin. But, in teens and adults, it’s typically on the hands, inner elbows, neck, knees, ankles, feet and around the eyes. Seborrheic dermatitis and cradle cap are typically on your scalp, face and ears. Periorificial dermatitis is found around your eyes, mouth, nostrils and sometimes the genitals.

How common is dermatitis?

Some types of dermatitis are very common while others are less common. Atopic dermatitis affects two percent to three percent of adults and 25% of children. Contact dermatitis happens at some point to 15% to 20% of people.

Is dermatitis contagious?

No type of dermatitis is contagious.

What’s the difference between dermatitis and psoriasis?

Psoriasis and dermatitis – especially seborrheic dermatitis – can look similar. Both look like patches of red skin with flakes of skin on top of and around the redness. However, in psoriasis, the scales are often thicker and the edges of those scales are well-defined.

Seborrheic dermatitis and psoriasis do overlap in a condition called “sebopsoriasis.” That is when you have the symptoms of both.

Discuss your questions with your healthcare provider regarding which type of skin condition you have. You can have more than one skin condition at a time. Treatments for one may not work for the other.

What’s the difference between dermatitis and eczema?

Eczema is actually a type of dermatitis. It is also known as atopic dermatitis.

What’s the difference between dermatitis and rosacea?

Rosacea can cause red skin that looks like dermatitis. However, rosacea can also cause pimples, and the redness is typically found on your forehead, nose, chin and cheeks. Have your healthcare provider take a look at your skin to determine if your condition is dermatitis, rosacea, or something else.

Does dermatitis hurt?

Dermatitis can cause pain for some people. The symptoms can be different depending on the type of dermatitis.

Does dermatitis burn?

Some people feel a burning sensation. Others feel itchiness or both itchiness and a burning feeling. The sensations vary from person to person, and from type to type.

Symptoms and Causes

What causes dermatitis?

Dermatitis is caused by a combination of immune system activation, genetics and environmental triggers.

  • Immune system. Sometimes your immune system overreacts. If you have atopic dermatitis, your immune system reacts to seemingly small irritants or allergens. This causes inflammation.
  • Genetics. Researchers have observed that if others in your family have dermatitis, you’re more likely to have it. Additionally, experts have identified changes to genes that control a protein that helps your body maintain healthy skin. Your skin cannot remain healthy without normal levels of that protein.
  • Environment. Your environment may make your immune system change the protective barrier of your skin. That causes more moisture to escape, and that can lead to dermatitis. Possible environmental factors include exposure to tobacco smoke and some types of air pollutants. Fragrances in some skin products and soap are also possible.
  • Exposure. Some types of dermatitis are caused by exposure to chemicals and other irritants. Perioral dermatitis, for example, may be caused by exposure to fluoride in water or toothpaste.

If you have dermatitis, you might also have another condition that doesn’t cause it, but is often found alongside it:

  • Sleep loss.
  • Depression.
  • Anxiety.
  • Asthma.
  • Allergies.

What are the signs and symptoms of dermatitis?

The symptoms depend on the type of dermatitis. You may have one type, or you may have several. Each type may have one or more of the following symptoms:

  • Itching.
  • Red rashes and bumps.
  • Rashes that look and/or feel like a burn.
  • Dry skin.
  • Fluid-filled blisters.
  • Thickening, hardening and swelling skin.
  • Crusting, scaling and creasing skin.
  • Painful ulcers.
  • When scratched, the rashes may ooze fluid or bleed.

Here are examples of signs and symptoms of common types of dermatitis:

  • Atopic dermatitis (eczema). Atopic dermatitis happens when there is damage to the skin barrier. This causes the skin to become inflamed, red, dry, bumpy and itchy.
  • Contact dermatitis. Contact dermatitis is an allergic or irritant reaction that causes a painful or itchy skin rash. As the name suggests, you get contact dermatitis from coming into contact with an allergen. Examples include an allergen like poison ivy and an irritant like a chemical.
  • Cradle cap (infant seborrheic dermatitis). Cradle cap is a harmless skin condition on the scalp of a baby that appears as yellow scaly patches surrounded by a red rash.
  • Diaper dermatitis (rash). As the name suggests, diaper dermatitis is when a rash appears on any part of a baby’s skin covered by a diaper. The skin gets broken down by wetness, movement and waste products.
  • Dyshidrotic dermatitis. This type of dermatitis causes itchy blisters on the edges of your fingers, palms, toes and the soles of your feet. The blisters can be painful.
  • Neurodermatitis. This type of dermatitis is caused by intense itching that irritates the nerve endings of the skin.
  • Nummular dermatitis. If you have circular, itchy spots on your skin, you might have nummular dermatitis. Your skin gets dry and itchy and you may get open sores.
  • Periorificial dermatitis: Periorificial dermatitis looks like acne or rosacea. It develops around your mouth, eyes and nose.
  • Seborrheic dermatitis (dandruff). Seborrheic dermatitis (called dandruff when it’s on your head) appears as red, dry, flaky, itchy skin on your scalp and other parts of your body.
  • Stasis dermatitis. Dermatitis of this type is caused by a problem with blood flow in your veins. Your ankles may swell and there may be scaling, itching, pain and open sores.

Does stress cause dermatitis?

Yes. Stress can cause and/or aggravate some skin conditions including dermatitis. There are mental/emotional signs of stress and physical signs of stress. They include:

Mental/emotional signs:

  • Constant worry, anxiety, feeling overwhelmed.
  • Difficulty concentrating.
  • Irritability, mood swings, or a short temper.
  • Depression.
  • Low self-esteem.
  • Difficulty relaxing, or using alcohol, tobacco, or illegal drugs to relax.

Physical signs:

  • Muscle tension and aches and pains.
  • Diarrhea and constipation.
  • Sleeping more, or less.
  • Loss of sex drive.
  • Feeling nauseated or dizzy.

Try these tips to reduce your stress:

  • Take deep breaths. Count to ten.
  • Don’t aim for perfection. Accept that you can’t control everything.
  • Exercise every day.
  • Get plenty of sleep.
  • Limit caffeine and alcohol.
  • Eat healthy meals.
  • Laugh a lot and try to have a positive attitude.
  • Journal.
  • Talk to friends and family, and to a therapist.

What worsens dermatitis? What triggers it?

Try your best to figure out what triggers your dermatitis. It’s important to remember that it can affect people differently.

Is your dermatitis triggered by a chemical you clean with? Do you get it every time you go to your uncle’s house, because he’s a smoker? Does your scalp feel itchy since you started that new shampoo? Did that rash on the inside of your wrist appear after you tried that new perfume? Does excessive sunlight make your dermatitis better or worse? Do you feel itchy every time you wear that wool sweater?

Remember what else worsens dermatitis: stress, hot showers, allergens like pollen and pet dander, etc. Find out what worsens your dermatitis and do your best to avoid it.

Diagnosis and Tests

How is dermatitis diagnosed?

Your healthcare provider will take a close look at your skin. They will look for classic signs of dermatitis such as a rash, redness, scales, dryness and more. They will ask about the symptoms you’re experiencing. Are you itchy? Does your skin feel like it’s burning? Is your skin dry? Have you come into contact with anything that might irritate your skin?

What other questions might my healthcare provider ask to diagnose dermatitis?

The conversation with your healthcare provider will need to cover a lot of information. Be sure to be specific about your symptoms.

  • Where is your dermatitis located?
  • What have you used to try to treat your dermatitis?
  • What medical conditions do you have? Allergies? Asthma? Celiac disease?
  • How long have you had symptoms of dermatitis?
  • Do you take hot showers?
  • Is there anything that makes your symptoms worse?
  • Are you around chemicals?
  • Have you noticed that something triggers or worsens your dermatitis? Soaps? Detergents? Cigarette smoke?
  • Is there so much pain or itchiness that you have trouble sleeping? Working? Just living your normal life?

What tests are done to diagnose dermatitis?

Usually your healthcare provider will be able to diagnose dermatitis based on examining your skin. However, when there is doubt, they may perform the following tests:

  • Blood tests to check for causes of the rash that might be unrelated to dermatitis.
  • A skin biopsy to distinguish one type of dermatitis from another.
  • An allergy skin test.

Management and Treatment

How is dermatitis treated? What medications are used?

The type of treatment depends on the type of dermatitis and its location. Step number one is to avoid whatever triggers the dermatitis. That may be stress, a chemical, tobacco smoke and/or a number of other irritants that cause or worsen your dermatitis. Step number two is to try remedies on your own. Step number three is medication prescribed by your healthcare provider.

What are the at-home remedies I can try?

There some treatments you can do at home, but you should only do them with instructions and permission from your healthcare provider:

  • Ultraviolet light. Ultraviolet A or B light waves can help your skin.
  • Wet wrap therapy. This therapy increases moisture in your skin.
  • Bleach baths. The amount of bleach is diluted. You shouldn’t do this more than twice a week. Check with your healthcare provider before you try this therapy.

There are some other treatments you can do at home with no supervision:

  • Use moisturizer. Right after you shower or bathe, apply moisturizer to your skin. This helps keep your skin hydrated.
  • Don’t overheat. Keep your space at a cool temperature and avoid high humidity.
  • Protect your skin. Stay away from anything that could irritate it. This includes rough clothing like wool.
  • Decrease your stress. Take steps to keep your stress levels down. If you need to, see a therapist for counseling and a psychiatrist for medication.
  • Bathe in lukewarm water. Be sure to use lukewarm water instead of hot. Take no more than one bath or shower per day.
  • Use a mild soap. Use soap or cleanser that is unscented.
  • Avoid scratching. Scratching at your dermatitis irritates it. You could break the skin, risking infection.

Your healthcare provider may prescribe one or more of the following medications:

  • Moisturizing creams. Creams that hydrate and help restore the skin barrier.
  • Calcineurin inhibitors. These topical medications decrease inflammation.
  • Corticosteroid creams and ointments. Corticosteroids decrease inflammation.
  • Phosphodieterase-4 inhibitors. This also helps with inflammation.
  • Biologics. This injection blocks functions of the immune system that affect dermatitis.
  • Oral medications. Pills that reduce immune responses that affect dermatitis.
  • Antihistamines. These are used, sometimes, for contact dermatitis.
  • Antibiotics: These can be used for people who have perioral dermatitis.

Is there a cure for dermatitis?

No treatment can claim to eliminate the symptoms of dermatitis 100% of the time. Treatments manage symptoms with varying degrees of success. Talk to your healthcare provider about the best treatments for you.

Should I see a dermatologist?

Yes, if your usual healthcare provider is unable to help with your dermatitis. Dermatologists specialize in skin conditions.

How long does it take to recover?

The length of recovery time depends on the type of dermatitis and the treatment you get. Even with treatment, it can take several weeks or months to improve. Atopic dermatitis can be with you lifelong, but you can reduce the symptoms with treatment.

Can dermatitis damage my skin permanently?

If you scratch your skin too much and too hard, you could possibly leave scars.

Prevention

How can I prevent or reduce my risk of dermatitis?

Do your best to avoid what triggers your dermatitis. That might be foods you’re sensitive or allergic to, chemicals that irritate your skin and/or soaps that do the same. Moisturize your skin regularly. Don’t overheat. Use a humidifier to keep the air from getting too dry. Try not to scratch. Reduce your stress.

What foods can I eat or avoid to reduce my risk of dermatitis?

If you have food allergies, then one of the reasons why you must avoid that food is that it may cause or worsen dermatitis. Up to 25% of people with dermatitis herpetiformis have celiac disease, a sensitivity to gluten. Examples of common allergies include peanuts, dairy, eggs, sugar and alcohol. Pay attention to what you eat. If your dermatitis flares up after you eat a certain food, then you might have an allergy.

Discuss diet changes with your healthcare provider. It may also be helpful to see a dietician. Dieticians can help you create new meal plans.

Outlook / Prognosis

How long will I have dermatitis?

Dermatitis can be with you lifelong. It can start in infancy and continue through adulthood. It can start in the teenage years and disappear by young adulthood. Each possibility depends on the person and on the type of dermatitis they have.

Are there complications of dermatitis?

There are complications that come with dermatitis. The following do not apply to all types, and do not apply to all people, but are still common:

  • Viral skin infections. Try not to scratch because that can worsen the infection.
  • Bacterial skin infections. Try not to scratch because that can worsen the infection.
  • Sleep loss.
  • Conjunctivitis (pink eye).
  • Blepharitis (inflammation and redness of your eyelid).

Will dermatitis cause scars?

Scratching your skin can sometimes lead to infections and scars. Try to get treatment as soon as you notice dermatitis symptoms so that you can avoid this.

Living With

What is it like living with dermatitis?

Dermatitis is both common and normal. Many people live with it.

Managing your symptoms is important for living with dermatitis. Do your best to keep your dermatitis “under control.” You can do this by following your healthcare provider’s instructions. Try your at-home remedies and take any prescribed medications.

You may find that there are times when your dermatitis disappears. This is known as a “remission” period. Other times you may have a “flare up,” which is when your dermatitis gets worse.

Do your best not to scratch your dermatitis as this can lead to infections and scars.

When should I see my healthcare provider?

Don’t wait until you’re so uncomfortable that you can’t sleep before seeing your healthcare provider about your skin. See them as soon as symptoms start so that you can get treatment. See them especially soon if you think there’s an infection, or if you’re in a lot of pain.

What questions should I ask my healthcare provider?

  • What type of dermatitis do I have?
  • How can you tell that it’s that type of dermatitis?
  • If I don’t have dermatitis, what other skin condition might I have?
  • Is there a specific brand of moisturizer that you recommend?
  • Is there a prescription shampoo, cream or lotion that you can prescribe?
  • How often should I see a dermatologist regarding this condition?
  • What soaps, lotions, makeup, etc. should I avoid?
  • What medications do you recommend?
  • What at-home treatments do you recommend?

A note from Cleveland Clinic

See your healthcare provider as soon as you start to see symptoms of dermatitis. Feeling itchy and/or in pain all the time affects your quality of life. It’s distracting, uncomfortable and can even keep you from having a good night’s sleep.

Dermatitis is very normal, but it may make you feel self-conscious in public. It can affect your self-esteem and your social life or relationships. But remember that as many as 15% to 20% of people experience some form of dermatitis at some point in time, so know that you’re not alone!

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