Dermatitis herpetiformis causes itchy bumps and burning blisters as a result of a gluten sensitivity that makes your immune system overreact. You may have this condition if you also have celiac disease. Although the bumps on your skin look similar to herpes, you don’t have herpes. Treatment with medications and a gluten-free diet is effective.
Dermatitis herpetiformis is a long-term (chronic) condition that causes itchy bumps and blisters on your skin as a result of a gluten sensitivity. Gluten is found in common foods such as wheat, rye and barley.
Most people diagnosed with dermatitis herpetiformis have celiac disease, but they may or may not have gastrointestinal symptoms like diarrhea, weight loss and abdominal discomfort. This happens because celiac disease can be asymptomatic with dermatitis herpetiformis. Dermatitis herpetiformis is sometimes called the skin manifestation of celiac disease. You can have dermatitis herpetiformis without having celiac disease.
Other terms for dermatitis herpetiformis include:
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No, the herpes virus doesn’t cause dermatitis herpetiformis.
In the word “dermatitis,” “derm” means “skin” and “itis” means “inflammation.” The word as a whole means “inflammation of the skin.”
The word “herpetiformis” refers to the blisters and bumps that look like herpes lesions. The only connection it has to the herpes virus is sharing its name and the way it looks.
Dermatitis herpetiformis can affect anyone at any age. However, it’s most likely to affect people:
It’s possible but rare among children, people who are Black and people of African or Asian descent.
Dermatitis herpetiformis affects 10% to 25% of people diagnosed with celiac disease. An estimated 0.4 to 2.6 out of 100,000 people in the United States receive a dermatitis herpetiformis diagnosis each year.
Symptoms of dermatitis may include:
Dermatitis herpetiformis looks like a cluster of itchy bumps on a patch of discolored skin (rash). These bumps can be darker than your natural skin tone or red to purple. Blisters can also form on your skin. Blisters are circular, often fluid-filled lumps on the surface of your skin. Blisters caused by dermatitis herpetiformis sometimes look like symptoms of herpes.
Dermatitis herpetiformis commonly occurs on your:
Dermatitis herpetiformis doesn’t directly cause hair loss. However, hair loss may occur if you have celiac disease. Many people diagnosed with celiac disease also have dermatitis herpetiformis.
An autoimmune reaction to gluten causes dermatitis herpetiformis. When you eat and digest food products that contain gluten, your immune system activates and produces antibodies (IgA). These antibodies deposit into your skin, which causes itchy bumps and blisters.
Autoimmune conditions like dermatitis herpetiformis can run in your biological family. You’re more likely to get dermatitis herpetiformis and/or celiac disease if a first-degree relative has it. The genes closely associated with dermatitis herpetiformis are HLA-DQ2 and HLA-DQ8.
No. You get dermatitis herpetiformis when your body is sensitive to gluten.
A healthcare provider will diagnose dermatitis herpetiformis after physically examining your skin. They may offer tests to confirm a diagnosis like:
The tests will help determine if you have this type of dermatitis or a different skin condition.
When you meet with a healthcare provider, they might ask the following questions:
Sometimes, dermatitis herpetiformis is mistaken for:
A healthcare professional may need to test your skin to determine an accurate diagnosis.
You may be at a higher risk of developing another autoimmune condition if you have dermatitis herpetiformis, including:
You’re also at a higher risk of developing:
Yes, it’s possible to have dermatitis herpetiformis without celiac disease. Of those diagnosed with celiac disease, 10% to 25% also have dermatitis herpetiformis. If you don’t have celiac disease, then there isn’t any food you need to avoid with regard to dermatitis herpetiformis. If you have celiac disease, you must avoid all foods with gluten to prevent symptoms.
Treatment for dermatitis herpetiformis includes:
Dapsone will relieve your itching as soon as an hour, and typically before 48 hours. If dapsone doesn’t help, your healthcare provider may prescribe sulfapyridine or sulfasalazine.
You may need to continue taking dapsone for one to two years to prevent more dermatitis herpetiformis bumps and blisters from forming.
A gluten-free diet helps your dermatitis herpetiformis by:
Gluten triggers your immune system to overwork, and it targets your skin. When you eat gluten, you’ll experience symptoms of dermatitis herpetiformis. When you avoid gluten, you won’t have symptoms.
Common foods to avoid that contain gluten include:
Getting the full results of a gluten-free diet may take several months. See a nutritionist if you need help with your new diet.
There aren’t any at-home remedies that can relieve your dermatitis herpetiformis symptoms, aside from eating gluten-free. This isn’t like other types of dermatitis (like contact dermatitis) that improve with moisturizers, creams and other treatments. It isn’t recommended that you use at-home remedies like apple cider vinegar on your skin to treat dermatitis herpetiformis, as it could irritate your skin.
A healthcare provider will monitor how well you feel while taking dapsone with regular blood tests. While rare, if the dermatitis herpetiformis flare-ups continue despite the gluten-free diet and medication, you might need to remove iodine from your diet as well. A healthcare provider will help you navigate changes to your diet to help you feel better.
When you begin treatment with medications, you may feel less itchy within an hour or up to 48 hours. It could take a few days to a few weeks for your skin to clear up completely. The bumps and blisters will sometimes go away spontaneously. They may leave behind brown or pale marks on your skin.
There aren’t any known ways to prevent dermatitis herpetiformis. You can reduce the likelihood of your symptoms flaring up by eating a gluten-free diet.
The symptoms of dermatitis herpetiformis can come and go throughout your life because there isn’t a cure. You may have periods of remission, which are timeframes when you don’t have any symptoms, and periods when symptoms flare up. Remission is spontaneous, and only about 12% of people diagnosed with dermatitis herpetiformis experience it. Even if you’re in remission, you should still eat a gluten-free diet.
A dermatologist can help you treat symptoms that affect your skin. You may want to visit a dietitian or a nutritionist if you have celiac disease to help you eat a gluten-free diet.
There’s no cure for dermatitis herpetiformis. If you don’t eat gluten, the bumps and blisters caused by dermatitis herpetiformis will go away. Staying on a gluten-free diet keeps your symptoms in remission. Dermatitis herpetiformis doesn’t harm your body and it’s not deadly.
See a healthcare provider as soon as you notice symptoms of dermatitis herpetiformis. This condition can cause uncomfortable itchiness and a burning sensation that can interfere with your quality of life. You’ll want to get treatment as soon as possible.
A note from Cleveland Clinic
Living with dermatitis herpetiformis can be difficult. Giving up gluten is a challenging but necessary consequence of celiac disease and dermatitis herpetiformis. You may feel awkward in social situations if your bumps and blisters are visible. You may feel distracted by the itchiness — you might even be unable to sleep because of it. Be sure to follow your healthcare provider’s instructions for treatment. Take your medicines and read product labels to avoid eating food that has gluten. If you stay gluten-free, then you’ll be dermatitis herpetiformis-free, too.
Last reviewed by a Cleveland Clinic medical professional on 12/02/2022.
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