Dermatitis is an umbrella term for many conditions where the skin becomes irritated or develops a rash. Unlike bacterial, viral, or fungal skin infections like athlete’s foot, dermatitis is not contagious.
Types of Dermatitis
Allergic Contact Dermatitis
Our body’s immune system is a powerful defense system that works with our skin to keep potentially harmful substances at bay. Sometimes, though, it can be hypersensitive to seemingly harmless materials, causing an allergic response in some individuals. Allergic contact dermatitis occurs when an allergen touches your skin, causing symptoms that may include an itchy rash, swelling, hives, redness, and burning at the site several hours or days later. Very rarely does the response occur immediately.
When you touch something your body detects as an allergen for the first time, your body won’t respond with allergic contact dermatitis. Instead, it creates a protein in your blood called antibodies that remain on high alert for the next time it detects the foreign invader, at which point they bind themselves to the substance to stop it from damaging your body further.
While your body can lose its hypersensitivity to a particular allergen over time, it’s more common for subsequent exposures to present progressively more severe symptoms.
- Nickel in jewelry
- Rubber or latex
- Dyes and fabrics, especially organic fibers like wool
- Plants including poison ivy, sumac, and oak
- Perfumes and dyes in cosmetic products
- Topical medications
The best treatment option is an official diagnosis and avoiding the allergen altogether. Of course, that’s not always possible, so your doctor may recommend:
- OTC hydrocortisone or antihistamine creams and oral antihistamines to relieve itching
- Prescription topical or systemic steroids
- Keeping the area moisturized to help heal the skin barrier
Atopic dermatitis is more commonly known as eczema. It is a chronic condition that usually appears in early childhood, causing incredibly itchy, tender patches of skin that may become inflamed, swell, crack, ooze, and scale over. You are more likely to have atopic dermatitis if there is a family history. Many children “outgrow” eczema, but it can continue into adulthood or first appear later in life.
Symptoms disappear between flare-ups, which may be brought on by dehydrated skin, chemical skin irritants, exposure to some pollutants, and stress.
- Hypersensitive immune system
There is not currently a medication or therapy that can eliminate eczema, but there are steps you can take to limit flares.
- Keep the skin hydrated with hypoallergenic, fragrance-free moisturizers
- Avoid strong soaps and detergents
- Avoid sudden changes in body temperature
- Limit your time spent in the water
- Apply topical steroids to limit scratching
- Invest in eczema-safe bathing products
- Use a humidifier to increase environmental moisture
- Topical prescription creams
Good hygiene practices help keep our skin healthy by removing toxins, dead skin cells, excess oils, and microbes. Those who neglect regular bathing can develop dermatitis neglecta, a buildup of dead skin cells, dirt, oil, and sweat that harden into hyperpigmented scales. They can be difficult to scrub away at first, but dermatitis neglecta typically disappears once the patient resumes regular cleansing.
- Some mental illnesses that affect self-care practices
- Skin sensitivity
- Surgery or injury that makes bathing difficult
- Physical exfoliation with a washcloth, soap, and water
- Salicylic or glycolic acid to loosen scales
While technically an irritant contact dermatitis, diaper dermatitis is specific for babies, toddlers, and senior citizens who have to wear diapers or incontinence products. The combination of friction, a warm and moist environment, and exposure to an irritant causes a rash. It presents with shiny skin, redness, small bumps, itchiness, tenderness, burning, pain, and in some cases, skin lesions.
The best way to prevent diaper dermatitis is frequent changing and choosing hypoallergenic products. If you notice that the condition occurs more often after switching to a different brand, it may contain an allergen.
- Spending too long in a wet diaper
- Sensitive skin
- Introducing new foods to baby’s diet
- Allergens in the diaper or incontinence product
- Ointments that create a barrier between the diaper and skin
- Frequent diaper changes
- Topical corticosteroids
- Switching to diapering products that don’t contain dyes, perfumes, or alcohol
- Using warm water and a soft cloth instead of disposable wipes
- Letting the area air dry or gently patting it dry before re-diapering
Commonly associated with the skin disorder atopic dermatitis, the cause of Dyshidrotic Dermatitis is unknown. It causes blisters, itching, redness, cracking, excessive sweating on the hands and feet, and pain in the area just before blisters appear. It is localized to the palms, fingers, soles of the feet, and toes.
- Seasonal allergies
- Some metals in jewelry
- Weakened immune system
- Cold, wet compress
- UV light therapy
- BOTOX shots
- Topical or systemic steroids & other prescription creams
- Foods high in nickel or cobalt
Irritant Contact Dermatitis
Unlike allergic contact dermatitis, irritant contact dermatitis appears when your skin is exposed to chemicals damaging the skin barrier. Depending on the strength of the substance and how long you’re exposed, symptoms can range from very mild to quite severe. Physical factors can also play a role, such as rubbing your hands together while frequently exposing them to strong soaps.
The rash that develops with irritant contact dermatitis may be accompanied by pain, swelling, blisters, inflammation, leathery patches, and crusting. It’s far more common in workers in industries that require frequent hand washing, working with strong chemicals, or contact with plants.
- Soaps, detergents, and household cleaners
- Hair dye
- Hand sanitizer
- Avoiding the irritant with protective clothing
- Creams that create a barrier between the skin and irritants
- Keeping the skin well-hydrated to maintain the skin barrier
- Steroid creams and oral drugs
- Cool compresses
- Bathing with oatmeal to reduce itching
Neurodermatitis also goes by lichen simplex chronicus and causes an “itch-scratch” cycle in which scratching the affected area causes it to itch even more. The raised patches of skin can take on a leathery, scaly appearance that may cause lifelong hyperpigmentation.
Experts aren’t sure what causes neurodermatitis, which can appear in response to normal scratching, like that which accompanies a bug bite. It is more common in those who experience frequent stress and chronic skin conditions.
The key to treating neurodermatitis is breaking the itch-scratch cycle by addressing the behaviors, emotions, and physical symptoms in conjunction with the rash.
- Topical lidocaine patches
- Mental health therapy
- Anti-anxiety or anti-compulsion medications
- Prescription antihistamine creams or pills
- Corticosteroid injections
If you notice patches of coin-shaped, itchy, oozing skin, you may be dealing with nummular dermatitis, also known as discoid eczema. It looks similar to ringworm and atopic dermatitis, so it may be necessary to perform a skin biopsy for your dermatologist to diagnose the condition.
- Dry skin
- Contact dermatitis
- Poor blood flow
- Insect bites
- Topical corticosteroids
- Topical antibiotics
- Astringent compress
- Using a humidifier
- Moisturizing several times a day, particularly after bathing
Dandruff and cradle cap are both forms of seborrheic dermatitis, a condition that causes itching, redness, greasy scales, white flakes, and crusting. While it usually affects the scalp, it can occur anywhere on the body where oil glands are most active, including the face, behind the ears, navel, joint creases, back, and upper chest.
Those living with naturally oily skin are more likely to develop seborrheic dermatitis, which can flare up in response to cold, dry air, stress, and exposure to chemicals like rubbing alcohol.
Seborrheic dermatitis doesn’t have a single cause but is instead a response to several factors:
- Yeast overgrowth
- Increased androgen levels
- Increased skin oils
- Inflammation due to injury
- OTC dandruff shampoos
- Antifungal shampoos
- Betamethasone valerate shampoos
- Topical antifungals
- Topical corticosteroids
- Topical calcineurin inhibitors
- Oral antifungals
- UV phototherapy
Talking to Your Dermatologist About Dermatitis
While most cases of dermatitis are mild cases in response to an allergen or irritant, it is absolutely essential to speak with your dermatologist about skin rashes so that they can help you find the trigger. Continued exposure damages the skin barrier and opens the door to other infections, permanent scarring, and other serious complications. They can also help you find treatments that relieve the symptoms.
Once you know the triggers and as long as the symptoms don’t worsen, you can follow your doctor’s advice regarding over-the-counter and prescription treatment options.
If dermatitis occurs with a fever, vomiting, dizziness, or trouble breathing, seek medical help immediately, then follow up with your dermatologist and PCP.