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Dermatitis
Definition
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.

Symptoms

Contact dermatitis on the wrist

Seborrheic dermatitis on the face

Atopic 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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Causes
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; jewellery 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. Neurodermatitis 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.

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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

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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 rosaceous, adult acne or seborrheic dermatitis, involving the skin around the mouth or nose. Possible underlying factors include: Makeup Moisturizers Topical corticosteroids

Complications
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.

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Scarring and changes in skin colour are other potential complications from dermatitis.

Treatments and drugs

By Mayo Clinic staff 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 Neurodermatitis 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, counselling can help you learn how your emotions and behaviours can fuel or prevent itching and scratching.

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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.

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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

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 non-prescription topical cream that contains at least 1 percent hydrocortisone. It may provide some relief. Consider taking a non-prescription 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 no drowsy formula during the day. Avoid products that seem to trigger your rash and protect yourself from contact with them . Wearing non latex 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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