How To Deal With Dermatitis The Right Way?

Are rashes, blisters or itchiness constant companions of your skin? You might be having a skin condition called dermatitis.

If left untreated, dermatitis can cause a lot of discomfort and even interfere with your daily life. Read this article to know what dermatitis is and how to deal with it.

Highlights:

• What Is Dermatitis?
• Types Of Dermatitis & Its Symptoms
• Causes Of Dermatitis
• How Does Dermatitis Damage Your Skin?
• How Can Dermatitis Be Treated?
• Tips For Prevention Of Dermatitis
• How Long Does Dermatitis Last?
• When To See A Doctor About Dermatitis?

What Is Dermatitis?

The word dermatitis literally means inflammation of the skin (‘derm’- skin + ‘itis’- inflammation). ‘Dermatitis’ is a term used to describe one of the many skin conditions that causes irritation and redness of skin along with swelling, oozing of fluids and even pain. [1] Long standing dermatitis can cause hardening of the skin, leading to the formation of scales.

Dermatitis is not contagious and usually does not pose any serious health risks. However, it can cause physical discomfort in the form of irritation and pain. Some people may also become conscious of their physical appearance due to the constant presence of rashes or blisters on their body.

Types Of Dermatitis & Its Symptoms

While there are several types of dermatitis, some occur more commonly than others. The different types of dermatitis differ in symptoms and site of occurence. However, your doctor is the best person to diagnose which form of dermatitis you have.

Let us take a look at a few types of dermatitis, symptoms and site of occurrence:

1. Atopic Dermatitis (AD)

This is a form of eczema that results in itchiness of the skin, which leads to rashes. [2] The skin barrier is damaged in AD making the skin dry, flaky or thickened. It may even ooze fluids. AD usually appears by 5 years of age and may disappear before adolescence, but many adults suffer from AD as well.

AD can affect any area of your skin, but kids tend to get dry, itchy rashes in the creases like the fold of the elbow, knee or neck.

2. Contact Dermatitis

As suggested by its name, contact dermatitis is caused when your skin comes in contact with an irritant or allergen, for example poison ivy, formaldehyde etc. It is characterised by the appearance of painful, red rashes or blisters.

People employed in certain professions such as industry workers, healthcare professionals, beauticians, etc. who work with irritating chemicals on a daily basis are at high risk of developing contact dermatitis. [3]

3. Diaper Rash

Babies wearing diapers for prolonged periods may develop redness or rashes on their bottom. The wet skin accompanied by movement can cause chaffing and make your baby extremely uncomfortable. Frequent change of diapers, keeping the affected area clean and application of appropriate diaper creams can bring relief to your young one.

4. Seborrheic Dermatitis (dandruff, cradle cap)

This form of dermatitis can affect both adults as well as kids. In adults it causes red, dry, flaky and itchy skin, appearing most commonly on your scalp as dandruff. It can also affect oily parts of your face or chest.

In young kids it causes a harmless, yellow crust like skin on the head known as ‘cradle cap’, which can not be removed easily. Washing your baby’s head with a mild shampoo can help loosen the scales.

5. Dyshidrotic Dermatitis

It is characterized by painful blisters usually appearing on the tip of your fingers, toes, edges of your palm or sole of your feet. [4] Common triggers include soaps, shampoos and metals such as nickel, cobalt, etc. Avoiding triggers and using medications can help prevent flare-ups of dyshidrotic dermatitis.

6. Neuro Dermatitis

Also known as lichen simplex chronicus, this is a chronic disorder causing intense itching and scratching. This may lead to the damage of nerve endings in the skin and formation of thick scaly patches. Non-steroidal topical creams or oral medications prescribed by a doctor can help heal the skin and relieve the itch-scratch cycle. [5]

7. Nummular Dermatitis

‘Nummular’ means coin shaped. This form of dermatitis is characterized by coin-like or discoid patches of itchy, oozing skin that can appear on your arms, legs or torso. Men are more affected by this than women. Topical corticosteroids along with antibiotics can effectively eliminate this type of dermatitis. [6]

8. Periorificial Dermatitis

As the name suggests, this dermatitis appears as small, red papules on your face. It occurs most commonly around the mouth, nose or eyes and very rarely on the genitals. [7] While adult women aged 15 to 45 years are more susceptible, children can also be affected.

Application of topical steroids, sunscreen products or other cosmetics can trigger this form of dermatitis.

9. Stasis Dermatitis

This is caused by venous insufficiency, a blood circulation disorder leading to lack of oxygenated blood supply especially in the lower legs. There can be swelling and appearance of orangish-brown spots on the lower leg.

Although aging is the most common cause of poor circulation, it can indicate the advent of other life threatening diseases. Immediate medical attention is recommended to avoid ulcerations and infections. [8]

Causes Of Dermatitis

It is difficult to pinpoint the exact causal agent for most types of dermatitis. An interplay of your genetics, immune system and environmental triggers are mostly responsible for the flare-ups of episodes of dermatitis.

1. Genetics

The genes which you have inherited from your parents by birth can make you more susceptible to a particular form of dermatitis. For example, mutation in the filaggrin gene which is responsible for formation of skin barrier runs in the family and is found in most AD patients.

2. Immune system

Your immune system may be hyperactive if the regulatory component of your immune system is not functioning properly. This may lead to hypersensitivity or allergic reactions and increased inflammation as seen in most dermatitis.

3. Environmental triggers

These play an important role in aggravation of any skin condition including dermatitis. If you are constantly exposed to pollutants or chemicals, your already sensitive skin is bound to react, especially if you are already genetically predisposed to dermatitis. Fragrances in skin care products are an example of irritants that can cause flare-ups in sensitive skin.

How Does Dermatitis Damage Your Skin?

Skin is the largest organ of your body that protects your internal organs from damage and infection. In case of dermatitis, the inflammation and irritation leading to itching of the skin can damage the skin’s protective barrier. This exposes you to secondary bacterial or viral infections.

Certain forms of dermatitis can also make your skin dehydrated, patchy and crusted. Avoiding possible triggers and taking appropriate medical care can help manage symptoms of dermatitis well and allow you to live a regular life.

How Can Dermatitis Be Treated?

For most kinds of dermatitis, there is no absolute cure. Your dermatologist may perform a skin biopsy to determine which skin condition you have, or run an allergy test to identify the triggers that cause flare-ups. Your doctor will prescribe medicines to help relieve the symptoms like itching and inflammation.

A. Medical Treatments

Common medical treatments used to deal with dermatitis include the following:

• Topical corticosteroids for applying on the affected areas. These are especially used to reduce itchiness.
• Using topical immunosuppressants such as calcineurin, help to reduce the hyperactivity of the immune system.
• Controlled phototherapy, which involves exposure to controlled amounts of light (natural or artificial) to the affected area on the skin. This can provide temporary relief to some patients.
• Oral steroids or antibody injections like dupilumab are prescribed for patients with severe dermatitis that does not respond to other medications. [9]

B. Home Remedies

Certain simple yet effective ways of dealing with dermatitis include:

• Warm baths once or twice daily will keep your skin clean and lessen chances of infections. Adding baking soda or using an oatmeal scrub might help.
• Keeping your skin moisturised is extremely important, as dermatitis can breach the skin’s protective barrier and cause loss of water. Well moisturised skin will itch less, thus reducing chances of more skin damage.

C. Alternative Practices

• Alternative medical practices such as acupuncture and chiropractic spinal manipulations can give relief to dermatitis conditions such as eczema, These, however lack scientific evidence of efficacy.

D. Diet

Dietary supplements are also often taken by patients with dermatitis with the hope of boosting skin health. However, this too has not been proved scientifically.

E. Counselling

Psychological counselling might be required to help reduce stress and distress caused by the appearance of dermatitis.

Tips For Prevention Of Dermatitis

The most important step in preventing dermatitis is identifying your triggers and avoiding them as much as possible. Your triggers may include but are not limited to:

A. Foods :

Foods like nuts, seafood can cause severe flare-ups of dermatitis

B. Artificial fragrances :

Avoid using fragrant skin care products or cosmetics with harsh chemicals. Instead choose mild non-irritating skin products that suit your skin type.

C. Exposure :

Avoid exposure to irritants. Use protective covering such as gloves while handling chemicals, detergents etc. to prevent it from coming in contact with your skin.

D. Stress :

This is known to initiate or increase your dermatitis episodes. Try meditation, light exercises and get sufficient sleep to avoid stress.

It is also very important to avoid scratching the affected area and instead keep it well moisturised. Scratching not only makes open wounds prone to infections but also can make your immune system hyperactive. You can use occlusive bandages at night to prevent scratching while asleep.

How Long Does Dermatitis Last?

Dermatitis can be acute, sub-acute or chronic. Acute dermatitis lasts for a short period of time, from a few days to maybe few weeks depending on the type of dermatitis. In case of contact dermatitis, the flare-up usually subsides within days after the irritant or allergen has been eliminated.

Chronic dermatitis on the other hand, may last for a lifetime, with maybe seasonal episodes of flare-ups and remittance. Subacute dermatitis is somewhere in between acute and chronic. During the subacute phase, the dermatitis has started healing but may flare-up in between.

When To See A Doctor About Dermatitis?

If you have one or many of the following conditions you should seek advice from your dermatologist:

• If despite all treatments, you still have unbearable itching, pain or discomfort.
• You are unable to sleep well or carry on with your daily activities because of your skin condition.
• You suspect an infection in the affected area.
• The appearance of rashes or scales is affecting you psychologically.

Wrapping Up

Dermatitis is a broad term encompassing a number of skin conditions primarily characterized by inflammation, irritation and dried or crusted skin. Dermatitis is not contagious but can affect the quality of your life. Taking appropriate precautions and medications as per your dermatologist's advice will help manage dermatitis symptoms and ensure you an enjoyable day to day life.

Begin By Knowing Your Skin