Dermatitis is a type of skin rash that can happen after your skin touches something that irritates it or something you are allergic to causing skin inflammation. All dermatitis are characterized by red, itchy rashes that form on different parts of the body. Some of these rashes would blister, weep, peel, or crust. The distribution and characteristics of the rash depend on the severity and on the type of dermatitis.
There are many types of dermatitis but the two most common types are Contact Dermatitis and Atopic Dermatitis (eczema).
Contact dermatitis is a type of dermatitis that forms on a portion of skin that gets in contact with certain substances or material. Contact dermatitis is classified into two: irritant contact dermatitis and allergic contact dermatitis. Irritant contact dermatitis happens when the skin touches a strongly irritating substance once or when the skin gets repeated contact to a particular material. Allergic contact dermatitis happens when the skin gets in contact with a material that it is allergic to. Triggers for contact dermatitis are usually found in products that are used on a daily basis. Examples of these are soaps, cleansers, detergents, perfumes, cosmetics, jewelries, clothing, plants (poison ivy or poison oak), metals in jewelry etc. Contact dermatitis can develop upon initial contact to the culprit substance; however, it is also possible to get contact dermatitis upon re-exposure to a substance that was previously used unremarkably in the past.
Signs and Symptoms
- Red, itchy, dry, scaly rash is seen on the area of contact, usually around the hands.
- The shape of the rash is sometimes be well demarcated and follows the pattern of the irritant material.
- Blisters can also form, which would eventually ooze and crust.
- Pain is common especially if there is a break in the skin usually from repeated scratching.
- The simplest yet most effective way of addressing contact dermatitis is by avoiding the inciting agent. Refrain from using the irritant or allergenic material.
- If staying from the inciting agent is not possible, use protective equipment to shield your skin. For example, use gloves when dealing with strong cleansers or soaps.
- Find hypoallergenic substitutes to the products that you are allergic to. For example, you can find hypoallergenic substitutes to the soaps or cosmetics that you are using.
- Soothing anti-itch and moisturizing creams can be used to relieve the itchiness and the dryness of the skin.
- A special kind of bath called an oatmeal bath
When to see a doctor and treatments
A visit to a doctor is warranted if the rash persists for two weeks or gets worse despite avoidance of the inciting agent. If you have a long-standing rash and you are not sure if it is due to contact dermatitis, a doctor can help you diagnose the rash and identify possible irritants or allergens.
Doctors would usually prescribe steroid creams or ointments that help decrease the itching and inflammation of the rash. If the rash is more widespread or severe, oral steroid tablets might be added. A wet dressing may be prescribed for weeping or crusted rashes. Wet dressings consist of a layer of wet material that is in contact with the rash, covered with a dry material on top. Wet dressings are usually left in place overnight to hydrate the rash and prevent it from cracking.
Atopic Dermatitis (Eczema)
Atopic dermatitis is a form of eczema that is common among people who have strong history of allergies. Doctors do not know the exact cause and there is no test to confirm the diagnosis but the condition has a strong familial predisposition meaning it can be passed down from parent to child.
Signs and Symptoms
- Atopic dermatitis is characterized by red, itchy, dry, scaly rashes that usually start to appear in infancy or early childhood.
- In infants, the rashes are found on the scalp, cheeks, and extensor surfaces of the arms and legs (elbows and knees). The diaper area is usually spared.
- In older children and adult, the rashes are found on the face, sides of the neck, wrists, and flexural surfaces of the arms and legs (inner elbow and back of the knees).
- The rashes can become thick and dark from repeated scratching.
- The rashes can also form blisters that can weep or crust. It can even be infected.
- Since atopic dermatitis usually gets itchy when the skin is dry, use of unscented, hypoallergenic moisturizing creams and lotions can be helpful to prevent drying and cracking of skin.
- Avoid allergens that might cause flare-ups like dust, pollens, animal dander, or molds.
- Avoid substances that might aggravate the rash like strong soaps, perfumes, or synthetic fabrics.
- Avoid other environmental factors which exacerbate such as dry air, hot temperatures, and stress or worry
When to see a doctor and treatments
A rash that persists for more than two weeks or a rash that progressively gets worse warrants a visit to a doctor. There is no specific test to diagnose atopic dermatitis; instead, its diagnosis is based on a detailed history of the signs and symptoms of the rash and a history of allergy. There is no definitive treatment for atopic dermatitis; instead, most of the treatments are aimed at controlling the rash and minimizing flare-ups.
- Doctors can prescribe moisturizing creams or ointments to keep the skin hydrated and to prevent drying and flaking.
- Wet dressings can be used in tandem with these moisturizers.
- Steroid creams or ointments, which help decrease the itching and inflammation of the rash, can also be prescribed. If the rash is more widespread or severe, oral steroids might be added.
- Antihistamine pills that are given to control allergic reactions can also be helpful in relieving the itchiness especially at night.
- Immunomodulators or drugs that are used to control the immune system might also be given topically to halt the body’s allergic response. However, these are usually reserved for moderate or severe cases that do not respond to steroids and moisturizers.
- Phototherapy or the use of ultraviolet light can also modulate the immune response to allergy. However, it is reserved for moderate to severe cases because of its risk of causing skin cancer.
Although the condition cannot be cured, about half of children with eczema grow out of it by the time they become adults.