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Just like the name suggests, dermatitis or eczema results from skin irritation from allergens, irritants, or environmental conditions such as dry air. When dermatitis is triggered, the skin combats what the body interprets as a foreign and harmful substance. The result is a patch of skin – or several patches of skin that are red, itchy, and puffy. They may even blister and ooze.
It’s estimated that over 30% of people in the United States suffer from eczema. It’s common in young children who then often deal with it throughout life, going through periods of flare-ups followed by a period without symptoms. Sometimes as a person ages the symptoms decrease and may disappear entirely. For others, it’s a life-long battle.
Depending on the cause and type, people of any age can develop dermatitis. Those with a family history are more likely to develop it, as are people with seasonal or food allergies. Dermatitis is not contagious and does not spread through contact with a person who has it.
Early symptoms include:
As dermatitis progresses, scaly or thickened patches of skin appear where the body is building up a defense against the irritant. These patches are often located on the face, neck, hands, and legs. It may also be found in the creases of skin at the knees and elbows. These spots may get infected if scratched.
Other symptoms include blisters, open sores, and oozing and crusting.
Eczema is an umbrella term for skin irritation and inflammation that can be further diagnosed as a specific subtype depending on symptoms and causes.
When the term eczema is used as a specific condition, it refers to atopic dermatitis, one of the most common forms of dermatitis. People with atopic dermatitis usually have flare-ups in early childhood that cause intense itching and redness. Infants may have patches on the scalp, sometimes known as “cradle cap”.
Allergic contact dermatitis is caused by an allergy to ingredients in common household cleaners, personal products, chemicals used in clothing such as formaldehyde and polyester, and metals. If the cause of dermatitis is suspected to be an allergen, patch testing – the application of several allergens on the skin to check for a reaction – can show which allergens to avoid.
Irritant contact dermatitis isn’t an allergy to a particular substance but a reaction to a harsh irritant like caustic chemicals. It can also be caused by friction from rough clothing or surfaces. When the chemical or physical irritant comes in contact with the skin, it rubs the protective oils off and allows the irritant to go even further into the skin.
Painful, swollen blisters appear on the hands and feet, filled with fluids. Dyshidrotic dermatitis is more common in adults, particularly around pollen season. It may also appear in people with sweaty hands and feet, people with a nickel or cobalt allergy, and people under stress. A family history also raises the chance of developing dyshidrotic dermatitis.
Nummular dermatitis presents as coin-shaped marks on the lower body and lower arms, although they may appear anywhere on the skin. These round marks may appear after the breakage of the skin from a scrape or bug bite. Poor blood flow in the legs can also cause breakouts. Nummular dermatitis is more common in men in their 50s and 60s, and women between 15 and 25 years old.
Irritation caused by repeated scratching of the skin is called neurodermatitis. Unconscious scratching during the day and even while sleeping causes the skin to thicken as a measure of protection from constant breaking. A telltale sign is a patch of skin on the back shaped like a butterfly that people can’t reach. A person may believe that they itch from bug bites or from rashes where there are none, in which case there may be an underlying psychological cause. Others may just scratch out of habit.
Although the causes of dermatitis aren’t fully known, it’s likely caused by a genetic anomaly in the skin cells. Skin is meant to be a barrier that keeps moisture in while keeping harmful germs out. In some people’s cases, the skin is not as efficient at protecting the body so the immune system goes into overdrive to protect the body.
The immune system may react to many different things.
Such triggers include:
Dry, cold climates
Contact with irritants
Certain foods like dairy and nuts
Essentially anything that causes an inflammatory reaction or that strips away the skin’s natural defenses may cause dermatitis.
Although there is no true cure for eczema, it can be managed with a variety of treatments. Depending on the severity of the dermatitis, it may sometimes clear up on its own after a few weeks or months. For stubborn cases, it may not resolve until a medical provider prescribes medication.
Moisturizing is the key to at-home management. Warm, but not hot, showers and baths can help. Oatmeal baths and
Moisturizing immediately after showering also can show some relief. Using gentle soaps and wear soft, natural fibers such as cotton. Over-the-counter topical steroids such as hydrocortisone can also be beneficial.
From there, a medical provider may prescribe a topical steroid, an anti-inflammatory cream or ointment that will help with itching and redness. Systemic steroids work in the same way as topical steroids but are injected or taken orally. These aren’t generally recommended and are used only in very severe cases.
Rashes that are not eczema can sometimes signify a more serious condition. Psoriasis symptoms are quite similar to dermatitis, but psoriasis is an autoimmune disorder where the body is attacking itself. Rashes similar to dermatitis may also appear as part of a viral infection such as measles, chickenpox, and Fifth disease. When in doubt, it’s always best to seek medical care for a sure diagnosis.