Clients often come in asking what to do about various types of dermatitis, so today we’re going to take a good look at it. 

Dermatitis is essentially skin inflammation. The term “dermatitis” is somewhat broad and actually refers to a number of different conditions. You’ll often see it combined with a qualifier, such as “contact dermatitis”, to make it more descriptive. Adding to the complexity is eczema. Eczema and dermatitis are two different words that are used to describe the same condition. However, eczema is more commonly used when referring to an area that is crusting, scaling, or oozing, rather than just red and itchy. Furthermore, when the word eczema is used on its own, it usually refers to atopic dermatitis (atopic eczema). 

There are many types of dermatitis, but we’re going to talk about the 3 most common forms: Atopic, Seborrheic and Contact. All together, dermatitis makes up 30% of all dermatologist consultations. 

Atopic Dermatitis

If you have a persistent, itchy, unexplained rash that also appears crusty and purulent, you may have atopic dermatitis. It most frequently affects children but can stay until adulthood. This condition is primarily immune driven with some environmental factors. People who have a family history of asthma, seasonal allergies or other hyper immune conditions are at higher risk of developing atopic dermatitis. 

Seborrheic Dermatitis

Seborrheic dermatitis is a skin condition that is categorized by greasy plaques and yellowish scales occurring in areas rich in sebaceous glands. Common areas include the scalp, back of the ear, and center of face (near nose). This relatively common skin disorder is often associated with infection by Malassezia furfur, a fungus that grows on skin. You may have experience with using shampoos containing selenium sulfide for controlling dandruff, which is seborrheic dermatitis of the scalp. Antifungal and corticosteroid creams are also used to control this condition and prevent relapse. 

Irritant Contact Dermatitis

It’s all in the name in this case, as contact dermatitis develops when you come into contact with something that causes an allergic reaction or injures the skin. The reaction can fester and feel itchy, stingy, give you a burning sensation, or can turn into blisters. It can be divided into two categories: irritant contact dermatitis or allergic contact dermatitis. The irritant variant of this condition is more common and makes up 80% of cases.  Here is the difference between the two: 

With irritant dermatitis, a substance physically damages the skin. It is commonly caused by household cleaners, bleach, and other chemicals. Allergic dermatitis, on the other hand, occurs when a particular substance triggers a hypersensitivity reaction. Common triggers include poisonous plants, mango skins, preservatives, and fragrances. Allergic dermatitis is usually localized and well demarcated; a rash found on the trunk of your body is often caused by clothing dyes or fabrics. Shampoo may trigger a reaction in adjacent areas, such as the neck, eyelids, and behind the ears. 

What To Do About Various Type of Dermatitis

Contact Dermatitis

Options for managing contact dermatitis are relatively straightforward. The first priority is to remove the irritants and prevent any continued exposure. This however, can be challenging when dealing with an invisible irritant such as fragrance or soap. Corticosteroids, such as cortisone, are the first choice for managing contact dermatitis. UV therapies are often used for cases that do not respond to other forms of treatment.

Seborrheic Dermatitis

For most people, seborrheic dermatitis is a relatively mild condition. It affects areas of the body that have a high number of sebaceous glands. While the exact cause is unknown, it is thought to be associated with fungal growth on the skin’s surface. Evidence supporting this theory comes from the effectiveness of antifungal treatments (shampoos, creams, etc.). However, some experts believe that there is an immune component to seborrheic dermatitis; skin fungi may produce certain fatty acids that trigger an immune response in some individuals. This is why anti-inflammatory agents, such as cortisone also work for managing seborrheic dermatitis. 

Previously, I wrote a post describing what to do about allergic reactions to waxing, but you can use the same suggestions:

Diphenhydramine (Benadryl) cream is an over-the-counter medication that temporarily blocks the effects of histamine. By using it topically, you may control itchiness, redness, and swelling.

Hydrocortisone cream may also be used to control itchiness and irritation, however, you should avoid using hydrocortisone creams long-term as they may cause skin-damaging side effects.

Ibuprofen (Motrin), taken orally, may further reduce redness and swelling.

Atopic Dermatitis

The treatment for atopic dermatitis is less straightforward. People who live with this condition need close supervision by a dermatologist. Options for managing atopic dermatitis include removing possible triggers (foods/ allergens), regular bathing, and thorough moisturizing… think Cherry-O: Lip-savior & Body Balm. A doctor may suggest using several medications including cortisone, immunosuppressants, and antibody therapy. 

My Personal Experience with Dermatitis 

My personal experience with dermatitis occurred a couple of years ago. I had a small itch above the hairline on the back of my neck. I figured it would go away, but I kept scratching it and making it worse. It felt so good while I scratched it, but I paid dearly for that short pleasure. The area grew even though I applied all of my natural remedies. As it was keeping me up at night, I finally went to an allergist and a dermatologist. It turned out that I didn’t have allergies, so I was given 25 injections of steroids in the area which hurt like heck! They said I’d need to return every 5 weeks until it was gone. 

Within 3 weeks, the itching and burning was back and since I didn’t want to endure that scary treatment again, I scheduled an appointment with an acupuncturist. She took one look at the dermatitis and immediately put me on an anti-inflammatory diet. Apparently, the foods I was eating were causing “heat” in my body which manifested as dermatitis.

As soon as I changed my diet and started drinking pureed turmeric root juice on a daily basis the effects of the dermatitis started going away. Additionally, I continued with the acupuncture treatments for a while, but now all is calm as long as I maintain the diet. Our bodies communicate with us, but we need to figure out how to comprehend what they’re saying. It’s possible that I was taking in something that my body didn’t like and the elimination of that substance helped me to get better.

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Photos: Copyright © 2003 Lippincott Williams & Wilkins.