What is it
Dermatitis and eczema are general terms for many recurring noncontagious skin rashes. Sometimes eczema is used to refer to rashes that occur chronically and often without an identifiable external cause, while dermatitis includes symptoms caused by specific triggers that affect many people in much the same way. Often the two terms are used interchangeably. (Technically, dermatitis simply means inflammation of the skin and refers to the symptoms, not the cause of the irritation.)
There are various types of dermatitis, some grouped by causes, others by specific symptoms and locations on the body. All of them have symptoms of itching and redness, and they often worsen if scratched. The following are among the most common types.
A chronic skin irritation, this condition is characterized by a hypersensitivity, or allergy, to common substances that don’t bother most people. (Atopic is derived from a Greek word meaning away from the place.) The condition is primarily inherited and usually affects people with a family history of the dis order, or of asthma or hay fever. Symptoms typically first appear in infancy, then flare up at intervals during adulthood.
This form of eczema, also known as allergic contact dermatitis, is an acute rash or irritation caused by substances such as soaps, detergents, cosmetics, and other types of chemicals that come in direct contact with the skin. Because the irritation is usually localized, you can often discover what the cause is though sometimes the reaction won’t occur until several hours after you’ve come in contact with the allergen. Also, it may take more than one contact with a substance before dermatitis first occurs. But then the skin becomes sensitized so that any repeated contact produces a reaction.
Flaking and scaling are typical of seborrheic dermatitis, which tends to occur around the scalp, eyebrows, and face. It is also a cause of dandruff.
A chronic ailment of middle-aged adults, this is caused by pooling of blood in the lower legs. Symptoms, which include red, scaly patches, usually first appear on the inside of the lower leg around the ankles.
- Itching, initially, followed by redness, swelling, and dryness that occurs in specific areas, typically the hands, face, scalp, wrists, behind the knees, and in front of the elbows.
- Oozing blisters and crusting of the affected areas.
- Peeling and chafing.
- Thick and scaling patches of skin (chronic cases) due to scratching.
What causes it
Dermatitis may be caused by allergies, as well as by irritants, sweating, and infections though it may occur for no apparent reason. Sensitivity to irritants and/or allergens sometimes takes years to develop, and symptoms in some cases may appear only after prolonged exposure.
Common triggers can include food (wheat, milk, seafood, eggs), clothing (wool and silk, especially), skin lotions, detergents and soaps, stressful situations, antiperspirants, plants (poison ivy, oak, sumac), and medications.
Next to poison ivy, the most common cause of allergic skin rashes is nickel, which is used in costume jewelry, coins, keys, tools, zippers, and other fasteners. An estimated 6 percent of Americans are allergic to nickel, and among women the incidence is higher probably 10 percent because the needles used for ear piercing often contain nickel.
Other common allergens linked to contact dermatitis are cosmetics (especially nail polish), dyes, and leather.
Occasionally, a previously tolerated medication turns into an allergen and causes itching. Stasis dermatitis is often linked to varicose veins.
What if you do nothing
Some cases of dermatitis will clear up on their own. But if your skin is very itchy, it’s hard to avoid scratching, which can aggravate the eczema and cause it to appear in other areas where you scratch. When you can’t avoid the urge to scratch, make use of the self-care remedies or contact your physician for more potent treatments.
Self-care for most forms of dermatitis entails stopping the itch-scratch cycle and avoiding known triggers. Therefore, in addition to easing your discomfort, try to identify the substance that’s causing your symptoms. If you can dis- continue using it or coming in contact with it, you may not need medical help.
Scratching worsens dermatitis, so try to resist the urge. Keep your fingernails clean and as short as possible to prevent possible infection.
Suppress the itch
Over-the-counter cortisone creams and lotions may help if the irritation or allergy is minor. As a rule, you should use creams or ointments only on dry rashes. If a lesion is oozing, use lotion or liquids. Oral anti- histamines may also help relieve the itching. Be wary of “-caine” preparations, such as benzocaine. These deaden the itching, which may feel good momentarily, but they can cause secondary allergic reactions.
Compress the itch
Try a cold compress and that old standby, calamine lotion. Some people have also found temporary relief with milk compresses: pour very cold milk onto a washcloth and leave it on the affected area for three minutes or so; apply another wet cloth for three minutes; repeat several times throughout the day as needed.
Bathe less frequently
Limiting yourself to as few as two baths or showers per week can help keep your skin from drying out. It’s also helpful to bathe in lukewarm water.
Wear loose cotton clothing
Cotton clothing allows perspiration a potential irritant to evaporate easily. Avoid woolen and silk garments; their fibers may irritate your skin.
Try support stockings for stasis dermatitis
These special stockings can improve circulation in the legs.
Pinpoint the source of irritation
If your face is itchy and irritated, suspect a cosmetic. If your hands are cracked and itchy, suspect some chemical you handle (dish detergent, for example). Some people become allergic to nickel after having their ears pierced, and any form of nickel that touches the body produces intense itching and sometimes a rash that looks like poison ivy. The rash may appear anywhere on the body, not necessarily on the ear lobes.
Stay away from substances to which you are hypersensitive. If soap or detergent or other chemicals cause problems, wear rubber gloves. Make sure any jewelry is nickel free. If you have your ears pierced, make sure it’s done with a stainless-steel needle, and be sure that your first pair of earrings are stainless steel or high-quality 18-carat gold studs.
After bathing, apply unscented moisturizer on damp skin immediately to seal in the moisture. If you develop dermatitis on your hands in cold weather, apply moisturizer regularly to keep your hands soft. If you have in a dry climate, or are experiencing dry weather, moisten indoor air with a cool-mist humidifier.
When washing or bathing, avoid harsh soaps or detergents
Use your automatic dish washer and clothes washer as much as possible to avoid contact with detergents.
Some dermatitis is triggered by stress. If that appears to be true for you, try to maintain emotional stability. Stress reduction techniques such as yoga or meditation can help.
Avoid swimming in chlorinated pools
Chlorine is an abrasive chemical. (However, you may find that swimming in saltwater bays and the ocean isn’t a problem.)