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Dermatitis

Also listed as: Skin disorders - dermatitis

• Signs and Symptoms
• What Causes It?
• What to Expect at Your Provider's Office
• Treatment Options
• Following Up
• Special Considerations
• Supporting Research

Dermatitis (also called eczema) is an itchy inflammation of the skin. It is not contagious. There are many types of dermatitis.

Signs and Symptoms

• Itching, pain, stinging, or burning
• Blisters, thick or scaly skin, red skin, sores from scratching

What Causes It?

• Allergic reactions (for example, to poison oak or ivy)
• Low humidity or soaps and detergents
• Chemicals, such as nickel and cobalt
• Working with chemicals or wetting hands often
• Genetic make up

What to Expect at Your Provider's Office

Your health care provider will try to determine the cause of your dermatitis and make sure you have dermatitis and not a similar disease, such as psoriasis, skin cancer, or some psychological conditions.

Treatment Options

• You can take some corticosteroids, such as prednisone, internally to reduce swelling. You can apply others, such as hydrocortisone, directly to the skin to relieve discomfort.
• Antihistamines relieve itching; some may also help you sleep.
• Antibiotics, either topical (to put on your skin) or in pill form, are prescribed if there is an infection.

Complementary and Alternative Therapies

Food allergies can cause dermatitis. Following nutritional guidelines and using herbal support may help reduce inflammation and hypersensitivity. Hypersensitivity associated with stress and anxiety may be helped by mind-body techniques such as meditation, tai chi, yoga, and stress management.

Nutrition

Note: Lower doses are for children.

• Eliminate or reduce exposure to environmental or food allergens. Common allergenic foods are dairy, soy, citrus, peanuts, wheat (sometimes all gluten-containing grains), fish, eggs, corn, and tomatoes.
• Reduce pro-inflammatory foods in the diet, including saturated fats (meats, especially poultry, and dairy), refined foods, and sugar.
• Eat more fresh vegetables, whole grains, and essential fatty acids (cold-water fish, nuts, and seeds).
• Fish oil (10 g per day for 12 weeks) helps reduce leukotriene B4, an inflammatory substance that plays a role in eczema.
• Probiotics (bifidobacteria and lactobacillus, 3 - 5 billion live organisms per day) may boost the immune system and control allergies.
• Borage oil and evening primrose oil contain the essential fatty acid GLA (500-900 mg per day, in several doses -- amount of GLA varies by supplement), which acts as an anti-inflammatory. Evidence is mixed, with some studies showing that GLA helps reduce symptoms and others showing no effect. Children should be given cod liver oil (1 tsp. per day) or omega-3 oils (fish oils). Some cod liver oil products contain high levels of vitamin A, which can be toxic over time.
• Beta-carotene (25,000 - 100,000 IU per day), zinc (10 - 30 mg per day), and vitamin E (200 - 800 IU per day) support immune function and skin healing.
• Vitamin C (1,000 mg two to four times per day) inhibits histamine release. Rose hips or palmitate are citrus-free and hypoallergenic.
• Bromelain (100 - 250 mg two to four times per day) helps reduce inflammation.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Flavonoids, a substance in dark berries and some plants, have anti-inflammatory properties, strengthen connective tissue, and reduce hypersensitivity. The following flavonoids may be taken in dried extract form.

• Catechin (25 - 150 mg two to three times per day), quercetin (50 - 250 mg two to three times per day), hesperidin (50 - 250 mg two to three times per day), and rutin (50 - 250 mg two to three times per day).
• Rose hips (Rosa canina) are also high in flavonoids and may be used as a tea. Drink 3 - 4 cups per day.

Sarsaparilla (Smilax species) helps heal hot, red, inflamed skin, and gotu kola (Centella asiatica) is good for dry, scaly, crusty skin. Use 3 ml sarsaparilla and 2 ml gotu kola tincture daily, or 3 cups tea per day.

Creams and salves containing one or more of the following herbs may help relieve itching and burning, and promote healing. The best evidence is for forchamomile (Matricaria recutita). Chickweed (Stellaria media), marigold (Calendula officinalis), and licorice ( Glycyrrhia glabra ) may be helpful, although little scientific evidence is available.

Witch hazel ( Hamamelis virginiana ) cream can relieve itching. Liquid witch hazel can help with "weeping" or oozing dermatitis.

Peppermint leaf tea may be cooled and applied to relieve itching and burning. An external menthol ointment can also help.

Homeopathy

Some of the most common remedies used for dermatitis are listed below. Usually, the dose is 3 - 5 pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms get better.

• Antimonium crudum for cracked skin
• Apis mellifica for hot, swollen vesicles
• Rhus toxicodendron for intense itching and burning
• Sulphur for intense burning and itching with scaling skin
• Urtica urens for burning, stinging pains

Acupuncture

Acupuncture may help restore normal immune function and reduce the hypersensitivity response.

Massage

Massage may help reduce stress, which makes dermatitis worse.

Following Up

Carefully avoid whatever gives you dermatitis, and prevent infection and scarring by not scratching.

Special Considerations

Check with your health care provider before using any medication if you are pregnant or nursing.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:144.

Berth-Jones J, Graham-Brown RA. Placebo-controlled trial of essential fatty acid supplementation in atopic dermatitis. Lancet 1993;341:1557-60.

Habif TP. Clinical Dermatology. 3rd ed. St. Louis, Mo: Mosby-Year Book; 1996.

Isolauri E, Arvola T, Sutas Y, et al. Probiotics in the management of atopic eczema. Clin Exp Allergy. 2000;30:1604–1610.

Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357:1076–1079.

Korting HC, Schafer-Korting M, Hart H, et al. Anti-inflammatory activity of hamamelis distillate applied topically to the skin. Influence of vehicle and dose. Eur J Clin Pharmacol 1993 ;44:315-8.

Middleton E, ed. Allergy: Principles and Practice. 5th ed. St. Louis, Mo: Mosby-Year Book; 1998.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:29, 326, 394.

Rakel RE, ed. Conn's Current Therapy. 50th ed. Philadelphia, Pa: WB Saunders Co; 1998.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Durango, Colo: Kivaki Press; 1994:36.

Stewart JCM, et al. Treatment of severe and moderately severe atopic dermatitis with evening primrose oil (Epogam): a multi-center study. J Nutr Med . 1991;2:9-16.

• Review Date: 6/15/2006
• Reviewed By: Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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