Introduction:

Dermatitis is an itchy inflammation of the skin. It is not contagious or dangerous, but it can be uncomfortable. There are many types of dermatitis, including allergic dermatitis, eczema, and seborrheic dermatitis (which causes dandruff). Eczema is a chronic condition, and symptoms may come and go.

Signs and Symptoms:

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

What Causes It?:

• Contact dermatitis: caused by allergic reactions (for example, to poison oak or ivy, or soaps, or detergents)
• Seborrheic dermatitis: may be caused by oily skin or hair, or brought on by stress
• Atopic dermatitis (eczema): exact cause is unknown, but may be due to a combination of dry skin and an autoimmune reaction. People who have eczema often have other allergies.

What to Expect at Your Provider's Office:

Your doctor 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. Your doctor may be able to make a diagnosis by examining you, or by doing a patch test to see what substances you might be allergic to.

Treatment Options:

Treatment varies depending on the type of dermatitis you have. For eczema, applying wet, cool compresses may help relieve itching. Taking a cool bath with baking soda or colloidal oatmeal added to the water may also help.

Drug Therapies

• Hydrocortisone creams, to reduce redness and itching in contact dermatitis and eczema.
• Medicated shampoos, to relieve seborrheic dermatitis.
• Antihistamines, to relieve itching associated with eczema.
• Topical calcineurin inhibitors (TCIs), such as pimecrolimus (Elidel) and tacrolimus (Protopic), may be used to treat eczema. These drugs help suppress an overactive immune system. TCIs are used when topical steroid creams do not work.
• Antibiotics may be prescribed to treat skin infections.

Complementary and Alternative Therapies

There are several complementary and alternative therapies and strategies that can help treat dermatitis. For example, many people with eczema have food allergies, so eating a healthy diet may help reduce inflammation and allergic reactions. Dermatitis associated with stress and anxiety may be helped by mind-body techniques, such as meditation, tai chi, yoga, and stress management.

Nutrition

Check with your doctor before giving a supplement to a child.

• Avoid exposure to environmental or food allergens. Common foods that cause allergic reactions are dairy, soy, citrus, peanuts, wheat (sometimes all gluten containing grains), fish, eggs, corn, and tomatoes.
• Eat fewer saturated fats (meats, especially poultry, and dairy), refined foods, and sugar. These foods contribute to inflammation in the body.
• 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) -- In one study, people taking fish oil equal to 1.8 g of EPA (one of the omega-3 fatty acids found in fish oil) had significant reduction in symptoms of eczema after 12 weeks. Researchers think that may be because fish oil helps reduce leukotriene B4, an inflammatory substance that plays a role in eczema. If you take anticoagulants (blood thinning medication), talk to your doctor before taking fish oil. If you're taking high dose fish oil make sure you use a brand that removes most of the vitamin A. Too much vitamin A over time can be toxic. The dose used in this study is very high, speak with your doctor to find the right dosage for you.
• Probiotics (bifidobacteria and lactobacillus, 3 - 5 billion live organisms per day) may boost the immune system and control allergies, especially in children. However, the scientific studies are mixed; more research is needed to know for sure if probiotics will help reduce eczema symptoms.
• Evening primrose oil (6 g per day) -- In some studies, evening primrose oil helps reduce the itching associated with eczema. However, other studies have found no benefit. People who take anticoagulants (blood thinners) should talk to their doctor before taking evening primrose oil.
• Borage oil, like evening primrose oil, contains 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 eczema symptoms and others showing no effect. People who take anticoagulants (blood thinners) should talk to their doctor before taking evening primrose oil.
• Vitamin C (1,000 mg 2 - 4 times per day) can act as an antihistamine. In one study, it helped reduce symptoms of eczema, but more studies are needed. Rose hips or palmitate are citrus free and hypoallergenic.
• Bromelain (100 - 250 mg 2 - 4 times per day), an enzyme derived from pineapple, helps reduce inflammation. Bromelain can have a blood thinning effect.
• Flavonoids, antioxidants found in dark berries and some plants, have anti-inflammatory properties, strengthen connective tissue, and may help reduce allergic reactions. The following flavonoids may be taken in dried extract form: Catechin (25 - 150 mg 2 - 3 times per day), quercetin (50 - 250 mg 2 - 3 times per day), hesperidin (50 - 250 mg 2 - 3 times per day), and rutin (50 - 250 mg 2 - 3 times per day).

Herbs

The use of herbs is a time honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider. When applying herbs to the skin it is important to make sure that you have no open wounds as serious infection can result.

• Topical 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 chamomile (Matricaria recutita). Chickweed (Stellaria media), marigold (Calendula officinalis), and licorice (Glycyrrhia glabra) may be helpful, although there is little scientific evidence to support this cliam. One study did find a licorice cream was more effective than placebo.
• Witch hazel (Hamamelis virginiana) cream can relieve itching. Liquid witch hazel can help with "weeping" or oozing dermatitis.
• St. John' s wort (Hypericum perforatum), used as a topical cream, has shown promise in one double blind study. People with eczema who used St. John' s wort on one arm and a placebo cream on the other saw more improvement with the arm treated with St. John' s wort.
• Other herbs that have traditionally been applied to the skin to treat dermatitis include Sarsaparilla (Smilax sp.) and marshmallow (Althea officinalis).

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of dermatitis based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• 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

Following Up:

Carefully avoid any substance that causes a skin reaction. Prevent infection and scarring by not scratching.

If your skin becomes infected, see your doctor right away, especially if you notice red streaks on your skin. That could be a sign of cellulitis, which can be life threatening for some people.

Special Considerations:

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

Some evidence suggests that breastfed children are less likely to develop eczema.

Alternative Names:

Skin disorders - dermatitis