Dermatitis, or inflammation of the skin, is a common problem
that usually results in red, swollen or blistered, intensely
itchy areas of skin.
Some people with an allergic tendency, often inherited, will
suffer from the chronic form of dermatitis known as eczema. This
is sometimes referred to as endogenous (meaning from within)
But many others will experience a form of dermatitis called
exogenous (contact) dermatitis. Exogenous means due to external
factors. Contact dermatitis is the result of direct contact with
a variety of substances.
There are two types of contact
irritant and allergic.
Irritant contact dermatitis is produced by the direct chemical
effect of certain substances on the skin. The severity of the
dermatitis will depend on how long the substance is in contact
with the skin and the concentration of the offending material.
Common causes of irritant contact dermatitis include detergents
and solvents, acids, alkalis, oils and skin cleansers.
Certain occupations are more prone to this form of dermatitis.
The allergic form of contact dermatitis is less common,
affecting a small number of people who, for some reason, become
sensitive to certain common everyday substances.
They may have been in contact with these materials for years
before the sensitivity develops.
The most common cause of allergic contact dermatitis, usually
affecting women, is nickel. This is found in many metal objects
worn next or close to the skin. Costume jewelry, metal studs on
jeans and sleepers in pierced ears are usually to blame. Other
allergens are chromates-especially in cement-rubber and some
creams and ointments used for medical purposes.
Eczema (atopic dermatitis)
This condition develops in childhood and may last into
adulthood, although an adult can develop eczema without having a
Atopic dermatitis is a type of eczema. With eczema, the skin is
extremely itchy and usually dry. This condition has no known
People who have atopic dermatitis also have a greater chance of
developing allergies such as hay fever or asthma.
In babies, eczema takes the form of a rash around the mouth and
cheeks. Then older children have eczema, rashes may appear
behind the knees, in the creases of the elbows, and on the neck.
Itch-scratch-Itch cycle dermatitis
This develops when an itchy area is scratched or rubbed
,repeatedly. The skin becomes harder and annoyingly itchy.
Scratching makes this worse. It
may be hard to break the itch-scratch-itch cycle.
This is red, flaky, slightly itchy skin on an adult's scalp and
face. The area from the side of the nose to the corner of the
mouth may be affected, as well as the scalp and eyebrows.
The person often has dandruff, too.
WHAT YOU CAN DO
When contact dermatitis is suspected, the obvious first step is
to try and find the cause. With an irritant cause this is
usually easy, especially as the skin problem is often confined
to those areas actually in direct contact with the irritant.
With an allergic cause the rash may be more widespread, making
identification of the cause harder. If the rash is less obvious
at weekends or during holidays, it is probably due to a work
A streaky rash is often due to an allergy to a plant, which the
affected person has brushed past. Primula and poison ivy are
Sometimes patch testing, in which a number of suspected
materials are applied to separate areas of skin for up to 48
hours, will solve the mystery.
Treatment of contact dermatitis usually, requires the use of
corticosteroid creams or ointments. Whenever possible, contact
with the cause must stop. This might mean abandoning a favorite
piece of jewelry, or taking meticulous care always to wear
protective gloves when doing housework.
PREVENTING AND TREATING
There are a number of different products available that can help
in the prevention and treatment of dermatitis. Ask your
pharmacist for advice about the products that are best for you.
A gentle, pH –balanced soap substitute or soap-free
wash should be used all over the body if there is a
general tendency to dry skin.
Normal soap is alkaline and can damage skin, and products with
perfumes or lanolin may actually aggravate' the condition.
A good lather is not
necessary for cleaning.
Moisturizers or emollients
Moisturizers should be applied frequently, although some
moisturizers with multiple ingredients may aggravate an allergy
or dry skin. Try choosing
moisturizers that are free from lanolin and additives such as
perfume, colorants and parabens.
Ointments may be more effective for dry skin than creams.
Barrier creams are good for
people who frequently have their hands in water or have
Antipruritic (anti-itch) preparations
Oatmeal and tar-based pine oil products are useful in the bath
to help relieve itchy skin.
Bath oils can also be helpful, although constant use may stop
natural oil production. You should not use more than the
recommended amount, and you should be careful as they make the
Anti-inflammatory creams and ointments can help reduce
inflammation and help to soothe the skin.
Steroids such as hydrocortisone should be used sparingly and
only while there is inflammation, and should not be applied more
than twice daily, They should not be applied to broken skin or
to the face.