What is Dermatitis
Dermatitis is the general term for non-contagious skin conditions that result in skin inflammation. Dermatitis can affect people of all ages and equally affects both men and women. Early stages of dermatitis are characterised by dry, itchy and reddish skin. More severe or later stages of dermatitis can result in crusty, scaly skin, painful cracks and even blisters. Dermatitis can be acute or chronic or both. The terms dermatitis and eczema are often used interchangeably – eczema is often referred to as “atopic dermatitis” as well.
Causes of Dermatitis
A combination of factors including health conditions, allergies, genetic predispositions, age, asthma and occupational hazards affect a person’s risk of developing various types of dermatitis conditions. These can be further exacerbated by scratching the affected areas, causing open sores and infection which can spread to other areas of the body. Dry skin, an immune system dysfunction and environmental factors can lead to atopic dermatitis (eczema); direct contact with allergens or irritants can lead to contact dermatitis; a yeast infection in the oil secretions of the skin can result in seborrheic dermatitis.
Types and Symptoms of Dermatitis
The different types of dermatitis are classified as follows:
|Type of Dermatitis||Symptoms|
|Atopic Dermatitis (Eczema)||Dry skin condition that can flare-up and become red, sore and itchy. (For more information on this skin condition, visit our page on eczema)|
|Contact Dermatitis||Contact with skin irritants causes mild dryness and skin redness and the appearance of skin burns. It can be painful, red, fluid-filled and ulcerated. Common irritants to skin include detergents, soaps, formaldehyde, synthetic fibres, some plants (including chrysanthemums, daffodils, tulips), metals such as nickel or cobalt (which can be found in jewellery).|
|Neurodermatitis (lichen simplex chronicus)||Common symptoms include itchy skin around a limited area, leathery/scaly skin patches, a raised and dark patch of skin. This disease occurs due to repeated scratching of an itchy area – the itch-scratch cycle causes the affected skin to become thick and leathery. It appears in patches on the neck, scalp, shoulders, feet, ankles, wrists and hands.|
|Nummular dermatitis||This skin disease involves oval sores on the skin and often occurs after injury to the skin. It is more common in men than women and affects mostly adults in their 50s and 60s. Living in a dry environment or having very hot showers can cause this condition.|
|Otitis Externa||This is an inflammatory skin condition of the external auditory canal (the ear canal). The symptoms include redness, swelling, scaling and thickening of the canal skin lining. There are also varying degrees of discomfort, itch, deafness and pus discharge. The most common cause of this condition is bacterial or fungal infection.|
|Perioral Dermatitis||Symptoms of this skin disease include small red, pus-filled bumps around the mouth and sometimes the skin around the nose, cheeks and eyes as well. Misuse or overuse of corticosteroid inhalers, nasal sprays and creams are linked to the cause of this condition.|
|Seborrheic dermatitis||The skin rash appears on areas with a lot of sebaceous glands, hence the name. It can cause scaly patches, red skin, and dandruff, and it can also occur on other areas of the skin, such as the genitals, under the breasts, and in other hairy areas. This usually affects adults and infants. It is also called “cradle cap” when it occurs in babies.|
|Stasis dermatitis||This skin condition is normally develops in people with poor blood circulation, most commonly in the lower limbs and those with congestive heart failure. Inefficient blood circulation in the lower limbs result in pooling of blood and fluid build-up and oedema. This in turn causes scaling, open sores or itchy, reddish skin, especially around ankles. Other symptoms include calf pain and swollen legs. Pregnant women and overweight adults have a higher chance of developing this skin disease.|
Treatments for Dermatitis
Before any treatment is prescribed, your dermatologist first identifies the type of dermatitis you have, as well as its causes. Once identified, steroid creams such as prescription cortiscosteroid are given to most forms of dermatits as they are anti-inflammatory and heal the irritated area of skin. Alternatively, non-steroid creams such as hydrocortisone are prescribed for milder forms of dermatitis; these are called topical calcineurin inhibitor (TCI) creams and are usually prescribed for children above the age of 2.
In the case of seborrheic dermatitis, cleansers such as dandruff shampoos which contain salicylic acid, sulfur and/or selenium are recommended. For contact dermatitis, avoidance of contact with the substance that caused the irritation along with anti-histamines and corticosteroids are recommended.
As dry skin leads to further irritation of the skin, emollients such moisturizers must be used daily to build the protective skin barrier, reduce water loss and reduce the chance of developing dermatitis. Antiseptic solutions along with mild soaps are recommended to cleans the skin and prevent further infection from spreading. Anti-itch medication in the form of anti-histamines may also be given as a complementary treatment. Occasionally, a course of antibiotics is required if there is any evidence of secondary skin infection.
In very severe or extensive cases of dermatitis, oral steroids such as prednisone and prednisolone may be given. as short term solutions as these may have side effects if continued for prolonged periods. Other non-steroidal oral immunosuppressive medications such as azathioprine, methotrexate and ciclosporin may be given if the treatment needs to be ongoing. Phototherapy (UV light) is another treatment option for extensive dermatitis. However, this treatment is usually only reserved for severe cases of dermatitis as there are potential side effects. This treatment involves controlled exposure of the affected area to UV light (UV-A or UV-B) for a few minutes a couple of times weekly for up to several months.