Deep Dive on Dermatitis
As a dermatologist, dermatitis is possibly the most common skin concern I see in my clinic – yet the types, causes, and treatments for this condition often remain unclear to many patients.
In today’s journal, I take a deep dive into dermatitis, sharing my expert perspective on diagnosing, understanding, and treating this inflammation and irritation.
What Is Dermatitis?
Dermatitis is a general term for skin irritation and encompasses a variety of inflammatory conditions. It usually presents as an itchy, dry, and reddened rash, which can appear anywhere on the face or body. In some cases, the skin may become flaky or cracked and may ooze or blister.
Though not contagious, it is often uncomfortable and can impact a person’s confidence.
Different Types And Triggers
There are several types of skin condition that are categorised under this umbrella, each with its own set of triggers. Below, I outline those most commonly seen in my clinic:
Atopic Dermatitis: Also known as eczema, this form typically begins in infancy or early childhood and is often characterised by an itchy, red rash, particularly in skin creases such as the inner elbows, backs of the knees, and wrists.
Causes: Primarily influenced by genetics, especially in individuals with a family history of eczema, asthma, and/or seasonal allergies.
Allergic & Irritant Contact Dermatitis: This type results from direct contact with an irritant or allergen and usually presents as a rash that may burn, sting, itch, or blister.
Causes: Common triggers include metals such as nickel, detergents, and certain fragrances and preservatives in cosmetic products.
Dyshidrotic Eczema: Also called pompholyx, this form is marked by intensely itchy blisters on the hands and feet, which may fluctuate in severity depending on triggers.
Causes: Stress and seasonal changes are common factors, often coupled with a genetic predisposition.
Seborrheic Dermatitis: This type can occur at any age but is most common among infants, adolescents, and middle-aged adults. It typically appears as scaly patches, skin discoloration, and dandruff.
Causes: Thought to be an inflammatory response to excess Malassezia (a yeast that naturally lives on the skin). Certain medical conditions (including Parkinson’s disease, HIV, epilepsy, and depression) may increase the risk.
Stasis Dermatitis: Most commonly seen on the lower legs, this form causes itching, inflammation, discoloration, and, in severe cases, skin thickening and ulcers.
Causes: Often linked to poor circulation, but genetic and environmental factors (such as allergens, irritants, overheating, or sweating) may also play a role.
Perioral Dermatitis: More accurately referred to as periorificial dermatitis, this condition involves small red or flesh-coloured bumps, pustules (white, pus-filled bumps), and scaly, dry patches around the mouth and eyes, which may itch or burn.
Causes: Likely due to a combination of factors, including hormonal changes, skincare products, prolonged use of topical steroids and inhaled steroid sprays, and fluorinated toothpaste.
How To Treat Dermatitis
Treatment depends on the specific type of condition diagnosed, and it is essential to consult a dermatologist before starting any treatment. Below are common treatment approaches for each condition:
Atopic Dermatitis: Typically managed with emollients to soothe and moisturise the skin. Topical corticosteroids help reduce inflammation, and in severe cases, light therapy or oral medications may be recommended.
Allergic & Irritant Contact Dermatitis: Treatment focuses on identifying and avoiding the trigger. TRUE® Patch testing may be used to detect allergens. Emollients and corticosteroids are commonly prescribed.
Seborrheic Dermatitis: Managed with medicated shampoos and antifungal creams, often combined with topical corticosteroids.
Dyshidrotic Eczema: Treated with emollients and topical corticosteroids. In more severe cases, wet dressings, phototherapy, or immunosuppressants may be considered.
Stasis Dermatitis: Treatment aims to improve blood flow and reduce symptoms. Compression stockings, leg elevation, and corticosteroids are typically advised.
Perioral Dermatitis: Treated with topical antibiotics like metronidazole or clindamycin, and sometimes oral antibiotics. Simplifying your skincare routine, discontinuing steroids, and avoiding makeup can help manage symptoms.
My Treatment and Product Recommendations
It is important to consult with your doctor before starting any treatments. However, in addition to the above, there are some over-the-counter treatments that are generally effective for both the face and body. Look for ingredients like shea butter, hyaluronic acid, ceramides, niacinamide, and colloidal oatmeal.
Below are a few of my regular recommendations that can be obtained without a prescription:
Antihistamines: These can be helpful for relieving allergy symptoms or itching associated with some forms of dermatitis, most commonly eczema.
Hydrocortisone: A topical hydrocortisone cream can help reduce irritation, itching, and inflammation. However, it should only be applied to the body – not the face.
Emollients For The Body: E45 Cream is very soothing, helping to repair the skin barrier and reduce dryness and itching. Alternatively, Aveeno Dermexa Daily Emollient Cream contains a high oat content and ceramides to hydrate and relieve irritated skin. Ideally, these should be applied immediately after showering to help retain moisture.
Hand Relief: My Joonbyrd CONFETTI SKY Multitasking Hand Treatment contains niacinamide, hyaluronic acid, and amino acids to deeply replenish moisture and support the healthy function of the skin barrier on hardworking hands.
Emollient For The Face: CeraVe Moisturizing Cream contains three essential ceramides to help maintain the skin’s protective barrier while locking in moisture.
LED Light Therapy: LED light has shown promising results for those suffering with dermatitis. The CurrentBody Skin LED Light Therapy Mask 2.0 is comfortable to wear, with short, 10 minute session times.
