Dermatitis—Causes and Treatments
Dermatitis, also referred to as eczema, is a term used to describe
a broad variety of skin irritations that involve inflammation and red itchy rashes.
The condition is not life-threatening and cannot be passed from one person to another
through any sort of contact, though it can have a familial component.
Seen commonly in children, dermatitis is often outgrown by adulthood. However, it
can also be persistent or recurrent, starting early in infancy and affecting an
individual right into adulthood. Certain types are associated with infants, for
example, "cradle cap," whereas others are particularly bothersome for
the elderly, such as "winter itch."
Inflamed red itchy skin is the most general description of the symptoms accompanying
dermatitis. However, blisters, scabbing, scaling, flaking or oozing of the skin
may also be present. The type of rash an individual with this condition experiences
depends on the particular kind of dermatitis from which he or she may be suffering.
Types of dermatitis
There are a variety of names used to describe the different types of dermatitis.
These categories can be based on the location, cause or appearance of the condition.
Sometimes these terms are used interchangeably, which can lead to some confusion,
but in treating it's helpful to identify the basic type before choosing a treatment
plan. Here are the most common types described:
disease of the skin that that may have a hereditary component in individuals who
also have hay fever and asthma. Atopic
dermatis is the most common form of eczema.
Skin irritation includes dry, itchy, red, and cracked skin behind the ears, on cheeks,
arms, and legs.
skin rash resulting from repeated and direct contact with an allergen such as poison
ivy or other irritant-containing substance such as cleaning products. The rash is
very itchy but usually confined to the area of allergenic contact. It can start
with a mild redness and itch then progress to a severe itch with blisters and severe
Hard water dermatitis—(not
technically a type—but, worth of mention in the discussion of dermatitis)
A common cause of dry skin and often a significant contributor to seborrheic dermatitis
(and cradle cap), atopic dermatitis (eczema) and contact dermatitis outbreaks. The
culprit is alkaline (high pH) water that contains high levels of iron, magnesium
and/or calcium ions.
extremely itchy red rash characterized by its coin-shaped patches on the skin. The
discoid patches may contain oozing blisters, scaling, and scabs. It most often affects
the backs of arms and lower legs, as well as the buttocks.
red bumpy rash with blisters and scaling that occurs around the mouth and chin region.
It can resemble and be confused with acne or the skin condition rosacea.
dermatitis with itchy blisters that develop on the sides of the fingers, palms of
the hands, and soles of the feet.
Seborrheic dermatitis/cradle cap—Most
often affects the scalp and face but may be found on other areas of the body where
hair is present. It can present with dry, yellow, greasy, or scaly patches of the
skin sometimes starting as dandruff.
Stasis dermatitis/venous eczema—An
inflammation of the skin caused by the pooling of blood underneath the skin in the
ankles or varicose veins in the lower legs. The inflammation will start in the ankle
and can work its way up to just under the knee. A non-painful but itchy, red scaly
rash can develop. Increased scratching of the rash can cause painful ulcers to develop.
Allergies and dermatitis
In simple terms, dermatitis is the skin's way of reacting to an allergen, irritating
substance, scratching, or severe dryness. Because of the broad spectrum of potential
causes of most forms of this skin disease, an exact cause may go unidentified or
be impossible to determine.
12 common allergens:
- Poison ivy, poison oak, poison sumac
- Nickel (found in hairpins, earrings, and zippers)
- Latex (rubber) products
- Pet dander
- Soy products
Dermatitis that is caused by an allergen or irritant is called contact dermatitis.
Approximately 20% of contact dermatitis cases are the result of allergic reactions;
the other 80% are caused by irritants such as chemicals in the workplace. It can
be difficult to differentiate an allergenic dermatitis from an irritant dermatitis
because the rashes are very similar in appearance, and some chemicals can be allergens,
too. An irritant-caused dermatitis will generally show up on the skin within minutes
of coming into contact with the irritant, and the rash is usually more painful than
itchy. A dermatitis caused by an allergic reaction can take 24—48 hours to
appear, but sometimes will take even longer to develop, with repeated contact with
the allergen required before sensitization takes place and a rash appears.
Allergens are characterized by their ability to invoke an overreaction
from your immune system that causes inflammation. In dermatitis caused by an allergy,
the inflammation is present within the layers of the skin. The offending allergen
could be any one of or several substances found in the environment, originating
from animals, foods, plants, or manmade substances. There have been thousands of
substances identified as potential allergens, but fewer than 30 are responsible
for the majority of allergic and contact dermatitis cases.
Common dermatitis irritants:
- Wool and synthetic fibers
- Detergents and soaps
- Personal hygiene cosmetics, hair dyes, fragrances and perfumes
- Chemicals such as chlorine, solvents, formaldehyde, or mineral oil
An irritant could be any substance that causes skin irritation after direct
contact. The substance usually has to be present in high concentrations or for a
prolonged period of time to cause a dermatitis reaction, but not in all cases.
Diet and dermatitis
Some researchers believe that poor nutrition is an important contributing factor
to many types of dermatitis. But while links between specific dietary deficiencies
and imbalances are apparent, the underlying mechanisms for these associations have
yet to be fully established.
It is known that meat and dairy products contain a proinflammatory fatty acid called
arachidonic acid (AA). As part of the body's natural healing process, this
acid is converted into the potent mediators of inflammation known as leukotrienes,
prostaglandins, and thromboxanes. Inflammation is one of the body's
natural responses to a threat, but poor diet can lead to an imbalance between proinflammatory
and anti-inflammatory molecules, contributing to inflammation that is out of proportion
to the threat. Chronic inflammation can manifest downstream in a host of health
problems, including skin disorders such as dermatitis.
Diets containing trans fats (hydrogenated vegetable oils) or high in saturated animal
fats have also been linked to thickening of the blood, putting greater pressure
on the arteries, which can further add to skin inflammation associated with dermatitis.
Foods high in saturated fats may also contain high levels of toxins associated with
Studies have shown significant improvements in dermatitis patients who lower their
intake of trans fats and saturated animal fats, particularly when supplemented with
the group of essential fatty acids known as omega-3 fatty acids. Essential
fatty acids (EFA's) counterbalance pro-inflammatory molecules such as AA in the
inflammatory cascade, which can lessen dermatitis symptoms such as itching and scaling
of the skin. The best sources of fatty acids are cold-pressed vegetable oils like
extra-virgin olive oil, freshly ground flaxseed, and wild-harvested cold-water fish
and other seafood.
Many patients who adopt a vegetarian, vegan, or Mediterranean diet that is high
in EFA's and fresh fruits and vegetables see marked improvement in their symptoms.
Here are 10 additional nutritional steps to healthier skin:
Investigate any food allergies or sensitivities by using a food diary. Record foods
that you ingest on a daily basis and any reactions you may have, paying particular
attention to the skin. Eliminate all foods you may suspect for at least a couple
weeks, then slowly re-introduce them one by one, watching closely for any reactions.
If there are no reactions, they may be considered safe. If you experience reactions
they should be completely eliminated from your diet.
The eight most common food allergy culprits are dairy products, eggs, peanuts, tree
nuts, soy, wheat, fish, and shellfish. Many other foods that can evoke an allergenic
response, however, such as acidic fruits (including tomatoes) and innumerable others.
Limit fatty red meats and consider buying organic, grass-fed, leaner meats.
Avoid trans fats whenever possible, as they are pro-inflammatory.
Sugar is another common ingredient in our diets that can cause skin irritation,
so all sugary foods such as soft drinks and juice should be limited.
Avoid or limit alcoholic beverages.
Most processed foods contain chemicals that lengthen their shelf life; many of these
are considered toxins that can cause skin irritation, and they should be limited
or altogether avoided.
Increase your intake of EFA's through cold-pressed virgin vegetable oils and seafood.
Drink a liter and a half of water daily to aid in flushing toxins from your tissues.
Your healthy diet should consist of at least five helpings of fresh veggies per
day, brown rice, lean meats, wild-harvested fish (unless you are allergic), and
plenty of water.
Steroid treatments for dermatitis
Steroidal topical ointments are the most commonly prescribed treatment for dermatitis.
All steroid ointments, except hydrocortisone cream, need to be prescribed by your
doctor. They come in various strengths and are rated I (strongest) through VII (weakest).
These creams work by constricting the blood vessels in the upper layer of the dermis.
This constriction reduces the itching and inflammation associated with dermatitis.
When the itching and inflammation subside, so do most of the other symptoms. The
stronger the cream, the more the blood vessels will be constricted.
Steroid creams are effective in reducing the symptoms of dermatitis; however, they
do not come without side effects. Working closely with your doctor and being fully
aware of these side effects is the best way to minimize your risk and get the best
results from this type of treatment. Some of the most common side effects are:
Tachyphylaxis—When the skin builds up a tolerance
to the strength of steroid you are using, it can lead to an inability of the blood
vessels to constrict, and you may then require a stronger prescription. This can
occur after four or more days of continued applications three times per day. Stopping
use for four or more days will generally allow your blood vessels to regain their
ability to constrict.
Steroid rosacea—Fair-skinned people are the most
commonly affected by this side effect. It occurs when a tolerance to the steroid
is built up in the skin, leading to a return of the facial flushing and the need
for a stronger prescribed cream. Any attempt to cut back or stop the steroid generally
leads to a return of the flushing.
Skin atrophy—Repeated use of steroid cream in the
same area leads to progressive thinning of the skin. The skin can become lax, wrinkled,
shiny and depressed below normal levels. Stopping the steroid will reverse most
of these effects, but it can take months for the skin to re-thicken.
Striae/stretch marks—These occur when steroid cream
is applied to areas of the body where skin touches skin, e.g., armpits or groin.
Once stretch marks of the skin appear they are irreversible, and oftentimes become
irritated to the point where they need their own treatment. The best approach when
this happens is to stop the use of steroidal cream to arrest further damage.
Topical steroid allergy—Testing has revealed that
4—5% of people with dermatitis who are prescribed steroidal creams experience
an allergy to components of the cream itself. Those using multiple prescriptions
or over-the-counter medications who have chronic skin conditions are at greater
risk for an allergic response to topical steroids. It is recommended that the use
of these creams be stopped if you experience an allergic reaction.
Alteration of immunity—Steroids alter the way your
immune system works, so the skin can become more vulnerable to bacterial or fungal
infection with their use. If the cream is then applied to skin overtop a bacterial
or fungal infection, it can cause it to become more irritated.
Glaucoma—There are isolated reports of links between
steroids (even topical kinds) and glaucoma. Glaucoma is an infection inside the
eye which causes increased pressures on the optic nerve and if left untreated can
lead to blindness.
Probiotic treatment for dermatitis
Probiotics are "good" bacterial organisms, such as Lactobacillus
and Bifidobacterium, that live in our digestive tracts and help ward off
diseases, manufacture vitamins, and improve nutrient uptake. Our beneficial gut
flora can be killed or weakened due to overuse of antibiotics, infection, competition
with pathogens, or other stresses. When this happens our bodies become more vulnerable
to disease. Fortunately, probiotics can be supplemented into our diets to aid the
body in preserving healthy levels of good bacteria.
In a 2005 Australian study of 56 children suffering from severe atopic dermatitis
(AD), those given equal amounts of probiotics twice daily for a period of eight
weeks were found to have milder atopic dermatitis in comparison with those taking
the placebo. According to the authors, the contribution the study made to scientific
understanding was threefold: it was the first to show benefit with probiotics in
under-two-year-olds with moderately severe AD; the beneficial effects were still
apparent two months after the supplementation was ceased; and their observations
provided further evidence for a role of probiotics in the management of this skin
Here in the States, Dr. Sharon Glick, Director of Pediatric Dermatology at Kings
County Hospital Center and SUNY Downstate Medical Center, both in Brooklyn, New
York, performed her own small study on nine children under the age of eight with
severe atopic dermatitis. She likewise found that the group taking probiotics had
a greater reduction in symptoms than those taking the placebo. To her surprise,
those that had the more severe cases improved more quickly than those with less
Dr. Glick and others believe that those suffering with atopic dermatitis have increased
levels of intestinal permeability. This means that the intestines' ability to function
as a barrier to toxins and irritants of all kinds is compromised, which may contribute
to the development of atopic dermatitis. According to Dr. Glick, probiotics have
been shown to reverse increased intestinal permeability, modulate the mucosal immune
response, and decrease inflammation in infants with food allergies. Instituting
the probiotics thereby boosts the intestines' ability to function as a barrier,
resulting in the reduction of atopic dermatitis symptoms.
To date, most of the studies evaluating the effect of probiotics on atopic dermatitis
have been done on children, not adults; therefore, it is not known whether adults
suffering from AD would derive the same positive results. Indications are good that
there is a role for probiotics in the clinical management of food allergy and atopic
dermatitis, but more research is needed to establish which beneficial organism work
best and for whom.
Clearly, taking probiotics is a great way to generally boost your immune system
and protect your digestive system. If you suffer from atopic dermatitis, it is suggested
you talk to your dermatologist about adding probiotics to your treatment plan.
Traditional Chinese treatments
Traditional Chinese Medicine (TCM) is an alternative healing practice that can be
effective for treating dermatitis. A course of TCM may include herbal preparations
in oral, topical, or injectable form; acupuncture; auriculotherapy (ear acupuncture),
and other treatments. The emphasis in Chinese herbal medicine is on combinations
of different herbs based on the individual and their specific condition. The three
basic functions that Chinese herbal medicines perform are detoxification and elimination,
health building, and health management and maintenance. The aim is to correct imbalances
throughout the body, not just in the skin.
One of the first Western studies evaluating the use of Chinese herbal medicine to
treat dermatitis was conducted in London on both children and adults. Patients were
given a daily herbal mixture of ten different herbs for a period of two months.
The researchers found that compared to the control patients, those taking the herbs
had significant improvement of scaling, redness, inflammation, itching, and other
symptoms. Most importantly, they followed up with those patients who continued to
use the herbal medicine, and a year later found that their improvements had continued.
Those who discontinued use had declined and experienced a return of symptoms. Lastly,
they found that those continuing their use of the herbs were able to minimize their
dose and eventually discontinue the treatments without reoccurrence of symptoms.
As effective as Chinese herbal medicine can be, it is important to note that there
have been cases of serious side effects. Liver and kidney toxicity have been reported
as a result of taking a regimen of Chinese herbal medicine. There have been cases
of both liver and kidney failure, resulting in transplants and even death. Unfortunately,
because of the high variance in the herbs used in these cases, it has not been determined
which herbs caused the toxicity.
The herbs used in traditional Chinese medicine are not regulated by the US FDA,
so contamination and impurity are potential concerns. Nonetheless, many dermatologists
and other medical providers in the US are becoming increasingly familiar with Chinese
herbal medicine due to high demand for effective alternative healing modalities.
When making a decision about whether to use this form of alternative medicine, it
is important to work closely with a qualified practitioner and make certain you
are being screened for any toxicity that may arise.
The leaves of the tea plant, a native to the Orient, have also been found helpful
for treating dermatitis. A study in Japan showed that drinking tea can lead to moderate
improvement in symptoms. Over 100 patients with recalcitrant (not responding to
treatment) dermatitis symptoms were instructed to drink tea three times daily so
the total amount equaled one liter. (The type used was oolong tea, a specialty tea
produced by partial oxidation of the tea leaf, intermediate between the process
for green and black teas.) Positive results were shown after one or two weeks, with
moderate improvement coming after a month. Tea does contain caffeine, which can
increase anxiety levels in certain people. Anxiety has been noted to trigger dermatitis
outbreaks, so tea should be taken cautiously, or decaffeinated version sought out.
Decaffeinated teas may contain a lower concentration of the antiallergic constituents,
Western herbal medicine treatments
Whesterners have also used herbs for centuries to heal and cleanse the body. Many
herbalists and homeopathic doctors believe that herbs can help cleanse toxins from
our systems, strengthening our bodies and allowing us to head off a case of dermatitis.
Herbs are thought to be effective through several different healing pathways. For
example, burdock and red clover are liver tonics, which when taken orally can help
the liver to filter toxins from the blood. When the liver is filtering effectively
the skin is healthier. Calendula flowers, licorice root, and ginkgo all have antiseptic
and anti-inflammatory properties. They can be applied topically in lotion, oil or
ointment form to the affected area to reduce itching and inflammation. The gel from
Aloe vera plants, the juice of plantain leaves (Plantago officinalis)
or a poultice of the leaves themselves can also be applied topically to the affected
areas to help soothe skin irritations associated with dermatitis.
Other natural herbal treatments can be prepared to help relieve the itching associated
with dermatitis. Recipes for topical pastes may include:
- Green clay and goldenseal root in equal parts
- Equal parts salt, water, clay, and peppermint oil
- Calamine lotion
- Coal tar lotions, shampoos, bath oils
To help soothe irritated skin you can steep a chamomile tea bag in hot water for
several minutes, allow it to cool slightly, then place it on the irritated skin
for a couple of minutes. This may provide some relief to the area and can be repeated
Topical evening primrose oil (EPO) is another herbal extract found helpful by some
for dermatitis conditions. Studies have not fully established its efficacy, however,
with disappointing results in some and encouraging results in others. Among other
variables, it is quite possible that the method in which EPO is applied greatly
affects outcome. In a study done in Germany, the authors found that an emulsion
of EPO in water worked best to speed healing of the skin layers.
Our diets don't always provided all the necessary supplementation our bodies require
to be effective in fighting off infections. Certain supplements have been found
safe and helpful for improving dermatitis.
The vitamin B group as a whole is responsible for assisting in the metabolism of
proteins and fats in our food. It also plays a vital role in countering stress and
overall support of a healthy nervous system. A compromise in any one of these areas
can trigger dermatitis. Taking a high-quality supplement containing the full vitamin
B-complex, by supporting these everyday functions, may help prevent dermatitis attacks.
Those that suffer from dermatitis have also been shown to have lower levels of the
particular B vitamin known as folic acid, or vitamin B9. Increasing folic acid intake
may help to improve symptoms. B9 can be taken in supplement form but is also found
in abundance in legumes such as lentils; dark green leafy vegetables such as spinach,
parsley, turnip and mustard greens; broccoli, beets, asparagus, and romaine lettuce;
and calf's liver.
Vitamin E and selenium are antioxidant nutrients that support metabolic processes
and healthy skin. They delay the process of oxidation of fatty acids, which play
a key role in healthy skin. Vitamin E can be found in raw nuts and seeds, virgin
vegetable oils, and soybeans. Selenium can be found in onions, cabbage, broccoli,
celery, and whole grains. Both can be taken orally through supplementation.
A lack of zinc has been associated with dry skin and lack of circulation, both of
which can play a role in worsening dermatitis. Brewer's yeast, pumpkin seeds, and
whole grains are foods rich in zinc. It is also available in supplemental form.
Some dermatologists and nutritional experts have suggested that balancing the ratio
of omega-3 to omega-6 fatty acids in the diet is key in treating dermatitis. Studies
have been conducted on the effect of supplementing with plant extracts such as evening
primrose oil (EPO) and borage oil. These particular oils are high in the essential
fatty acid known as gamma linolenic acid (GLA). Although there was a very
plausible mechanism to explain why supplementation with this essential fatty acid
might help resolve atopic dermatitis, and numerous studies have been conducted,
the results have become muddled in publication. Ultimately, it appears neither borage
oil nor evening primrose oil on their own are fully effective, although some individuals
may certainly find them helpful.
10 Lifestyle changes to help dermatitis
The best treatment for dermatitis is to first identify the type you are suffering
from. Each type is unique to itself and therefore its treatment may also be. However,
even if your type is unknown there are some general lifestyle changes you can make
and skin care guidelines you can follow that may improve your condition.
Keep your skin moisturized. Dry skin leads to cracking, and when your skin is cracked
it loses its ability to act as a protective barrier, even against dermatitis.
Over-the-counter topical antihistamines can greatly reduce the itching associated
with dermatitis. When the itching stops the inflammation is reduced, and the symptoms
associated with the dermatitis will subside.
Identify and avoid contact with anything that can irritate and dry the skin leading
to dermatitis conditions.
Treat other rashes, e.g., fungal infections, even though they may seem unrelated
to the dermatitis.
Limit scratching and keep fingernails short to avoid skin abrasions from scratching.
You can try using a cold compress to ease the itch and reduce the inflammation.
Avoid activities that cause sweating and overheating, as they can trigger the start
of the scratching cycle.
Wear loose-fitting cotton clothing, as it tends to be more comfortable for the skin.
Use fragrance-free detergents, and double-rinse clothing to remove any residual
Reduce stress, as it is thought to be a common cause for dermatitis flare-ups.
Natural topical treatment of dermatitis
DermaHarmony's Skin-Plaque Solution™ Spray
containing pyrithione zinc is among the most natural and effective forms of treatment
of various types of dermatitis without a prescription or the use of steroid creams.
It can usually restore the skin's appearance within 10 to 14 days.
The main ingredient in Skin-Plaque Solution is
pyrithione zinc, which for centuries has been recognized for its unique
healing properties. Pyrithione zinc has a number of qualities that may be helpful
in alleviating dermatitis symptoms. It is an antiseborrheic, which means that it
helps to prevent or relieve excessive secretions of the sebaceous glands. These
glands lie beneath the skin their function is to soften and lubricate the skin and
hair. When sebaceous glands become overactive, an outbreak of dermatitis can be
Pyrithione zinc also has antifungal and antibacterial properties, which may help
reduce skin inflammation associated with dermatitis. Topical zinc pyrithione is
generally recognized as a safe and effective treatment for reduction in the symptoms
associated with dermatitis.
If you suffer specifically from a seborrheic dermatitis, most often referred to
as dandruff or cradle cap, DermaHarmony's
Skin-Plaque Solution™ Shampoo is a safe and effective treatment. For
dandruff or seborrheic dermatitis that is severe and requires a more aggressive
treatment, we offer Skin-Plaque Solution™
Advanced Salicylic Acid Therapy Shampoo.
Natural supplementation treatment of dermatitis
Here at DermaHarmony we promote the healing of the digestive tract, good nutrition,
and supplementation for supporting ideal skin health and reducing inflammation in
the body. If you suffer from any form of dermatitis you should consider the nutritional
aspects of cleansing programs, as offered in our
DermaEssentials™ and DermaDetox™
Next to the digestive tract, your body's greatest elimination potential is through
your skin. When our digestive tract is over-run with toxins the body may store them
in fat cells or try to eliminate them through the skin. Therefore toxins can be
sitting on our skin all day, causing dermatitis irritations. Supporting a clean
inside through regular detox can lead to cleaner skin and thereby reduced dermatitis
You can try DermaHarmony products risk-free for 30 days. All orders come with a
full 37-day money-back guarantee. Read on for the answers you seek, then give us
a call at 1-800-827-3730 if you would like additional guidance.
How We Help
At DermaHarmony, our goals are to educate chronic skin care suffers about dermatology, share what contributes to health and wellness, and support our readers in any way we can. Our programs promote healthy skin with nutritional supplements, topical treatments and dietary guidance. Learn more about our programs or call us toll-free at 1-800-827-3730. Our Support Desk is open 9:00 a.m.–6:00 p.m. ET, Monday-Friday.
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Most visited articles on Dermatitis
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Seborrheic Dermatitis and Cradle Cap
Seborrheic dermatitis (SD) is a very common, intermittent skin condition characterized
most often by itchy flaky scales on the scalp. Red flaking skin may also be found
on the face or behind the ears. Often referred to as cradle cap when affecting infants,
many adults—especially those between the ages of 30 and 60—experience seborrhea
or SD as well.
Dermatitis - General
Dermatitis, also referred to as eczema, is a term used to describe a broad variety
of skin irritations that involve inflammation and red itchy rashes. The condition
is not life-threatening and cannot be passed from one person to another through
any sort of contact, though it can have a familial component.
Contact dermatitis, which is inflammation caused by direct contact with an irritant
or allergen, is one of the most common types of skin irritations. It is sometimes
referred to as "occupational dermatitis," as it is very common in occupations where
individuals come into frequent contact with irritants and allergens.
Nummular dermatitis is an inflammatory skin irritation characterized by its round,
coin-shaped lesions. Sometimes referred to as discoid eczema, it affects approximately
2 in every 1000 people in the United States and is most prevalent in middle-aged
Stasis dermatitis is an inflammatory skin condition that develops secondary to fluid
build-up, or blood pooling (stasis), just under the skin as a result of problematic
Perioral dermatitis is a common facial skin irritation affecting the skin around
the mouth, extending at times upwards or outwards onto the cheeks, and less commonly
around the eyes or forehead.
Dermatitis—Causes and Treatments—Reference
Documents and Further Reading
Principal Authors: DermaHarmony Editorial Staff
Date of Publication: 03/20/2008