Dermatitis

Dermatitis simply means skin inflammation, but it embraces a range of ailments. In most cases the early stages are characterized by dry, red, itchy skin, although acute attacks may result in crusty scales or blisters that ooze fluid. Since many agents can irritate the skin, a doctor will try to narrow the diagnosis to a specific category of dermatitis, even though treatment is similar for most types of skin irritation and inflammation.

Causes

The following are the most common general types of dermatitis and their typical causes:

Contact dermatitis typically causes the skin to develop a pink or red rash, which may or may not itch. Pinpointing the exact cause of contact dermatitis can be difficult. Among plants, the leading culprits are poison ivy, poison oak, and poison sumac, although contact with certain flowers, herbs, fruits, and vegetables irritates some people. Common chemical irritants include detergents, soaps, chlorine, some synthetic fibers, nail polish remover, antiperspirants, and formaldehyde (found in permanent-press fabrics, polishes, artificial-fingernail adhesive, particle board, and foam insulation). Wearing rubber gloves, unwashed new clothes, or plated jewelry can also cause contact dermatitis. The inflammation is frequently caused by cosmetics and skin-care products.

Nummular dermatitis consists of distinctive coin-shaped red patches that are most commonly seen on the legs, buttocks, hands, and arms of people 55 or older. Living in a dry environment or taking very hot showers can cause this condition, as can stress and other skin disorders.

Seborrheic dermatitis consists of greasy, yellowish scaling on the scalp and other hairy areas, as well as on the face or genitals, and in skin creases along the nose, under the breasts, and elsewhere. This ailment can be associated with a biotin deficiency in infants-where it is known as cradle cap-or with overproduction and block-age of oil glands in adults. It may be aggravated by stress and is common in AIDS patients.

Stasis dermatitis is caused by poor circulation. Veins in the lower legs fail to return blood efficiently, causing pooling of blood and fluid buildup. This leads to unhealthy skin growth and irritation, especially around the ankles.

Atopic dermatitis, or eczema, causes the skin to itch, scale, swell, and sometimes blister. Eczema usually runs in families and is often asso-ciated with allergies, asthma, and stress.

For information about other types of skin disorders, see also Diaper Rash, Hives, Impetigo, Psoriasis, Rashes, Scabies, and Shingles.

Diagnostic and Test Procedures

Most types of dermatitis can be diagnosed by a doctor's observation of the irritation and its location on the body. Sometimes a skin scraping will be taken for microscopic analysis.

To identify causes of contact dermatitis, a doctor may try patch tests, applying suspected irritants to areas of skin on the back. If no inflammation develops after two to four days, the doctor applies other potential irritants until the cause is clear.

Treatment

The first step in treating dermatitis is identifying and eliminating the cause. Most mild skin inflammations respond well to warm baths followed by application of petroleum jelly or over-the-counter hydrocortisone cream. Seborrheic dermatitis may respond to coal-tar-based shampoo; avoid sunlight for the first few hours after using it, since it increases the risk of sunburn on the scalp. Once irritants causing contact dermatitis are identified, treatment will be based on avoidance, allergy relief, or other coping mechanisms. To help dry the sores of nummular dermatitis, soak the area in salt water, then apply a corticosteroid cream. If you suffer from stasis dermatitis, wear support stockings and rest frequently with your legs elevated to help improve circulation.

Conventional Medicine

To reduce inflammation and heal the irritation of most types of dermatitis, a doctor usually recommends over-the-counter or prescription cortico-steroid cream, and might prescribe an oral anti-histamine to relieve severe itching and an antibiotic if a secondary infection develops. Severe cases of seborrheic dermatitis may call for cortico-steroid injections. Stasis dermatitis may involve treatment with tar or zinc paste, which must stay on the sores for up to two weeks; this technique requires bandaging by a trained professional.

Alternative Choices

Because many forms of dermatitis are chronic, most alternative therapies seek only to relieve the symptoms-itchiness, burning, and swelling.

Herbal Therapies

Over the centuries, countless herbs have been used to treat skin ailments. Picking out what's right for your condition can be difficult, so seek help from a trained practitioner. Here are some substances herbalists consistently recommend.

Burdock (Arctium lappa) boosts the immune system and helps reduce inflammation. Brew tea using 1 to 3 tsp of dried root per cup of boiling water, or take up to 1½ tsp of tincture daily.

Some practitioners believe evening primrose oil (Oenothera biennis) works as well as cortico-steroids for itchy skin and has fewer potential side effects, but the recommended dose of 500 mg three times a day can be costly. People with liver disease or high cholesterol should use it only under medical supervision; pregnant women should not use this treatment because it can affect their estrogen and progesterone levels.

Topical ointments made with calendula (Calendula officinalis) or chamomile (Matricaria re-cutita) are effective for treating many types of dermatitis. You can make another herbal remedy by mixing tinctures of nettle (Urtica dioica), cleavers (Galium spp.), and either goldenseal (Hydrastis canadensis) or myrrh (Commiphora molmol) in equal parts; take up to 1½ tsp a day. You can also make a tea from fresh nettles or fresh cleavers-1 tbsp of the herb steeped in a cup of boiling water-and drink three or four cups a day.

Warning: In some cases an allergy to nettle will worsen atopic dermatitis (eczema).

Homeopathy

For benign, short-term skin problems, an over-the-counter Calendula cream may soothe the in-flammation. Taking Rhus toxicodendron (12x) three or four times a day may relieve the itching of contact dermatitis. If you have a chronic form of dermatitis, a homeopath will investigate every-thing from your sleep patterns to your family history before recommending a remedy.

Light Therapy

When certain chronic types of dermatitis do not respond to conventional corticosteroid or coal-tar treatment, many doctors recommend using ultraviolet (UV) rays from an artificial light source. In light-therapy treatments, patients ex-pose the affected areas under a sunlamp, which emits UV radiation, for a prescribed period of time. In nearly all cases, the skin clears consider-ably in a matter of weeks.

Despite its apparent effectiveness, light therapy has its drawbacks. At four to eight sittings a month, treatment can be time-consuming for the patient and relatively expensive. Light therapy may cause premature aging of the skin and increase a person's risk of developing skin cancer. In some instances, the dermatitis can recur with-in a year.

In severe or persistent cases, the treatment can be supported with drug therapy. Light therapy supported with an oral medication called psoralen has good long-term results but carries additional risks.

Treatment with psoralen can cause liver problems in some patients; close monitoring by a physician is necessary. Pregnant women should avoid drug-supported light therapy altogether, since psoralen can cause fetal deformities. Women undergoing such therapy should wait several months after stopping treatment be-fore trying to become pregnant.

Some people try to avoid the doctor's office or hospital by using a tanning salon as their source of UV radiation. They won't find the healing rays they seek, however. Because of concerns about the risks of skin cancer, tanning salons must filter out the type of UV rays used in light therapy.

Even patients who own a sunlamp or who can find UV radiation commercially should rely on a doctor's care. Only a qualified physician can tell you how much UV radiation you can tolerate without risking long-term damage to your skin.

Mind/Body Medicine

Since some cases of dermatitis may be stress related, relaxation techniques such as yoga may be effective, particularly for atopic and seborrheic dermatitis. Guided imagery can also help: You create and control an image opposite to the physical manifestation of the ailment. For example, if you have a red, dry rash, imagine applying a soothing blue ointment to the affected area. This technique works best if you close your eyes and ears to outside stimuli and concentrate all your senses on the image in your mind; you need to smell the ointment, see the healing, and feel the relief.

Nutrition and Diet

Because some patients with seborrheic dermatitis are believed to have difficulty metabolizing fatty acids necessary for promoting the body's anti-inflammatory response, a doctor may suggest 50 mg of vitamin B complex twice daily. Vitamin A (25,000 I U a day) and zinc (50 to 100 mg a day) may aid in skin healing, while vitamin E ointment or capsules (200 to 400 IU a day) can help relieve itching and dryness. To avoid the risk of overdose, particularly of fat-soluble vitamins, have your doctor check dosages carefully and monitor your progress; a pediatrician must assess any vitamin supplements given to a child.

At-Home Remedies

Over-the-counter oatmeal or cornstarch preparations mixed into a warm bath may soothe the skin and relieve itching. Take care not to stay in the bath too long, because lengthy immersion can strip sensitive skin of essential oils.

For dryness, rub petroleum jelly or vegetable shortening on affected areas after a bath, or use a topical ointment containing aloe (Aloe barbadensis) or zinc.

Avoid eating potential allergens, such as milk, eggs, and wheat. You may get help from supplemental vitamins A, B complex, and E, as well as zinc.

If you suspect an allergy to a chemical or cosmetic, try an at-home patch test. Apply a small amount of the suspected irritant to a spot on your arm or back for seven days. If you have a reaction, you know it is a potential irritant.

Prevention

The best way to prevent a rash caused by contact with toxic plants like poison ivy is to wash the ex-posed skin with soap and water as soon as possible after contact. Most other cases of dermatitis develop in people with sensitive skin and can be prevented only by avoiding the irritant. If you have atopic or seborrheic dermatitis, for example, you have a higher-than-average chance of being allergic to nickel in jewelry or to getting dry skin during the winter. Fair-skinned people seem especially prone to skin problems. If you feel you are at risk, consider these preventive steps:

Use a humidifier at home and at work to keep the air from getting too dry.

Wear loose-fitting, natural-fiber clothing; untreated cotton is ideal.

Avoid plated jewelry, especially in your ears, to prevent nickel-related rashes. Surgical steel or 14-karat gold earring posts are safer choices.

Don't wear a watchband that presses against your skin for long periods; the friction and sweat buildup can cause rashes.

Supplement your diet with vitamins A, B complex, and E, and zinc.

Lubricate your skin after a bath using an unscented, preservative-free lotion or ointment.

Source : Alternative Medicine.

Symptoms

Dry, reddish, itchy skin indicates some type of dermatitis, or skin inflammation, of which there are many types.

A red rash that limited to the area of skin exposed to an irritant is probably contact dermatitis, an allergic reaction.

Red, itchy, circular patches of weeping, scaly, or encrusted skin signal nummular dermatitis, common in older people who have dry skin or live in dry environments.

Greasy, yellowish scales on the scalp and eyebrows, behind the ears, and around the nose indicate seborrheic dermatitis; in infants it is called cradle cap.

Scaling, greasy-looking, sometimes ulcerated skin appearing inside the lower legs and around the ankles may indicate stasis dermatitis. Extreme, persistent itchiness may indicate stasis dermatitis.

Extreme, persistent itchiness may singal atopic dermatitis, or eczema.

Call Your Doctor If :

your skin has oozing sores or other signs of infection. You may need treatment with antibiotics or other drugs.

the affected skin does not respond to treatment with over-the-counter creams or medicated shampoos. You should have a medical diagnosis and treatment.

during a flareup of eczema you are exposed to anyone with a viral skin disease such as cold sores or warts.

You are at increased risk of contracting the viral disorder.

Caution!

The Cosmetic Connection

If a rash develops on your face, neck, lips, scalp, or hairline, the prime suspects could be among your cosmetics or other skin-care aids, including perfume, deodorants, antiperspirants, shampoos, toothpaste, mouthwash, and aftershave lotion. The irritating ingredient in makeup and skin products is usually a scent or a preservative, but be wary of "unscented" products, too; they may contain chemicals that neutralize natural odors but that can also irritate your skin.

The claim that a cosmetic or skin-care product is "hypoallergenic," "organic," or "nonallergic" can be similarly misleading, since no product can be risk free for everyone. If you have sensitive skin, keep your cosmetics and skin-care aids simple and rely on unscented products.

Men Just Don't Get Some Types of Rashes

Paradoxically, unisex fashion trends have uncovered an unsuspected difference between the sexes. Men who wear pierced earrings or other forms of jewellery are far less likely than women to develop contact dermatitis from the nickel m plated jewellery. A team of scientists found that 12 percent of the 15-year-old girls in their study were sensitive to nickel, while less than 2 percent of the young men in a later study had a similar problem. Differences in the types of jewelry the two groups wear may account for some of the disparity, but the researchers also suspect that male and female hormones may playa; real but undetermined role.

Similar of Dermatitis

Atopic Dermatitis Tied to Sleep Disturbances in Children

Atopic Dermatitis Tied to Sleep Disturbances in Children Improved Sleep may be an Important Treatment Focus Atopic dermatitis (AD), or eczema, can cause more problems than just chronically red, itchy skin. According

Skin Cancer: Tips to Keep Your Skin From Harm

Skin Cancer: Tips to Keep Your Skin From Harm Medical experts continue to track the rise of malignant melanoma -- a type of deadly skin cancer that was once rare but is now increasing faster than any other

Prevent Skin Cancers

The UAB Comprehensive Cancer Center is leading a national research study of a drug that may aid in the repair of sun-damaged skin and in turn prevent the

Fixes For Skin Problems

To keep skin clear & free of problems, eating right plays a big part. Certain skin problems like acne & eczema can be seen as an attempt by the body to

Topical Skin Medications

Topical Skin Medications Virtually all skin medications are either topical or systemic. Topical medications are applied directly to the affected area of the skin. Systemic medications

Disorders and Diseases of the Skin

Causes The causes of skin diseases are very numerous, since the skin may be injured by many factors which do not affect the inner organs and tissues. There may

Diet to Promote Health of the Skin

Skin problems range from the simple to the complicated including serious infections and cancer of the skin. The skin also reflects a person's state of health

Topics:

Comments

Post new comment