Dermatitis (Eczema)

Dermatitis, commonly known as eczema, is a group of conditions that cause inflammation of the skin. It typically results in dry, itchy skin with a red rash, though symptoms can vary widely depending on the specific type of dermatitis. The condition is not contagious but can be persistent and recurrent. There are several types of dermatitis, including atopic dermatitis (the most common form, often beginning in childhood), contact dermatitis (caused by direct contact with an irritant or allergen), seborrheic dermatitis (affecting oily areas of the body), and others. While there is no cure for most types of dermatitis, treatments can help manage symptoms and prevent flare-ups.

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What Causes It?

Genetic factors - Family history of dermatitis, eczema, asthma, or allergies increases risk.

Immune system dysfunction - Overactive immune response to triggers.

Environmental irritants - Soaps, detergents, shampoos, disinfectants, or juices from fresh fruits, vegetables, or meats.

Allergens - Dust mites, pets, pollens, mold, or foods like dairy, nuts, or wheat.

Contact with irritating substances - Cleaning products, metals (especially nickel), perfumes, cosmetics, fabric dyes, or poison ivy.

Microorganisms - Bacteria, fungi, or yeast like Malassezia (particularly for seborrheic dermatitis).

Extremes of temperature - Hot or cold weather, high or low humidity.

Stress - Can trigger or worsen symptoms in many types of dermatitis.

Hormonal changes - Can influence seborrheic dermatitis and other types.

Certain medications - Reaction to some drugs can cause dermatitis.

Perspiration - Can lead to irritation, especially in hot, humid conditions.

Dry skin - Makes skin more vulnerable to dermatitis triggers.

Signs & Symptoms

Itching - Often intense, can be worse at night.

Dry, sensitive skin - May crack and flake.

Red or inflamed skin - Ranges from mild to severe.

Rough, leathery, or scaly patches - Texture changes in affected areas.

Swelling - Particularly in areas of intense inflammation.

Oozing or crusting - From scratching or infection.

Dark colored patches - May appear on the affected area.

Raw, sensitive, swollen skin - From scratching.

Raised bumps - May leak fluid and crust over when scratched.

Symptoms vary by dermatitis type:

Atopic dermatitis: Often in skin folds, worse at night with intense itching.

Contact dermatitis: Localized to areas that touched the irritant, can blister.

Seborrheic dermatitis: Greasy, yellow scales in areas with oil-producing glands.

Symptoms may come and go with flare-ups and remissions.

How We Diagnose

Our specialists use advanced diagnostic methods to accurately identify and assess your condition

Physical Examination

A dermatologist will examine your skin, noting the pattern and distribution of the rash, and ask about your symptoms, personal and family medical history, exposures to potential irritants, and your overall health.

Patch Testing

For suspected contact dermatitis, small amounts of potential allergens are applied to your skin under patches. After 48 hours, the patches are removed to check for reactions that might identify specific allergens triggering your dermatitis.

Skin Biopsy

A small sample of affected skin is removed and examined under a microscope to rule out other conditions that can mimic dermatitis, such as psoriasis or cutaneous T-cell lymphoma.

Blood Tests

May be ordered to check for signs of allergic conditions, immune system problems, or infections that might be causing or complicating your dermatitis.

Skin Scraping or Culture

Especially for seborrheic dermatitis or if infection is suspected, samples from the skin may be examined for fungal elements or bacteria.

Allergy Testing

Blood tests or skin prick tests may help identify specific allergens that could be triggering atopic dermatitis flares, though these tests are not always definitive.

Treatment Options

Personalized treatment plans tailored to your specific needs and condition

Topical Corticosteroids

Anti-inflammatory creams or ointments of various strengths that reduce inflammation and itching. For short-term use during flares, with potency tailored to the severity and location of the dermatitis.

Topical Calcineurin Inhibitors

Medications like tacrolimus and pimecrolimus that suppress the immune response in the skin without the side effects of steroids. Particularly useful for sensitive areas like the face or for long-term management.

Emollients and Moisturizers

Regular use of thick creams or ointments helps restore and maintain the skin barrier, preventing dryness and reducing the need for other medications. Most effective when applied to slightly damp skin after bathing.

Antihistamines

Oral medications that can help control itching, particularly sedating antihistamines at night to help with sleep disrupted by itching.

Phototherapy

Controlled exposure to UVB light in a medical setting can improve symptoms of certain types of dermatitis by suppressing the immune response in the skin. Often used when topical treatments aren't effective enough.

Systemic Immunomodulators

For severe, widespread dermatitis, oral or injectable medications that suppress the immune system may be prescribed, such as corticosteroids, cyclosporine, methotrexate, or newer biologics like dupilumab.

Antibiotics

If there is a secondary bacterial infection from scratching (commonly with Staphylococcus aureus), topical or oral antibiotics may be necessary to clear the infection.

Home Remedies

Gentle Skin Care

Use mild, fragrance-free soaps or soap substitutes. Take short, lukewarm (not hot) baths or showers. Pat skin dry gently rather than rubbing. Apply moisturizer immediately after bathing while skin is still slightly damp to lock in moisture.

Regular Moisturizing

Apply moisturizer multiple times throughout the day, focusing on affected areas. Choose thick creams or ointments rather than lotions for better barrier protection. Consider petroleum jelly for very dry areas.

Trigger Avoidance

Identify and avoid personal triggers that worsen your dermatitis, which may include certain foods, environmental allergens, stress, sweating, or specific fabrics like wool or synthetic materials.

Wet Wrap Therapy

For severe flares, apply medication and moisturizer, then cover with a wet layer (like damp gauze or clothing) followed by a dry layer. This increases medication absorption and soothes inflammation. Best done before bedtime.

Itch Management

Keep nails short and clean to prevent damage from scratching. Wear cotton gloves at night if you scratch while sleeping. Apply cool compresses to itchy areas. Distraction techniques can help reduce focus on itching.

Clothing Considerations

Wear loose-fitting, soft cotton clothing. Avoid rough, scratchy fabrics and tight clothing. Wash new clothes before wearing to remove manufacturing chemicals. Use fragrance-free laundry detergent and double-rinse clothes.

Environmental Control

Use a humidifier in dry or winter conditions. Keep the home cool to reduce sweating, which can irritate dermatitis. Use dust-mite-proof covers on bedding if dust mites are a trigger. Vacuum frequently with a HEPA filter vacuum.

Stress Management

Practice stress-reduction techniques such as deep breathing, meditation, yoga, or progressive muscle relaxation, as stress can trigger or worsen dermatitis flares.

Prevention Tips

Moisturize daily, even when skin is clear, to maintain the skin barrier.

Identify and avoid personal triggers that cause flares.

Take only short, lukewarm baths or showers (5-10 minutes).

Use gentle, fragrance-free soaps, detergents, and skincare products.

Pat skin dry gently after bathing, leaving it slightly damp for moisturizer application.

Apply prescription medications as directed, even during remission periods if recommended.

Wear soft, breathable fabrics like cotton; avoid wool and synthetic materials.

Control environmental factors: maintain moderate temperature and humidity levels.

Manage stress through relaxation techniques and adequate sleep.

For contact dermatitis, wear protective gloves when handling potential irritants.

Follow a regular skin care routine, especially during seasonal changes.

Consider food allergy testing if food triggers are suspected.

Keep a symptom diary to identify patterns and triggers.

Stay hydrated by drinking plenty of water throughout the day.

For seborrheic dermatitis, use medicated shampoos regularly as maintenance.

Surgical Solutions

Advanced surgical procedures performed by our expert specialists

No Direct Surgical Options

Dermatitis is typically managed with medical treatments rather than surgical interventions. However, certain procedures may be helpful in managing the condition or addressing complications.

Phototherapy Procedures

While not surgery in the traditional sense, phototherapy involves specialized equipment and medical supervision. UVB light therapy, PUVA (psoralen plus UVA), or newer narrow-band UVB treatments are performed in a controlled medical setting to reduce inflammation in the skin.

Intralesional Steroid Injections

For persistent, localized patches of severe dermatitis that don't respond to other treatments, a dermatologist may inject corticosteroids directly into the affected areas to provide targeted relief of inflammation.

Incision and Drainage

In cases where dermatitis has led to secondary bacterial infection with abscess formation, minor surgical drainage may be necessary to remove purulent material and allow proper healing.

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