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.
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.
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.
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.
May be ordered to check for signs of allergic conditions, immune system problems, or infections that might be causing or complicating your dermatitis.
Especially for seborrheic dermatitis or if infection is suspected, samples from the skin may be examined for fungal elements or bacteria.
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.
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.
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.
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.
Oral medications that can help control itching, particularly sedating antihistamines at night to help with sleep disrupted by itching.
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.
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.
If there is a secondary bacterial infection from scratching (commonly with Staphylococcus aureus), topical or oral antibiotics may be necessary to clear the infection.
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.
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.
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.
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.
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.
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.
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.
Practice stress-reduction techniques such as deep breathing, meditation, yoga, or progressive muscle relaxation, as stress can trigger or worsen dermatitis flares.
Dermatitis is typically managed with medical treatments rather than surgical interventions. However, certain procedures may be helpful in managing the condition or addressing complications.
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.
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.
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.
If you're experiencing symptoms of dermatitis (eczema), our expert team is here to help you find the right treatment approach for your specific needs.