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- What is dermatitis?
- Symptoms of dermatitis
- Causes of dermatitis
- Prevention of dermatitis
- Risk factors for dermatitis
- Complications of dermatitis
- When to see a doctor about dermatitis
- Diagnosis of dermatitis
- Conventional treatment of dermatitis
- Alternative/complementary treatment of dermatitis
- Living with dermatitis
- Caring for someone with dermatitis
Conventional treatment of dermatitis
Conventional treatment of dermatitis involves a combination of avoiding the allergen (or irritant) to prevent flare-ups from occurring in the first place, other lifestyle modifications, together with medication for treating any flare-ups of symptoms.
Prevention - reduce exposure to allergen
- Allergy testing - it is really advisable for people with dermatitis caused by an allergic reaction to an allergen to have allergen testing (skin prick test). This will help to identify which allergen(s) are causing the dermatitis symptoms
- Avoid the allergen(s) - it is recommended to avoid any known allergens which can trigger dermatitis symptoms. Commonly known allergens which should be avoided are: pollen, plants, dust mites, pet fur and animal dander
Prevention - reduce exposure to irritant
- Avoid the irritant - it is advisable to avoid any of the known irritants which can trigger the dermatitis symptoms. Commonly known irritants which should be avoided are: certain fabrics (especially wool), perfumes, cosmetics, cleaning products, soaps, shampoo, environmental chemicals, cigarette smoke, cosmetics
- Identify the irritant - it is advisable to take note of any worsening of symptoms after application of lotions and creams, or exposure to any environmental chemicals, certain fabrics as well as any other known irritants. This will help to identify the irritants and will enable avoidance of the irritant
Lifestyle modifications
- Avoid having hot baths or showers - very hot water can aggravate the dermatitis symptoms by creating further inflammation and should be avoided. When there are visible dermatitis symptoms on the skin, have a lukewarm or cooler (in summer) bath or shower and bathe as quickly as possible, as the warm water will dry the skin out quite quickly and this can make the symptoms of dermatitis worse (moisturise the skin straight after a bath or shower to prevent this)
- Don't scratch the skin - avoid scratching or rubbing the dermatitis lesions/lumps/blisters as this will only make the itchiness worse, will inflame the skin further and will make symptoms worse and possibly spread the dermatitis over a larger area of the skin
- Moisturise the skin - it is really important to reduce the dryness of the skin, especially after having a bath or shower. Moisturise the skin every day with a gentle, mild moisturiser that is as natural as possible (most organic skin care products contain less chemicals and are less likely to irritate the skin, but try to use one without too many perfumes as that can also irritate the skin)
- Protect the skin - in order not to irritate the dermatitis affected skin, it is advisable to wear light, natural fibres (not wool, unless it is lined) as this can prevent irritation of the skin from rough material fibres
- Reduce stress - research suggests that stress can aggravate dermatitis flare-ups, so it may be beneficial to engage in stress management techniques
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Helpful hints for parents of children with eczema
Babies, infants and young children tend to present with most cases of dermatitis and the following is useful some advice for parents:
- Cut fingernails - always keep the child's fingernails very short to prevent the child from being able to scratch the dermatitis lesions too much and make symptoms worse
- Keep the child cool - hot weather, hot baths, hot showers and hot climates will aggravate dermatitis symptoms, so always bathe the child in lukewarm water (using mild, natural soap, but as little as possible) and cool the child in hot temperatures with a wet facecloth, dabbed gently on the child's pulse points
- Use natural moisturisers/oils - try to use only natural skin care products on the child, which have less irritant chemicals that may be better tolerated by the child's skin and not cause further aggravation of symptoms. Consult your doctor on finding the best type of moisturisers and oils for your child
Medication
There are a number of different types of medications used to remedy the different types of symptoms associated with eczema:
- Antibiotics - your doctor may prescribe antibiotics if the dermatitis has been severely aggravated by a lot of scratching and this has caused a bacterial skin infection or an open sore. Your doctor may prescribe the antibiotics either for a short duration to treat a current infection or for a longer to treat a long-standing infection and to prevent recurrence of infection
- Antihistamines - if the itching symptoms are really severe and unbearable, your doctor may prescribe oral antihistamines tablets to prevent the urge to scratch the skin and worsen the eczema symptoms. Some antihistamines can cause drowsiness, so should not be used if you are driving or operating machinery, but can be useful if taken before you go to sleep as they will make you sleepier. Not all antihistamines cause drowsiness. Some are available without prescription at the chemist
- Corticosteroid creams or ointments - your doctor may prescribe a corticosteroid cream or ointment, which can help to relieve itching and other associated symptoms, such as scaling and thickening of the skin. Some corticosteroid creams are available over-the-counter and others need a prescription. Your doctor will advise you which type of creams are the best for your symptoms and will explain all the possible side effects from long-term use of these creams or ointments (which include skin irritation and discolouration, thinning of the skin and possible skin infection)
- Corticosteroid tablets - if the dermatitis is very severe, your doctor may prescribe corticosteroid tablets to be taken over a short-term. This medication reduces the inflammation in the skin, the itchiness and helps to control symptoms to a more manageable level. While corticosteroids are an effective treatment option for very severe dermatitis, they are not viable over the longer term as they have serious side effects, including loss of calcium from the bones (osteoporosis), more infections, thinning of the skin, cataracts and high blood pressure
- Immunomodulators - these are a newer class of medication which affect the immune system to stop it from causing the inflammatory symptoms, to help maintain normal skin and reduce flare-up of dermatitis symptoms. These medications can only prescribed by a doctor and are recommended to be only used where other treatments have failed or cannot be tolerated, as there is some concern about potential adverse effects on the immune system if this medication are used over a long term. This medication can only be used in children over the age of 12 and in adults
- Medicated wet dressing - if the skin where the dermatitis lesions occur cracks open, your doctor may prescribe a mildly astringent medicated wet dressing, which needs to be changed on a regular basis, to prevent infection
Phytotherapy (light therapy)
Phytotherapy is a newer type of therapy for eczema which involves treatment with ultraviolet light for mild to moderate atopic dermatitis in children over the age of 12 and in adults. In phytotherapy, the affected skin is exposed to controlled amounts of ultraviolet light for set periods, to reduce symptoms.
Phytochemotherapy (light therapy + chemotherapy)
In some people with atopic dermatitis, phytotherapy alone is ineffective, so it can be combined with Psoralen, which is a type of chemotherapy medication to more effectively treat the eczema. In phytochemotherapy, the treatment is the same as in phytotherapy, except that in this type of therapy, the medication is taken in conjunction with the light therapy, to enable it to work better.
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< 8: diagnosis 10: alternative treatment > Last reviewed: 15 January 2010 || Last updated: 15 January 2010
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NOTE: Mega doses of any type of vitamin, mineral, amino acid or herbal supplement cannot cure illnesses and in fact can be very dangerous and produce toxic side effects and interfere with medicine you are taking. Always ensure you consult your doctor before taking any type of complementary supplements.
Disclaimer: This guide is not intended to be used for diagnostic or prescriptive purposes. For any treatment or diagnosis of illness, please see your doctor.
