Dermatitis

Dermatitis is a generic term for any skin inflammation. Symptoms can affect any part of the body and can range from mildly irritating to severe.

Anyone can get dermatitis, although children are more susceptible to some forms of dermatitis and adults are more likely to experience other types. It is not contagious and therefore cannot be spread from person to person. Symptoms of dermatitis can include red rashes, swelling, itching or dry skin.

Common examples include contact dermatitis, atopic eczema and seborrheic dermatitis (dandruff).

Your GP or dermatologist can help you manage and treat the symptoms of dermatitis.

Dermatitis is commonly referred to as eczema

The terms ‘dermatitis’ and ‘eczema’ are often used interchangeably, but there are important differences between a condition like contact dermatitis, which is triggered by contact with an irritant or allergic substance, and atopic eczema, which is a long-term condition that runs in families.

Although it’s not life-threatening, dermatitis can be extremely uncomfortable and can cause embarrassment or emotional distress. 

Depending on the type of dermatitis, symptoms will vary. Dermatitis is highly individual, which means that the same condition can affect people in different ways.

Common symptoms include:

• Itchiness
• Dry skin
• Redness or other discolouration
• Rashes
• Bumps or blisters, possibly fluid-filled or oozing
• Flaking skin (dandruff)
• Thickened or swollen skin
• Cracked and scaly skin
• Weeping

Someone with dermatitis might experience itching, pain, discomfort or burning sensations.

There are many different types of dermatitis. Some of the more common types include:

• Contact dermatitis – this is when you get irritated, red or itchy skin after coming into direct contact with an irritant or allergen.
• Atopic eczema – this is the most common form of eczema in which your skin is dry, itchy and cracked. It often first appears in childhood and can either clear up or become a long-term condition.
• Seborrheic dermatitis – commonly referred to as dandruff in adults, seborrheic dermatitis is characterised by dry, flaky, scaly skin primarily on your scalp, but it can also appear on other parts of your body such as around the nose, ears or eyebrows.
• Infantile seborrheic dermatitis– more commonly known as ‘cradle cap’, this harmless skin condition causes crusting and flaking skin of the infant’s skin around the scalp, eyes and ears and typically resolves itself before the child’s first birthday.
• Pompholyx– also known as dyshidrotic dermatitis, this condition causes itchy, painful blisters on the palms, fingers and soles of the feet.
• Discoid eczema – sometimes known as nummular dermatitis, this condition is characterised by distinctive round or oval lesions on the skin.
• Perioral dermatitis – this is a red rash around your mouth that often appears like acne. If it appears on the genitals, it is referred to as periorificial dermatitis.
• Dermatitis herpetiformis – this chronic skin condition causes extremely itchy bumps or blisters along both sides of the body. 

There is overlap among the different types of dermatitis, and you can have more than one type at the same time.

If you are experiencing symptoms of dermatitis, it’s important to see a doctor to help you identify the type of dermatitis and the appropriate treatment.

"You should treat eczema as soon as it appears. If you leave it for very long trying to avoid putting treatments off, what happens is that you end up struggling to control it and having to use more treatments to achieve the same result that you would have if you started treating it at the beginning."

– Dr Agustin Martin-Clavijo, Consultant Dermatologist at The Priory Hospital.

Contact dermatitis is a skin reaction caused by direct contact with an irritant or allergen in your environment. Contact dermatitis is very common — up to 9% of the UK population is affected by this type of skin condition.

Symptoms of a contact dermatitis rash can be redness, swelling, oozing, painful blisters, hives, itchiness, burning or stinging.

Because contact dermatitis is caused by exposure to some substance, it can affect any part of the body, including the hands, face, neck, feet or groin area. This means contact dermatitis is sometimes diagnosed as hand eczema, eyelid dermatitis or genital dermatitis.

There are two types of contact dermatitis — irritant contact dermatitis and allergic contact dermatitis.

Irritant contact dermatitis

Irritant contact dermatitis is the most common type of contact dermatitis.

It happens when you develop symptoms as a result of exposure to common irritants in the environment. Symptoms can appear within minutes of exposure or up to 48 hours after. You can experience symptoms after just one exposure, whilst other times it takes repeated exposure to the irritant to cause a reaction.

There are many potential triggers for irritant contact dermatitis. Often, everyday substances that come into contact with our skin can cause symptoms. This means that it can be difficult to identify which substance is responsible for your symptoms.

Common irritants include:

• Soaps, detergents and cleaning products
• Bleach
• Perfumes and preservatives in cosmetics
• Nail polish remover and other solvents
• Antiseptics and antibacterials
• Paints and other varnishes
• Cement
• Rubbing alcohol
• Water (especially heavily treated water)
• Powders, dust and soil
• Plants
• Fertiliser and pesticides

Your symptoms could be made worse by exposure to heat, cold, friction and dry air.

“Because of the excessive —compared to the past — handwashing, there has been a huge increase in irritant hand dermatitis,” says Dr Martin-Clavijo.

He continues, “That’s why it’s so important to look after your hands. Whenever you can, try to use a soap substitute instead of soap and try to apply moisturisers. And for the hands, the trick is to use moisturisers in very little amounts, very often. For the rest of the body, we normally ask you to lather up, put on lots of moisturiser, but for the hands, it’s little and often.”

Allergic contact dermatitis

Allergic contact dermatitis occurs when the body is repeatedly exposed to a substance that it develops a specific allergic reaction to. It can take anywhere from days to months or even years for the body's immune system to develop an allergic reaction.

Common allergens include:

• Substances in cosmetics and toiletries such as fragrance, preservatives or hair dye
• Metals such as nickel or cobalt
• Rubber or latex
• Medications such as antibiotics or topical medicines
• Plants or botanicals

If you suspect that you have allergic contact dermatitis, you should see a dermatologist for patch testing.

Contact dermatitis treatment

A dermatologist can help you treat your contact dermatitis by identifying the cause of the reaction, treating the symptoms of your skin inflammation and helping you avoid the triggers.

Even with treatment, it can take several weeks for your symptoms to go away. The longer you have a rash caused by contact dermatitis, the more difficult it is to treat it.

Therefore, it’s important to see a dermatologist as soon as possible, so you can identify the cause and start a treatment plan. 

Atopic dermatitis is the most common form of eczema. Often called atopic eczema or even just eczema, this non-contagious condition is characterised by dry, itchy skin that can become swollen, cracked and sore.

Atopic eczema affects 1 in 10 adults in the UK and 1 in 5 children.

It commonly appears in childhood, but it can appear in later life as well. There is no cure, but symptoms generally come and go in episodes called ‘flare-ups’. Although uncomfortable, atopic eczema can be managed and treated.

The term ‘atopic’ refers to a tendency to be sensitive to allergens. Atopic eczema runs in families along with hay fever, asthma and food allergies. This means you are at more risk of developing atopic eczema if you or someone in your immediate family has a history of one of these conditions.

Individuals with atopic eczema are also susceptible to other forms of dermatitis, including contact dermatitis.

What are the causes of atopic eczema?

It is not known exactly what causes atopic eczema. However, we do know that it’s likely caused by a number of factors. Genetics plays an important role, as does your environment.

Common environmental factors that can trigger your eczema might include:

• Common allergens such as pollen, dust mites, pet dander or mould
• Irritants such as harsh soaps and detergents
• Certain fabrics
• Tobacco smoke
• Food allergies
• Certain weather such as dry air, heat or high humidity
• Personal stress levels

It can be helpful to keep track of these triggers when you are experiencing an eczema flare-up. You might be able to pinpoint what triggers your eczema and what makes it worse so that you can avoid potential irritants, allergens or other triggers.

Atopic dermatitis treatment

Although there is no cure for atopic eczema, treatment can help prevent flare-ups and soothe symptoms. With eczema, self-care and daily moisturisation are the first lines of defence.

You should keep your skin moisturised with the use of emollients or medical-grade moisturisers. This can include lotions, creams, ointments, gels or sprays. Your GP or pharmacist can help you choose the right products depending on the severity of your symptoms and the location of your eczema. You should use emollients often, even when you are not experiencing a flare-up.

For skin that is inflamed and sore, you can use a topical steroid, also referred to as a topical corticosteroid. These are prescribed by your GP or dermatologist for short-term use to heal the skin and help bring the eczema flare-up under control.

For most people with atopic eczema, an effective treatment plan includes avoiding known triggers, the daily use of emollients and topical medications.

Although you may hope for a quick cure for your eczema, it’s important to take a longer-term view of your skin health, explains Dr Martin-Clavijo. “What people should be thinking is not about ways to treat eczema quickly, but ways to treat eczema correctly. We always try to look for the long-term fix”.

If you have dermatitis, you might be at risk of developing other complications.

It can be difficult to avoid scratching dry, sore or itchy skin. However, excessive scratching can further damage cracked skin and increase the risk of bacterial or viral infections. If you suspect an infection, you should seek medical attention.

Bothersome itching can lead to poor sleep. Furthermore, a chronic skin condition can also cause psychological distress and lack of confidence. Children and adults with atopic eczema or other forms of dermatitis may feel self-conscious about their appearance.

This can lead to social isolation, frustration, sadness and depression. If you feel like dermatitis is negatively impacting your sleep, emotional health or quality of life, get in touch with one of our mental health support professionals.

There are a number of different treatments for dermatitis that can help to ease your symptoms.

Some common treatments for dermatitis may include one or more of the following:

• Emollients – daily moisturising with emollients to prevent dry skin is the first line of defence. Emollients should be used every day to replenish the skin’s barrier if you are susceptible to dermatitis.
• Topical corticosteroids – topical steroid creams like hydrocortisone relieve itching and inflammation. They come in different strengths and should be used in short bursts to relieve severe symptoms.
• Oral corticosteroids – in rare cases of severe contact dermatitis, your doctor might prescribe an oral steroid pill to reduce inflammation.
• Antihistamines – antihistamines help reduce itching and allergic reactions. While not as effective in treating itchiness for people with eczema, they may be recommended for use in helping to fall asleep.
• Topical calcineurin inhibitors (TCIs) – developed for treating atopic eczema, topical calcineurin includes tacrolimus ointment and pimecrolimus cream. They work by affecting the immune system and are helpful in cases when inflammation is not responding to topical steroid creams.
• Phototherapy – also called light therapy, this treatment involves treating atopic eczema with exposure to different bands of ultraviolet (UV) light to reduce inflammation and itching.
• Wet dressings – bandages or wet wraps are used to cover areas affected by eczema to keep the skin moist, protect from scratching and allow the skin to heal.
• Antibiotics – Antibiotics are typically prescribed in cases of infection.
• Medicated shampoos – over-the-counter anti-dandruff shampoos with selenium sulphide and zinc pyrithione can be used to treat the symptoms of seborrheic dermatitis (dandruff).

Your GP or pharmacist will be able to help you choose the most appropriate treatment for you and your dermatitis.

Prevention is key when you have atopic eczema or are at risk of other types of dermatitis.

It’s often easier and more effective to work on creating an environment free from environmental triggers and emotional triggers like stress than it is to treat a flare-up.

Avoid environmental triggers

Whilst it’s impossible to completely control your environment and eliminate potential triggers, there are many things you can do to avoid common irritants.

Some helpful prevention methods can include:

• Reduce the amount of dust in your house by vacuuming and dusting regularly
• Keep the windows closed when the pollen count is high
• Use gloves when handling irritant foods or substances
• Use humidifiers if your home is dry and keep it well ventilated in the winter
• Avoid synthetic fibres in your clothes and bedding and consider anti-allergenic bedding
• Choose mild soaps without dyes or perfumes
• Avoid cosmetics or toiletries with perfumes and fragrances

According to consultant dermatologist Dr Martin-Clavijo, “You can certainly do a lot of things to make eczema bad very quickly. So if you don't moisturise, if you don't stop using your shower gel when you have eczema or if you stop using your treatments, then that is a recipe for your eczema flaring up very quickly.”

Avoid emotional triggers

There is a well-documented link between stress and dermatitis, particularly atopic eczema.

Stress and anxiety can worsen your symptoms by increasing inflammation and hindering the skin’s ability to repair. It can become even more difficult to control your mood when you are tired from lack of sleep due to itching.

When it comes to living with dermatitis, relaxation and self-care are as important as treatment. A good exercise regimen, healthy diet and techniques for dealing with daily stress are important tools in preventing a flare-up.

Practice good skincare

For very dry skin prone to dermatitis, it’s important to maintain a good skincare routine.

This includes the following healthy skincare practices:

• Moisturise frequently and liberally
• Use an emollient after bathing to lock in moisture
• Bathe in lukewarm water instead of hot water
• Take a warm oat bat.
• Test all skincare products before using them
• Avoid soaps and other products with fragrance, perfumes or dyes

Working with a dermatologist can help you to build a specific regimen for your skin.

The sooner you seek treatment, the sooner you will be able to get your dermatitis under control. If it’s not clear what is causing your dermatitis or what type of dermatitis you have, your GP will refer you to a dermatologist for specialised treatment.

A dermatologist will be able to help you diagnose your dermatitis and determine the cause and triggers. If necessary, they can offer you patch testing to pinpoint what allergens might affect you.

A dermatologist can offer advanced techniques for dealing with all types of dermatitis and help you come up with a personalised treatment plan. This might include phototherapy, topical calcineurin inhibitors, stronger topical corticosteroids and additional medications for severe eczema (alitretinoin, dupilumab and baricitinib). 

Before your appointment, you should make a note of your symptoms, when they appeared, how long they lasted, what triggers you might have had and any factors that worsen your symptoms.

This will help your dermatologist to find the best treatment for you. Although it’s very common, dermatitis is irritating and painful. It can also cause significant emotional distress and lack of confidence.

Seeking treatment from a dermatologist as soon as possible can help you identify your triggers, treat your symptoms, and make a long-term treatment plan for control.

Book an appointment with one of our dermatologists today.

When you choose to go private with Circle Health Group, you can expect:   

• Flexible appointment times to fit your schedule
• The freedom to choose your hospital and your consultant
• Bespoke, consultant-led treatment plans tailored to your individual needs  
• Private en-suite rooms as standard 
• Tasty and nutritious meals cooked onsite to your dietary requirements
• Support from the same compassionate clinical team from beginning to end  
• Affordable, fixed-price packages with aftercare included  
• Flexible payment options to help spread the cost of your care

If you want to know more about treatment for dermatitis, book your appointment online today or call a member of our team directly on 0141 300 5009.

NHS, Contact Dermatitis: https://www.nhs.uk/conditions/contact-dermatitis/

NHS, Atopic Eczema: https://www.nhs.uk/conditions/atopic-eczema/

Eczema.org, Types of Eczema: https://eczema.org/information-and-advice/types-of-eczema/

Eczema.org, Perioral Dermatitis: https://eczema.org/information-and-advice/types-of-eczema/contact-dermatitis/

Celiac.org, Dermatitis Herpetiformis: https://celiac.org/about-celiac-disease/related-conditions/dermatitis-herpetiformis/

Eczema.org, Scalp Eczema: https://eczema.org/information-and-advice/types-of-eczema/scalp-eczema/#how-is-scalp

National Eczema.org, Eczema and Emotional Wellness: https://nationaleczema.org/eczema-emotional-wellness/

Content reviewed by Dr Agustin Martin-Clavijo in May 2022. Next review due May 2025.