Dermatitis / Eczema

Dermatitis and eczema are terms that are often used interchangeably. These conditions can be classified as acute or chronic.

Dermatitis is often acute and refers to an area of irritation usually because of contact with some type of allergen. With acute dermatitis the skin is often darker, thicker and itchier than surrounding unaffected skin.

Chronic dermatitis is also known as Atopic Eczema. This is often characterized by red swollen, scaly, blistering areas. This condition is particularly prevalent in children and usually there is some type of family history of the disease. Psychological stress can provoke or aggravate this condition because it interferes with suppressing normal immune responses.

Seborrheic dermatitis is related to a yeast called pityrosporum ovale (also known as malassezia furfur). People with this form of dermatitis seem to have a reduced resistance to this yeast. For some unknown reason, people with certain neurological disorders, including Parkinson's disease and stroke, are particularly prone to this form of dermatitis. Seborrheic dermatitis appears at after puberty. It varies in severity and can persist for years.

Dermatitis is not contagious.

CAUSES OF DERMATITIS

Allergic contact dermatitis is caused by skin contact with substances such as latex, perfume, metals, hair dye and other chemicals that most people do not have a reaction to.

Handling irritants such as detergents and other cleaning solvents, harsh chemicals and friction causes other forms of dermatitis.

Seborrheic dermatitis is caused by a reduced resistance to the yeast known as Pityrosporum ovale. It can be aggravated by other illnesses, stress and fatigue. But, compromised general health does not cause it.

DIAGNOSIS

Dermatologists can usually identify the type of dermatitis by sight and when necessary patch testing is performed to determine the source of the allergen.

TREATMENT

The most important aspect of treatment is to identify and address the source of the condition. Once the source has been identified, your physician can help to correct and control it.

These treatments include:

  • Antibiotics
  • Antihistamines
  • Hydrocortisone Cream
  • Ketoconazole or Ciclopirox Cream
  • Medicated shampoos
  • Systemic steroids
  • Tar creams
  • Topical steroid creams

SELF CARE AND LONG TERM CONTROL

Allergens—protect the skin and avoid known skin allergens

Bathing—use lukewarm water. Showers are better. Do not use standard bar soap. Use a mild substitute cleansing bar or liquid that your dermatologist recommends.

Clothing—wear soft cotton clothes that are comfortable and not tight. Avoid wool if possible.

Irritants—protect the skin and avoid known irritants

Moisturizers—apply non-perfumed moisturizers liberally and as often as necessary, particularly after bathing. Dermatologists can recommend appropriate products.

When these steps fail to improve or control the condition see your dermatologist for further help.

Dermatitis and eczema are terms that are often used interchangeably. There are many different types and causes of eczema.

  • Atopic dermatitis (AKA atopic eczema) is the name for a type of eczema that people are born with. The cause is not known but is presumed to be due to an altered skin barrier and an altered immune system.
  • Irritant dermatitis is a type of eczema that results from exposure to irritating chemicals such as bleach or harsh cleansers.
  • Allergic contact dermatitis is a type of eczema that results from exposure to a chemical that an individual is allergic to.
  • Dyshidrotic eczema is a type of eczema that affects the hands and feet, often with blisters. The cause is not known.
  • Seborrheic dermatitis is a common type of eczema that primarily effects the scalp. It can also affect the face and, less commonly, other body areas. The cause is not known but may be related to a yeast called pityrosporum ovale (also known as malassezia furfur).

Diagnosis

The diagnosis of eczema can usually be made visually. In some cases, where the diagnosis or cause is not obvious, a biopsy and/or patch testing (a form of allergy testing) can be helpful.

Treatment

The most important aspect of treatment is to identify and address the source of the condition. Once the source has been identified, your physician can make skin care recommendations and prescribe medications that can help to correct and control your condition.

Self-care tips that may be suggested by your dermatologist:

  • Bathing—use lukewarm water. Showers are better. Do not use standard bar soap. Use a mild substitute cleansing bar or liquid that your dermatologist recommends.
  • Protect the skin from irritating chemicals or known allergens.
  • Clothing—wear soft cotton clothes that are comfortable and not tight. Avoid wool if possible.
  • Moisturizers—apply non-perfumed moisturizers liberally and as often as necessary, particularly after bathing. Dermatologists can recommend appropriate products.

Treatment options include:

  • Topical steroids
  • Non-steroidal topical medications including tacrolimus (Protopic®), Pimecrolimus (Elidel®) and Eucrisa®
  • Ketoconazole or Ciclopirox cream (primarily for seborrheic dermatitis®)
  • Antibiotics (topical and oral®)
  • Oral antihistamines to control itching
  • Systemic steroids and other oral immunosuppressing agents
  • Phototherapy and laser
  • Dupixent®

Our dermatologists have extensive experience treating all forms of eczema and have access to all the latest treatments. We also have clinical trials available if you need access to new potentially cutting-edge treatments.

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