Dermatitis

What is dermatitis

Dermatitis is the name for a number of skin conditions that causes inflammation, irritation, reddening, scaling and thickening of the skin.

The main types of dermatitis are:

• Atopic dermatitis (or eczema) – eczema is a common skin disorder which causes the skin to become red, inflamed and itchy anywhere on the body. There are a number of different types of eczema that can occur
• Contact dermatitis – this type of dermatitis can be due to a reaction on the skin to either an allergen or an irritant substance which can affect the skin anywhere on the body
• Photodermatitis – this type of dermatitis is when the skin has an abnormal reaction to ultraviolent (UV) sunlight with a rash, blisters, or scaly patches on the skin that has been exposed to the UV light
• Seborrheoic dermatitis – this type of dermatitis affects the scalp, cheeks and body folds with small red lumps that are scaly in appearance. This type of dermatitis is sometimes confused with dandruff, but is not the same condition. In babies and children, if this type of dermatitis occurs on the scalp, it is called cradle cap and if it occurs in the genital/anal area, it is known as nappy rash

Facts about dermatitis

• Eczema is a very common skin disorder that is prevalent in Australia and other western countries
• Statistics show that western countries (especially USA, Australia and UK) are experiencing a very significant rise in allergic conditions, such as atopic dermatitis and contact dermatitis due to either an allergen or irritant
• About 50% of people with eczema develop symptoms within the first twelve months of life
• Another 20% of people with eczema develop symptoms by age five
• People who develop dermatitis (atopic or contact) usually also have asthma, allergic rhinitis (hay fever) or their direct family members have these conditions
• About 40%-60% of people with atopic dermatitis (eczema) also have some type of respiratory allergic condition
• Seborrheoic dermatitis is sometimes confused with dandruff, but they are not the same condition
• Irritant contact dermatitis (when a substance touches the skin and causes irritation) is the more common type of contact dermatitis, accounting for up to 60%-80% of all cases of contact dermatitis
• A great number of babies and toddlers develop some form of nappy rash and cradle cap

Symptoms of dermatitis

Symptoms of dermatitis mainly depend on the type of dermatitis:

Atopic dermatitis (or eczema)

• Blisters or pustules
• Inflammation of the skin
• Itchy skin
• Rash, which can cover small parts of the body, to the whole body
• Reddened skin
• Scaly patches of skin
• Weeping of the skin

Contact dermatitis

• Allergic reaction
• Blisters
• Bumps and lumps
• Cracked skin
• Dry skin
• Reddened skin
• Stinging (or burning) sensation

Photodermatitis

• Blisters
• Bumps or raised areas on the skin
• Darker patches of skin
• Eczema-like skin appearance
• Fever and chills
• Headache
• Inflammation
• Itchy skin
• Nausea
• Reddened skin
• Thickened and scarred skin

Seborrhoeic dermatitis

• Brownish yellow to red lesions on the scalp, cheeks and folds of the body
• Scaly bumps
• Scaly patches

Causes of dermatitis

The cause of dermatitis is not known, but some theories have been proposed to the reason why it occurs:

Allergens

Research suggests that a large number of cases of dermatitis are caused, at least in part, to an allergic reaction to a substance, which is known as an allergen. Underlying this allergic reaction is a faulty immune system, which does not recognise the allergen as harmless and over-reacts with symptoms of dermatitis. The most common allergens that can produce dermatitis on the skin include: foods, medication, dust, pets, plants, rubber, latex, nickel.

Genetics

Research shows that children with a family history of either asthma or allergic rhinitis (hay fever) are also more likely to develop dermatitis either in childhood or as adults. In addition to this, if there are family members with any of these conditions, it is another factor in likelihood of developing some form of dermatitis too.

Immune system

Another theory proposed about the cause of dermatitis is a faulty immune system that reacts abnormally, causes an inflammatory reaction (production of too many prostaglandins) to destroy the allergen or irritant and this produces symptoms of dermatitis.

Seborrhoeic dermatitis, while it is thought to be due to an overgrowth of a fungus, it is the immune system that is not functioning properly which enables the fungus to grow out of control and produce the symptoms of seborrhoeic dermatitis.

Irritants

Research suggests that many cases of dermatitis can also be caused, at least in part, to some type of irritant substance that touches the skin. This causes the immune system to over-react and produce symptoms of dermatitis. The most common irritants that can produce dermatitis on the skin include: environmental chemicals, laundry powders (or liquids), skin care lotions (or creams), dish dish washing liquids, laundry softeners, cleaning products, soap, shampoo, conditioner, perfume, cosmetics.

Prevention of dermatitis

Non-preventable risk factors

Dermatitis may be unpreventable in certain circumstances:

• Age – a high proportion of dermatitis cases seen by doctors occur in infants and young children. Approximately 50% of all dermatitis cases occur in infants under the age of one and about 70% of all dermatitis cases occur in children under the age of five
• Exposure to allergens – certain allergens can cause dermatitis to occur, either for the first time, or to aggravate it in people with an existing allergic reaction to certain allergens
• Exposure to irritants – certain irritants can cause dermatitis to occur, either for the first time, or to aggravate it in people with an existing reaction to certain irritants
• Family history – people with other family members who have eczema or other allergic conditions such as asthma or allergic rhinitis are more likely to develop dermatitis than people with no family history of these conditions. People who have asthma or allergic rhinitis (hay fever) themselves also have a higher probability of developing dermatitis too and as this has a genetic basis, it is difficult to prevent

Preventable risk factors

There may be ways to prevent dermatitis from occurring or reducing severity of symptoms:

• Avoid allergens – people who have dermatitis due to an allergic reaction to a specific allergen need to identify the allergen and avoid it as much as possible, to prevent recurrence of symptoms
• Avoid the irritants – people who develop dermatitis due to a reaction to a specific irritant need to identify the irritant and avoid it as much as possible, to prevent recurrence of symptoms
• Better nutrition – recent research suggests that certain deficiencies in certain nutrients may be a risk factor for the development of dermatitis. Specifically, research suggests that deficiency in the omega-3 essential fatty acids can cause dermatitis to occur and this deficiency starts with the pregnant and lactating mother, who if she is deficient in these nutrients, can risk her child developing dermatitis (or other allergic disorders such as hay fever) as a result
• Breastfeed babies – some recent studies suggest that babies which are breast-fed for at least six months after birth are less likely to have babies and children that develop eczema, dermatitis, allergic rhinitis (hay fever) or any type of allergic condition
• Inadequate air humidity – people living in an environment with a low humidity climate are more likely to be at risk for developing dermatitis, as the dryness in the air can dry out the top layers of the skin, leaving it open to developing dermatitis
• Reducing stress – studies show that stress can aggravate dermatitis or initiate it in infants, children and adults

Complications of dermatitis

In general and in most cases, dermatitis does not pose many complications other than the annoying symptoms, but in some cases complications can arise, especially if the dermatitis is severe, or undiagnosed and untreated for a long time:

• Depression – some people with severe dermatitis (or scars due to dermatitis) may not feel comfortable showing their dermatitis-affected skin in public, especially if it affects their face and other prominent body parts. If the feelings of isolation continue, this can then develop into a low mood and feelings of depression, which needs further medical attention. People with severe eczema need to get appropriate treatment in order to reduce their symptoms so that flare-ups of the condition are reduced
• Scar formation – if the dermatitis rash is scratched too often, this can cause the skin to develop further even inflammation and redness, making the symptoms worse. Subsequent blisters, lumps and nodules that form may develop into scars and these may be permanent
• Skin infection – the dermatitis affected skin is more susceptible to any type of bacterial infection because in many cases, the skin has cracks, blisters and other openings which the bacteria can enter. Severely affected skin with dermatitis needs appropriate treatment to prevent this complication

When to see a doctor about dermatitis

Many cases of dermatitis start in babies and infants (approximately 70% of all cases), so if your baby has a rash and eczema is suspected, then a doctor should be consulted for a diagnosis and appropriate treatment plan. Children are also quite susceptible to dermatitis, so any new rash in a child without fever or other visible symptoms should be taken to a doctor for diagnosis.

Adults with any of the symptoms of dermatitis should visit a doctor in order to diagnose this condition and get advice on an appropriate treatment plan. There are a number of options for treatment, both conventional and alternative and your doctor will advise which options are available and safe for your situation.

Diagnosis of dermatitis

Initial diagnosis of dermatitis is through the following tests:

• Medical history of symptoms – the doctor will take notes about the duration and severity of symptoms. The doctor will also ask a series of questions about your personal history and your family history of conditions such as allergic rhinitis, asthma and eczema. The doctor may also ask questions about your exposure to environmental chemicals, cleaning and laundry products and other factors, to determine if this rash is due to an irritant or an allergen, as this is important in a determining an appropriate treatment plan
• Physical examination – the doctor will review all the areas of the rash on the skin to determine if it is dermatitis or if the symptoms present another condition

If the doctor suspects that an allergen may be the cause of the dermatitis, the following test may also be requested:

• Allergy (‘skin prick’) test – this involves pricking the forearm with a very small needle and allowing some of the allergen into the skin. This is done many times with various allergens that the allergy specialist uses (including dust and pet hair brought from home) to determine if an allergy exists to a particular substance. Usually, if an allergy to the substance occurs, it will cause the skin pricked to form a welt, rash or lump. The allergy specialist (or immunologist) will have taken note of each substance used to enable determination of the substances that cause the allergic response

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

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, organic 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.

Alternative / complementary treatment of dermatitis

Most of the lifestyle recommendations which are available in the conventional treatments for dermatitis are also recommended by alternative/complementary practitioners. In addition to those, there are also some other treatments recommended.

People with dermatitis who are taking any type of medication need to consult with their doctor before trying any of the treatment options recommended here, as there could be potential for adverse side effects especially in combination with medications.

Herbs

There are a number of excellent herbs which may help to provide relief for symptoms:

• Aloe vera cream – the gel inside the leaves of the aloe vera plant is soothing and cooling, providing instant reduction in inflammation and relief from symptoms, providing potent anti-inflammatory and cooling effects
• Calendula cream – the herb calendula, when made up into a cream is soothing and provides a great reduction in inflammation symptoms over the longer term and in addition to this, it moisturises the skin, reduces dryness and reduces severity of symptoms
• Evening primrose oil – a cream that is made with evening primrose oil as the active ingredient is very effective at reducing the inflammation of dermatitis and reducing symptoms of itchiness, although it works even better when taken internally
• Tea tree oil cream – this oil of this native Australian tree has potent anti-fungal, anti-bacterial and anti-viral properties, which means it will prevent infection and it also can reduce inflammation as it has cooling properties (especially if in a cream), providing relief of symptoms

Vitamins

There are a number of vitamins which may help to provide relief for symptoms:

• Bioflavonoids – the antioxidant bioflavonoids should be used in conjunction with vitamin C to help reduce symptoms of inflammation associated with dermatitis (especially atopic dermatitis or eczema), as well as to boost the function of the immune system to prevent future flare-ups
• Vitamin A – numerous studies show that the antioxidant vitamin A is essential for ensuring the skin is healthy and elastic and the mucous membranes are not dried out, which can help to prevent flare-ups of symptoms
• Vitamin B complex – studies show that the B vitamins are necessary for healthy skin and proper circulation in the body. The B vitamins also assists with the proper reproduction of the cells in the body (which is needed in renewing the cells in healing) and assists with providing proper nutrition for the nerves to reduce stress
• Vitamin C – the potent antioxidant vitamin C works to relieve the symptoms of most types of dermatitis, but especially for dyshidriotic eczema (atopic dermatitis), which responds very well to vitamin C supplementation. Vitamin C provides support for the immune system
• Vitamin D – studies show that vitamin D is beneficial in treating the symptoms of dermatitis as it helps the skin to heal more quickly from any flare-ups. It can also be useful to use a cream with vitamin D on the skin affected with the dermatitis
• Vitamin E – the potent antioxidant vitamin E is very beneficial for the skin as it helps to relieve the itching symptoms and helps to moisturise the skin internally, preventing it form drying out. In addition to this, vitamin E also provides potent support for the immune system. A cream with vitamin E is also beneficial for any type of skin condition, as it helps to reduce dryness, which is a major factor in dermatitis

Minerals

There are a number of minerals which may help to provide relief for symptoms:

• Magnesium – the mineral magnesium helps to relax the smooth muscles and body tissues in general, which means it may be helpful in reducing the stress and anxiety associated with inflammation and pain of dermatitis
• Selenium – the potent antioxidant mineral selenium improves elasticity of all layers of the skin and may also assist to help the skin heal more quickly from dermatitis flare-ups
• Zinc – the antioxidant mineral zinc helps the tissues to heal more quickly and it also helps to reduce recurrence of symptoms. In addition to this, studies show that people who have dermatitis may have a deficiency of zinc, which could be a part of the reason for the recurrence of all the flare-ups

Other nutrients

There are a number of other nutrients which may help to provide relief for symptoms:

• Alpha lipoic acid – the nutrient alpha-lipoic acid is a potent antioxidant, which provides major support for the immune system to help it function better. Studies show that an improperly functioning immune system may be the major reason behind the development of dermatitis, so supporting the immune system’s function may reduce incidence of flare-ups
• Coenzyme Q10 – studies show that coenzyme Q10 helps to remove toxins from the body and provides support to the immune system to function more effectively
• Evening primrose oil – many studies show that the gamma-linolenic acid (GLA) in evening primrose oil has potent anti-inflammatory properties and seems to assist with alleviating symptoms such as itchiness and redness as well as reducing severity and duration of flare-ups
• Fish oil – the omega-3 essential fatty acids in fish oil have well documented anti-inflammatory properties and studies show that they may be useful for reducing itchiness, redness and inflammation associated with flare-ups of dermatitis symptoms
• Glutathione – the amino acid glutathione is potent antioxidant, which provides a big boost to support the immune system to help it function more effectively by normalising it and helping it to react more normally
• Probiotics – it may be beneficial to take probiotics (such as acidophilus) as they help to populate the gastrointestinal system with friendly “good” bacteria and this prevents overgrowth of yeasts and “bad” bacteria in the body, reducing risk of infection in the dermatitis lesions

Dietary modifications

There are a number of dietary modification strategies which may help to provide relief for symptoms:

• Eat more fibre – the diet should include plenty of wholegrains and other plant foods to help the colon eliminate toxins more quickly out of the body. Psyllium fibre (in the form of a powder added to foods) is often useful for this function as it is well tolerated by most people. Just make sure to add it a little at first, to get used to eating more fibre
• Eat more oily fish – the diet should include 3 portions of oily fish (salmon, mackerel, sardines or trout) each week. These types of fish contain the highest levels of omega-3 fatty acids, which reduce inflammation and this may assist in reducing dermatitis symptoms
• Eat more vegetables and fruit – as long as they do not aggravate symptoms, the diet should include 5-7 portions of vegetables and 2-3 servings of fruit each day. Vegetables and fruit are full of antioxidants, vitamins and minerals, plus because they are high in water, they help to keep the body hydrated and this may help to reduce dryness of the skin

Lifestyle modifications

There are a number of lifestyle modifications which may help to provide relief for symptoms:

• Apply a cold compress – use plain cotton fabric which has been moistened with cold water to the area on the skin which is inflamed with the dermatitis. This simple remedy can provide immediate (albeit temporary) relief, but enough to reduce the worst of inflammation and itchiness
• Avoid getting over-heated – high temperatures and sweating can cause an aggravation of symptoms in some people, so try to stay cool, use a cool compress to cool down the body and only touch the affected areas gently, to avoid aggravating the dermatitis symptoms
• Avoid scented soaps & detergents – perfumed soaps, shampoos, detergents, laundry liquids, softeners, cosmetics and skin care are known to aggravate existing dermatitis symptoms. Always use non-scented, organic soaps, skin care, cosmetics, dishwashing and laundry detergents, as well as cleaning products which are milder on the easily inflamed skin and are less likely to cause a reaction (experimentation will be necessary to find the right soap and detergent). Always read the label and avoid products that have synthetic ingredients, especially perfume and other additives that can cause irritation
• Avoid scratching the itch – by scratching the itchy patch(es) of dermatitis on the skin, it only makes it worse and increases the likelihood of developing worse symptoms and spreading the dermatitis over a bigger area of the skin. Use any one of the methods advised here to reduce the symptoms to help avoid scratching the itchy skin
• Avoid the allergen(s) – it is advisable to avoid any known allergens which can trigger dermatitis symptoms. Commonly known allergens which should be avoided are: pollen, dust mites and animal dander
• Avoid the irritant(s) – 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, soap, shampoo, environmental chemicals, cigarette smoke
• Drink more water – drink around 8-10 glasses of water each day as this will help to hydrate the body and tissue and prevent skin from drying out
• Limit exposure to sunshine – limit exposure to strong sunlight, as it can aggravate symptoms in forms of dermatitis, but especially in people with photodermatitis, who have an abnormal reaction to UV light
• Reduce exposure to stress – any type of meditation or calming therapy that will help to reduce stress and anxiety will help to reduce symptoms as stress is known to aggravate symptoms
• Stop smoking – studies show that nicotine can aggravate or even initiate some types of dermatitis (especially if there is an allergy to cigarettes). Do not smoke and do not be exposed to second-hand smoke from other people

Alternative treatments

• Naturopath – a naturopath can help to identify the source of the allergens or irritants. In addition to this, a naturopath can provide a tailor-made treatment plan with herbs, vitamins and other nutrients to help reduce symptoms of dermatitis

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with dermatitis

Management of dermatitis is achieved best by avoiding the allergens/irritants, reducing incidence of flare-ups, reducing symptoms and supporting the immune system to prevent recurrence:

Reduce severity of existing symptoms

• Apply a cool compress – use plain cotton fabric which has been moistened with cold water to the area on the skin which is inflamed with the dermatitis. This simple remedy can provide a great deal of immediate (albeit temporary) relief, but enough to reduce the worst of inflammation and itchiness
• Avoid having hot baths or showers – very hot water can aggravate the dermatitis symptoms by creating further inflammation and should be avoided. When dermatitis symptoms are visible on the skin, have a lukewarm bath or shower and bathe as quickly as possible, as the warm water will dry the skin out further and this can make the symptoms of dermatitis worse
• Avoid scratching the skin – scratching the itchy patch(es) of dermatitis only makes it worse and increases the likelihood of developing worse symptoms and spreading the dermatitis lesions over more area of the skin. Use one of the methods advised to reduce the symptoms to help avoid scratching the itchiness
• Eat more fish – the diet should include 3 portions of oily fish (salmon, mackerel, sardines or trout) each week. These types of fish contain the highest levels of omega-3 fatty acids, which reduce inflammation and this may assist in reducing dermatitis symptoms
• Moisturise the skin – it is very 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 they can irritate the skin)
• Omega-3 fatty acids – many studies show that the omega-3 essential fatty acids DHA and EPA (in fish oil) and the omega-6 essential fatty acid GLA (in evening primrose oil) are very beneficial in helping to reduce the severity and incidence of symptoms in people with dermatitis. Always discuss any supplementation with your doctor before trying it

Support the immune system to reduce flare-ups

• Antioxidant minerals – there are several minerals which have a potent antioxidant and immune boosting function and they also boost the healing process to occur more quickly. The best minerals for this are: selenium and zinc. These minerals enable the immune system to function more effectively and this may prevent and reduce reoccurrence of symptoms and further flare-ups. Seek advice from your doctor before trying them
• Antioxidant vitamins – there are several minerals which have a potent potent antioxidant and immune boosting function, plus they may help to prevent the skin from drying out. The vitamins most beneficial are: bioflavonoids, vitamin A, vitamin C, vitamin D, vitamin E. A multivitamin is the best way to provide adequate intake of these vitamins. Seek advice from your doctor before trying them
• Avoid the allergens – it is advisable to avoid the known allergens which can trigger dermatitis symptoms and cause flare-ups. Avoiding known allergens reduces incidence of flare-ups. Commonly known allergens to be avoided are: pollen, dust mites and animal dander
• Avoid the irritants – avoid the known irritants which can trigger the dermatitis symptoms and cause flare-ups. Avoiding known irritants reduces incidence of flare-ups. Commonly known irritants to be avoided are: certain fabrics (especially wool), perfumes, cosmetics, cleaning products, soap, shampoo, environmental chemicals, cigarette smoke. People with photodermatitis should avoid exposure to UV light on bare skin to avoid symptoms
• Identify the allergens – it would be most beneficial for the immune system to identify the allergens which cause the dermatitis in order to avoid them so that the immune system has a break from constantly working to remove them from the body
• Identify the irritants – it would be most beneficial for the immune system to identify the irritants which cause the dermatitis in order to avoid them so that the immune system has a break from constantly working to remove them from the body
• Other supplements – there are a number of other supplements which have antioxidant properties that boost the function of the immune system or which have other functions to remove toxins from the body that help the function of the immune system. The nutrients most beneficial are: alpha-lipoic acid, co-enzyme Q10, glutathione, probiotics. Seek advice from your doctor before trying them
• Reduce exposure to stress – research suggests that stress can aggravate dermatitis flare-ups, so it may be beneficial to engage in stress management techniques. This is beneficial in a number of ways, as stress reduction helps to boost the function of the immune system

Caring for someone with dermatitis

Partner

If you have a partner with dermatitis, there are a number of useful strategies you can use to help them:

• Avoid using perfumed products – most type of skin care, cosmetics, laundry and cleaning products contain some types of perfumes and other abrasive chemicals, which can irritate sensitive skin prone to dermatitis. To to find and use non-perfumed, mild, natural (certified organic) alternatives
• Don’t smoke – cigarette smoke is a known irritant to the skin and this could be one of the triggers for causing the dermatitis symptoms. Don’t smoke around your partner as their exposure to your second-hand smoke can be a trigger for their dermatitis symptoms
• Help your partner moisturise – especially if the dermatitis is on the back or on areas of the skin that are harder to reach, it may be helpful if you can help your partner to moisturise these areas
• Remove the allergens from the home – once the allergens that trigger the dermatitis have been identified, ensure they are not in the home to avoid exacerbating your partner’s dermatitis symptoms
• Remove the irritants from the home – once the irritants that trigger the dermatitis have been identified, ensure they are not in the home to avoid exacerbating your partner’s dermatitis symptoms

Friends

If you have a friend or family member with dermatitis, there are a number of useful strategies you can use to help them:

• Avoid using perfumed products – most type of skin care, cosmetics, laundry and cleaning products contain some types of perfumes and other abrasive chemicals, which can irritate sensitive skin prone to eczema. Try to ensure you have not just cleaned your home just before your friend or family member is about to arrive and don’t use air fresheners before your friend is due to come to your place
• Don’t smoke – cigarette smoke is a known irritant to the skin and this could be one of the triggers for causing the dermatitis symptoms. Don’t smoke around your friend or family member as their exposure to your second-hand smoke can be a trigger for their dermatitis symptoms

Parents

If you have a child with dermatitis, there are a number of useful strategies you can use to help them:

• Apply a cool compress – use plain cotton fabric which has been moistened with cold water to the area on the skin of your child which is inflamed with the dermatitis lesions, but do not rub or press hard as this will cause pain. This simple remedy can provide a great deal of immediate (albeit temporary) relief, which is enough to reduce the worst of inflammation and itchiness on your child’s skin. If the child is old enough, you can teach them how to do this too (instead of scratching their skin) to provide some relief
• Avoid using perfumed products – most type of skin care, cosmetics, laundry and cleaning products contain some types of perfumes and other abrasive chemicals, which can irritate sensitive skin prone to dermatitis. To to find and use non-perfumed, mild, natural (certified organic) alternatives
• Bath and shower in tepid water – ensure you bathe (or shower) your child in tepid water since hot water will dry out the skin and can be painful on active dermatitis. If your child is old enough, teach them how to use cooler water they take their shower and to bathe quickly
• Distract the child from scratching – you will need to use a number of strategies to prevent the child from scratching their itchy skin as that can spread it further
• Don’t smoke – cigarette smoke is a known irritant to the skin and this could be one of the triggers for causing the dermatitis symptoms . Don’t smoke around your child as their exposure to your second-hand smoke can be a trigger for their dermatitis symptoms
• Identify the allergens – there are a number of allergens that can possibly cause the dermatitis to occur, so work with your child to try to identify these triggers to avoid them. If an allergen is suspected of causing the dermatitis, discuss your testing options with your doctor, especially an allergy (skin prick) test, which can confirm which allergens may be causing the dermatitis
• Identify the irritants – there are a number of irritants that can cause dermatitis to occur, so try to identify so work with your child to try to identify these triggers to avoid them. Common irritants are soaps, shampoo, detergents, laundry powders/liquids, skin care, cleaning products and perfumes. Try to find more natural, less abrasive and non perfumed alternatives to determine if this makes any difference to your child’s dermatitis symptoms
• Moisturise after bathing – always moisturise your child after a bath (or shower), all over, to help reduce the dryness in the skin and reduce the likelihood of aggravating the eczema. Find a very mild, unperfumed and natural (certified organic) moisturiser that provides adequate emollient moisture for the skin. Older children can be taught to moisturise their own skin in areas that they can reach
• Provide fish in the diet – oily fish (mackerel, salmon, sardines, trout) contain the beneficial anti-inflammatory omega-3 essential fatty acids which studies show can be greatly reduce symptoms of eczema. Discuss the appropriateness of fish oil supplementation with with your doctor
• Use natural, soft fibres – when your child has an active dermatitis flare-up, ensure they dress with clothes that are natural and are made of soft fibres, such as cotton. Try to avoid any wool or wool mixes as these can irritate the skin, despite being a natural fibre

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Last reviewed and updated: 14 May 2024