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Dermatitis or eczema - understanding it, different types, and approaches to treatment

Content:

    Our skin, the body's largest organ, acts as a natural barrier, shielding us from numerous environmental factors. Despite this, various skin issues can arise, with dermatitis or eczema being one of the most prevalent.

    In the upcoming sections, we'll delve into the essence of dermatitis, its prevalent types, methods of identification, treatment approaches, and preventive measures.

    What is dermatitis?

    Dermatitis also known as eczema is a collective term for various skin imbalances that include skin irritation, rashes, itching, redness, discomfort, and irritations. The most common cause of these symptoms is often triggered by genetic predisposition, immune response disorders, allergies, infections, and irritation from environmental substances. When we talk about dermatitis or eczema, it most commonly refers to red, itchy, and very dry skin.

    The symptoms of dermatitis can be mild or they can cause serious problems, significantly impacting the quality of life for the affected individual.

    However, dermatitis is not a threatening condition that can be contagious, nor is it associated with poor hygiene. It is most often linked to hidden and complex factors that require a comprehensive approach to alleviate and treat this condition.

    Types of dermatitis

    In the following, we will look at the most characteristic types of dermatitis.

    Atopic Dermatitis

    Atopic dermatitis, also known as eczema, is one of the most common forms of dermatitis. It affects people of all ages but is particularly common in infants and young children. Characteristic symptoms include itching, dry and scaly skin, and rashes that often appear on the face, in the folds of elbows and knees, and on the hands.

    Contact Dermatitis

    Contact dermatitis results from skin contact with irritating or allergenic substances. Depending on the cause, contact dermatitis can be classified into allergic contact dermatitis, which occurs when the skin is exposed to a substance to which a person is allergic and irritant contact dermatitis, which is caused by direct irritation of the skin by substances such as soap or chemicals.

    Seborrheic Dermatitis

    Seborrheic dermatitis usually occurs in areas where sebaceous glands are more active, such as the scalp, its edges, or the area around the nose. This type of dermatitis is often associated with excessive sebum production and can manifest as greasy, scaly patches and red areas of the skin.

    Neurodermatitis

    Neurodermatitis is a skin disorder associated with chronic itching and scratching. Individuals with neurodermatitis may develop thick and rough skin in affected areas, further intensifying the itching.

    Winter Dermatitis (Hiemal Dermatitis)

    Winter dermatitis occurs mainly in colder months. Cold and low temperatures can severely dry out the skin, leading to itching, redness, and flakiness. This form of dermatitis is a common issue in the colder part of the year.

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    Causes of Dermatitis

    The causes of dermatitis vary depending on the type of dermatitis, but environmental factors are usually the triggers for individual outbreaks. When we talk about triggers, we refer to substances or a combination of factors that cause a reaction on the skin.

    Among the most common triggers are:

    • Stress
    • Hormonal changes
    • Environment
    • Irritant substances

    Causes of Contact Dermatitis

    It occurs immediately after contact with an irritating substance or allergen. Some of the most common ones include:

    • Detergents
    • Cosmetics
    • Nickel
    • Ivy and oak

    Causes of Atopic Dermatitis

    Atopic dermatitis or eczema most often occurs in response to several factors combined: dry skin, environmental influences, and skin bacteria.

    Factors may vary among individuals, but stress, hormonal changes, and irritating substances in the environment are among the most common triggers.

    Other factors that can trigger an outbreak of atopic dermatitis in some individuals include increased intake of sugar, dairy products, and red meat.

    Family history of atopic dermatitis is often a strong factor influencing the likelihood of developing atopic dermatitis.

    Causes of Seborrheic Dermatitis

    The exact cause of seborrheic dermatitis is unknown, but there is a strong connection with the yeast Malassezia, which is naturally present on the skin and triggers an inflammatory skin response.

    Certain diseases can increase the chances of seborrheic dermatitis, including:

    • HIV
    • Psoriasis
    • Epilepsy
    • Parkinson's disease
    • Rosacea

    Seborrheic dermatitis may occur during puberty, and at that time, the condition can be most severe.

    Causes of Stasis Dermatitis

    This form of dermatitis occurs due to poor circulation in the body. Weakened valves in the veins cause fluid to accumulate in the limbs. This fluid causes swelling around the affected area. Stasis dermatitis then appears in the areas of swollen skin.

    It most commonly occurs in the lower part of the legs, where blood circulation is weakest, but it can occur anywhere else as well.

    Risk Factors

    Beyond the causes, numerous risk factors can heighten the likelihood of dermatitis development. Among the most prevalent risk factors are:

    • Allergies, Atopic Dermatitis, and Asthma: Individuals with a personal or family history of atopic dermatitis, allergies, hay fever, or asthma face an elevated risk of developing atopic dermatitis.
    • Age: Atopic dermatitis commonly emerges in early childhood but may persist into adulthood. Conversely, contact dermatitis is more frequently observed in adults.
    • Other Health Conditions: Certain health conditions, such as Parkinson's disease, a compromised immune system, or HIV/AIDS, can elevate the probability of seborrheic dermatitis occurrence.
    • Occupational Factors: Those exposed to irritants in their profession, such as chemicals or specific fibers, are at a heightened risk of developing contact dermatitis.

    Symptoms of Dermatitis

    Symptoms vary depending on the type of dermatitis, and it's possible to experience multiple forms, each bringing its own set of symptoms. Here are some of the most common ones:

    • Red and rough skin
    • Itching
    • Rashes resembling burns
    • Dry skin
    • Fluid-filled blisters
    • Thickened and inflamed skin
    • Scaly and uneven skin
    • Painful sores
    • Fluid release when rashes are scratched

    Examples of symptoms for specific types of dermatitis:

    Atopic Dermatitis (Eczema)

    Atopic dermatitis occurs when there is damage to the skin barrier. This results in inflamed skin that becomes red, dry, thickened, with uneven texture, and itchy.

    Contact Dermatitis

    Contact dermatitis is an allergic reaction that occurs due to irritation. It causes a painful rash or intense itching. As the name suggests, contact dermatitis occurs in response to contact with a specific allergen.

    Neurodermatitis

    This type of dermatitis is a result of intense itching that irritates the nerve endings of the skin.

    Perioral Dermatitis

    Perioral dermatitis resembles acne or rosacea in appearance and develops around the mouth, eyes, and nose.

    Seborrheic Dermatitis

    Seborrheic dermatitis manifests as red, dry, scaly, itchy skin on the scalp and other parts of the body.

    Stasis Dermatitis

    This type of dermatitis causes problems with blood flow in the veins. As a result, ankles may swell, and there can be scally skin, itching, pain, and even open sores.

    What Can Worsen Dermatitis Symptoms?

    It's best to explore what could trigger a dermatitis flare-up. Keep in mind that people are highly diverse, and there are no one-size-fits-all rules.

    Do you suspect that your skin is irritated by any of the cleaning chemicals you use? Does the rash appear every time you visit a relative who smokes? Have you noticed itching on your scalp since changing shampoo? Perhaps the rash on the inside of your wrist appeared after trying a new perfume? What impact does the sun have on your dermatitis? And does just the thought of a wool sweater cause intense itching?

    Don't forget about other factors that can worsen dermatitis: stress, hot showers, allergens (pollen and animal dander), and the like. Explore what negatively affects your dermatitis and try to avoid those triggers.

    Possible Complications

    Constant scratching that damages the skin can lead to open wounds and ulcers. This increases the risk of bacterial and fungal infections. Such skin infections can spread and, in extreme cases, become life-threatening.

    In individuals with darker skin tones, dermatitis can cause the affected skin to darken or lighten. This is known as post-inflammatory hyperpigmentation and post-inflammatory hypopigmentation. It may take months or years for the skin to return to its normal tone.

    Diagnosis and Treatment of Dermatitis

    Diagnosing dermatitis typically involves a thorough skin examination by a doctor or dermatologist. The doctor will evaluate symptoms, delve into the medical history, and conduct a comprehensive examination. In cases of uncertainty, allergy tests may be performed to confirm the diagnosis.

    Which tests are necessary for diagnosing dermatitis?

    Ordinarily, a doctor bases the diagnosis of dermatitis on a detailed skin examination. However, in instances of ambiguity, they may conduct specific tests to assist in determining the diagnosis:

    • Blood tests to investigate potential causes of the rash unrelated to dermatitis.
    • Skin biopsy to distinguish between different types of dermatitis.
    • Allergy skin tests.

    Treatment

    The approach to treating dermatitis depends on its cause and the presenting symptoms. If home remedies fail to alleviate symptoms, it's advisable to consult your doctor for a tailored treatment plan.

    Potential treatment methods encompass:

    • Application of corticosteroid creams, gels, and ointments.
    • Use of a cream or ointment containing a calcineurin inhibitor on the affected area, impacting the immune system.
    • Controlled exposure of the affected area to natural or artificial light, known as light therapy or phototherapy.
    • Administration of oral tablets or injections with prescribed potency, especially for severe cases. Examples include oral corticosteroids or the biologic drug dupilumab.
    • Implementation of wet wraps, a medical procedure reserved for severe cases of atopic dermatitis. This involves applying corticosteroid ointment, wrapping with moist dressings, and covering with a layer of dry gauze.

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    Can CBD Cannabinoid Provide Relief for Dermatitis?

    CBD products showcase considerable therapeutic potential for eczema, offering several promising attributes. Research suggests that CBD harbors antimicrobial properties, capable of combating Staphylococcus aureus, a bacterium often responsible for infections in individuals with eczema and contributing to worsening symptoms.

    Cannabinoids also boast numerous anti-inflammatory properties, effectively curbing allergic skin reactions through the activation of cannabinoid receptors.

    In terms of itching, a study on a cannabinoid-rich cream revealed a notable 60% reduction in itch intensity. Furthermore, approximately 33.6% of participants no longer required topical steroid medications to manage their eczema.

    Beyond itch relief, cannabinoids may also prove beneficial in alleviating pain and providing comfort for joint-related discomfort.

    A 2019 study tracking 20 patients with various skin conditions, including eczema, concluded that a topical CBD cream is both safe and effective in addressing inflammatory skin conditions. The product not only alleviated itching but also contributed to skin restoration and improved the overall quality of sleep.

    Prevention

    Taking proactive measures to minimize the onset of dermatitis is crucial, particularly if you have a predisposition to its occurrence. Here are some insightful tips for prevention:

    • Avoiding irritants: Steer clear of known allergens or irritants that trigger your dermatitis.
    • Practicing proper hygiene: Opt for mild cleaning products and limit the frequency of showers or baths.
    • Nourishing the skin: Regularly applying moisturizing lotions and creams is key to maintaining well-hydrated skin.
    • Stress management: Incorporate relaxation techniques into your routine to effectively cope with stress, a factor that can significantly exacerbate dermatitis symptoms.
    • Choosing suitable clothing: Opt for garments crafted from natural materials like cotton and avoid fabrics that may irritate the skin.
    • Embracing a healthy diet: Cultivate a balanced and nutrient-rich diet, abundant in vitamins, minerals, and antioxidants, to promote overall skin health.

    FAQ - Dermatitis Frequently Asked Questions

    How does dermatitis differ from psoriasis?

    Dermatitis and psoriasis are distinct skin conditions. Dermatitis is skin inflammation resulting from exposure to irritants or allergens. Psoriasis, in contrast, is a chronic autoimmune disease leading to accelerated skin cell turnover and the development of scaly patches.

    What distinguishes dermatitis from eczema?

    Eczema is a specific type of dermatitis. While dermatitis is a general term for skin inflammation, eczema is a particular form characterized by itching, dry skin, and rashes.

    How is dermatitis different from rosacea?

    Rosacea is a separate skin condition marked by redness and visible blood vessels on the face. Dermatitis is a broader term encompassing various types of skin inflammation.

    Is dermatitis typically associated with pain?

    Dermatitis itself is usually not painful, but discomfort may arise from scratching and mechanical skin damage.

    Source:

    https://www.webmd.com/skin-problems-and-treatments/eczema/atopic-dermatitis-eczema
    https://www.healthline.com/health/eczema#causes
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736837

    Written by Barbara Novak on December 6, 2023, updated on December 7, 2023.

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