Dermatitis

Dermatitis (also called eczema) is an itchy inflammation of the skin. There are many types of dermatitis.

Signs and Symptoms

• Itching pain stinging or burning
• Blisters thick or scaly skin red skin sores from scratching

What Causes It?

• Allergic reactions (for example to poison oak or ivy)
• Low humidity or soaps and detergents
• Chemicals such as nickel and cobalt
• Working with chemicals or wetting hands often
• Genetic make up

What to Expect at Your Provider's Office

Your health care provider will try to determine the cause of your dermatitis and make sure you have dermatitis and not a similar disease such as psoriasis skin cancer or some psychological conditions.

Treatment Options

Treatment Plan

Treatment begins with avoiding whatever caused your dermatitis to appear. Relief for symptoms includes cool wet cloths to reduce swelling and itching. Burrow's solution added to the compress reduces bacterial growth. Various drugs may be taken to reduce your symptoms but do not cure the dermatitis. Antibiotics are used when an infection develops. Try not to scratch your skin. This is what usually causes the infection. Sometimes ultraviolet light is used to help cure dermatitis.

Drug Therapies

Prescription

• Corticosteroids—such as prednisone taken orally help to reduce swelling; swelling can reoccur or become worse when you stop taking them; various side effects
• Topical corticosteroids—such as hydrocortisone can be put on the skin to relieve itching; possible side effects
• Nonsteroidal topical creams—reduce the immune reaction that is causing your dermatitis; can be put right on the skin
• Antihistamines—relieve itching but do not cure the disease; some may help you sleep but you also can ask for a kind that will not make you drowsy
• Antibiotics—for infection; more effective if taken orally but also available as a skin cream

Over the Counter

• Some creams are available in nonprescription strength for mild dermatitis.

Complementary and Alternative Therapies

Following nutritional guidelines and using herbal support may help reduce inflammation and hypersensitivity. Hypersensitivity associated with stress and anxiety may be helped by mind-body techniques such as meditation tai chi yoga and stress management.

Nutrition

Note: Lower doses are for children.

• Eliminate or reduce exposure to environmental or food allergens. Common allergenic foods are dairy soy citrus peanuts wheat (sometimes all gluten-containing grains) fish eggs corn and tomatoes.
• Reduce pro-inflammatory foods in the diet including saturated fats (meats especially poultry and dairy) refined foods and sugar.
• Increase intake of fresh vegetables whole grains and essential fatty acids (cold-water fish nuts and seeds).
• Flaxseed borage or evening primrose oil (1 000 to 1 500 mg one to two times per day) are anti-inflammatory. Children should be given cod liver oil (1 tsp. per day) or omega-3 oils (fish oils).
• Beta-carotene (25 000 to 100 000 IU per day) zinc (10 to 30 mg per day) and vitamin E (200 to 800 IU per day) support immune function and skin healing.
• Vitamin C (1 000 mg two to four times per day) inhibits histamine release. Rose hips or palmitate are citrus-free and hypoallergenic.
• Selenium (100 to 200 mcg per day) helps regulate fatty acid metabolism and is a co-factor in liver detoxification.
• Bromelain (100 to 250 mg two to four times per day) helps reduce inflammation.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers; 10 to 20 minutes for roots.

Flavonoids a substance found in dark berries and some plants have anti-inflammatory properties strengthen connective tissue and reduce hypersensitivity. The following bioflavonoids may be taken in dried extract form.

• Catechin (25 to 150 mg two to three times per day) quercetin (50 to 250 mg two to three times per day) hesperidin (50 to 250 mg two to three times per day) and rutin (50 to 250 mg two to three times per day).
• Rose hips (Rosa canina) are also high in bioflavonoids and may be used as a tea. Drink 3 to 4 cups per day.

The following herbs support skin healing and lymphatic drainage; use in combination as a tincture (15 to 30 drops three times per day) or tea (2 to 4 cups per day). Peppermint (Mentha piperita) red clover (Trifolium pratense) cleavers (Gallium aparine) yarrow (Achillea millefolium) and prickly ash bark (Xanthoxylum clava-herculis).

Sarsaparilla (Smilax species) helps heal hot red inflamed skin and gotu kola (Centella asiatica) is good for dry scaly crusty skin. Use 3 ml sarsaparilla and 2 ml gotu kola tincture daily or 3 cups tea per day.

Oregon grape (Mahonia aquafolium) or red alder bark (Alnus rubra) taken as tincture (20 to 30 drops three times a day) helps the liver process waste.

Creams and salves containing one or more of the following herbs may help relieve itching and burning and promote healing. Chickweed (Stellaria media) marigold (Calendula officinalis) comfrey (Symphytum officianale) and chamomile (Matricaria recutita).

Peppermint leaf tea (Mentha piperita) may be cooled and applied to relieve itching and burning. An external menthol ointment can also help.

Homeopathy

Some of the most common remedies used for dermatitis are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Apis mellifica for hot swollen vesicles
• Rhus toxicodendron for intense itching and burning
• Urtica urens for burning stinging pains

Acupuncture

Acupuncture may help restore normal immune function and reduce the hypersensitivity response.

Massage

Massage may help reduce stress which makes dermatitis worse.

Following Up

Carefully avoid whatever gives you dermatitis and prevent infection and scarring by not scratching.

Special Considerations

Check with your provider before using any medication if you are pregnant.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:144.

Habif TP. Clinical Dermatology. 3rd ed. St. Louis Mo: Mosby-Year Book; 1996.

Middleton E ed. Allergy: Principles and Practice. 5th ed. St. Louis Mo: Mosby-Year Book; 1998.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:29 326 394.

Rakel RE ed. Conn's Current Therapy. 50th ed. Philadelphia Pa: WB Saunders; 1998.

Scalzo R. Naturopathic Handbook of Herbal Formulas. Durango Colo: 2nd ed. Kivaki Press; 1994:36.

Schulpis KH Nyalala JO Papakonstantinou ED et al. Biotin recycling impairment in phenylketonuric children with seborrheic dermatitis. Int J Dermatol. 1998;37:918-921.

Stewart JCM et al. Treatment of severe and moderately severe atopic dermatitis with evening primrose oil (Epogam): a multi-center study. J Nut Med. 1991;2:9-16.

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