Dermatitis: causes, symptoms, diagnosis, treatment and prevention

By Cristiano Antonino On Apr 20, 2023

Dermatitis is an inflammation of the skin. Considered one of the most common skin diseases today, there are different types and different symptoms

The causes of dermatitis can be many and varied, as are the symptoms, including itching, redness, swelling and irritation.

In adulthood, dermatitis can appear around the age of 30, while it is very common among children.

What is dermatitis?

The term ‘dermatitis’ refers to pathologies that affect the skin, particularly those that lead to symptoms such as itching, irritation and swelling.

Specifically, dermatitis can be identified as a form of skin inflammation, which can appear in adults as well as in infants and children.

The definition of dermatitis is therefore generic and covers different types of skin inflammation

This definition makes dermatitis a rather common condition, also because the causes can be many.

For example, there are forms of allergic dermatitis or types that affect and are caused by dietary deficiencies or infections.

There are many types of dermatitis, differing mainly in their causes.

While the triggering factors of the disease may be different, the symptoms are often identical.

From the mildest forms, it is possible to find real skin lesions in patients, leading to swelling and blisters.

Types and symptoms of dermatitis

The symptoms of dermatitis can be many, some appearing simultaneously while in other cases it is possible to suffer from only one symptom.

Among the most common are:

swelling of the skin
redness and blotches
scabs
exudation
blisters
desquamation

The different types of dermatitis can then lead to different symptoms:

in contact dermatitis, for example, blisters are more common on areas that come into contact with the allergy trigger;
in psoriasis, on the other hand, red/white patches with flaking of the skin are common;
seborrhoeic dermatitis, on the other hand, is characterised by the shedding of oily scales, an example of which is oily dandruff. The latter type of dermatitis can affect specific areas of the body, such as the face and head;

In perioral dermatitis, the most common symptoms are around the mouth, while in herpetiform dermatitis, in addition to itching, scales and redness, gastrointestinal problems may be associated.

Atopic dermatitis

Atopic dermatitis is one of the most common skin inflammations.

This disorder, which is chronic in nature, was discovered in the late 1800s by two dermatologists: Leonard Marie Lucien Jacquet and Lois Anne Jean Brocq.

The symptoms of atopic dermatitis are typical of skin inflammation and include dryness, the presence of scabs, erythema, severe itching, scaling and redness.

Twenty per cent of children suffer from this condition and the cause is an immune system that is not yet well formed, which can also lead to other disorders or allergies.

If atopic dermatitis is left untreated or becomes chronic, the symptoms can change and lead to rhagades, hyperkeratosis, lichenised areas of the skin and the patient’s inability to avoid scratching.

In some cases the itching is so severe that it leads to a severe worsening of the patient’s condition.

Usually these symptoms occur on the face, hands and the creases of the elbow, knees or neck.

In adults, however, dermatitis appears mainly on the hands around the mouth or on the eyelids.

Causes

As mentioned, the causes of dermatitis are many and vary depending on the type:

In contact dermatitis, the main cause is contact with irritating or allergy-inducing substances. Among the triggers of inflammation are various substances, such as nickel, latex, ivy and other herbs, cosmetics, perfumes and chemicals used in textiles;
psoriasis, on the other hand, can be caused by several factors, the most common being genetic predisposition or stress;
seborrhoeic dermatitis is caused by excess sebum or a predisposition to the fungus Malassezia furfur. In infants, it manifests itself with excessive milk crusts;
dermatitis herpetiformis is increasingly associated with coeliac disease, a chronic disease that leads to permanent gluten intolerance;
finally, perioral dermatitis is perhaps the most difficult type to detect, as the causes are not yet certain.

Diagnosis

Skin inflammations are many and varied in type and origin.

The triggering agents of skin diseases are many and this makes their identification very complicated.

In fact, the diagnosis of dermatitis is not simple: skin irritation can often be an isolated case or a symptom of more complex diseases.

The first step in diagnosing dermatitis is to study the patient’s lifestyle.

The anamnesis is in fact fundamental to start ruling out certain factors, such as genetics and hereditary diseases.

During an initial visit, information about the family, any diagnoses of relatives and medication intake may be requested.

This initial data is essential to give the doctor an initial overview, so that he or she can already formulate some hypotheses.

After this first visit, the general practitioner may prescribe another visit to a specialised dermatologist, who will be able to investigate more thoroughly.

Very often during these examinations, specific tests may be requested to identify any allergies or the causes of the dermatitis.

One of the most common is the patch test, which mainly rules out contact dermatitis.

This test involves the application of large patches, contained in aluminium discs, which are to be applied to the back.

These pads contain substances to which the patient may be allergic and must be kept on for at least 48 hours.

At the end of the test, the doctor will be able to analyse the reaction of the skin; in cases of severe redness or blistering, it is most likely allergic contact dermatitis.

If this type of test does not lead to any results, other blood tests may be required, or a small skin biopsy may be performed to diagnose other types of dermatitis.

Cures and treatments

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Treatments for dermatitis are very diverse and can change not only depending on the type of inflammation, but also on the severity of the symptoms and the type of patient affected.

Aspects such as age, the presence of other diseases or the psychological state of the patient are in fact fundamental in prescribing the most suitable treatment.

Younger patients, such as infants and children, are the ones who often achieve a complete resolution of the problem.

Especially in adulthood, dermatitis can reach chronic stages and present itself continuously.

Factors such as diet or healthy air can greatly influence the recurrence of inflammation.

Among the most prescribed and popular remedies for dermatitis are:

the use of cortisone and corticosteroids, particularly in the most severe cases, as they help to immediately decrease the state of high inflammation. Today, they are available in many types, such as lotions, ointments and creams;
the use of allergen- and irritant-free products, i.e. shampoos, emollients, bubble baths and creams without perfumes, nickel or parabens. These products are often based on pure vegetable fats and essential oils and do not contain chemicals;
in cases of allergic dermatitis, the use of antihistamines and antibiotics may be recommended;
phototherapy has led to numerous benefits and positive effects, as has the use of antiseptic substances.

These treatments for dermatitis often do not represent a definitive cure, but can lead to an immediate benefit on symptoms.

This can temporarily eliminate the inflammation, but if the dermatitis is chronic, it is very likely that the symptoms will reappear over time.

Prevention of dermatitis

Preventing dermatitis is not easy.

However, behaviours can be adopted that decrease the likelihood of symptoms appearing.

In younger children, it is essential to use personal hygiene products that are natural and do not contain irritants or chemicals that could cause allergic reactions.

Using dermatologically tested bath foams, creams and shampoos that are free of substances such as nickel and parabens can be essential to keep the skin clean without damaging it.

Keeping folded areas of the body dry is also important because it prevents the spread of bacteria, e.g. in the elbow, neck or behind the knee.

Even for adults, factors such as diet and healthy air can greatly improve the health of one’s skin.

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