Dermatitis/Eczema
Dermatitis is a common skin reaction which is characterised by a red and itchy rash, which can sometimes look swollen. This rash can flare up occasionally or be present all the time. Some people use the word "eczema" to describe dermatitis, and these two words can be used interchangeably.
Different types of dermatitis exist.
Some of the most common types of dermatitis/eczema are:
Atopic dermatitis/eczema
Atopic dermatitis usually occurs in people who have a tendency to get allergies, or who also have asthma or hayfever (allergic rhinitis). All three of these conditions (atopic dermatitis, asthma and hayfever) are closely related. Often these conditions run within families with a parent, child or sibling also affected.
Most people develop this condition in childhood, though it can occur at any age. The rash is usually intensely itchy and commonly occurs in the skin flexures (such as behind the elbows or knees). Sometimes the skin may be broken.
Although the exact cause is unknown, atopic dermatitis can be brought on by allergies such as reactions to certain foods, dust mites, pollen or animal fur, or made worse by irritants such as woollen clothes, perfumes, soaps and chemicals. Stress or changes in the weather can also cause flare-ups (periods of time where the skin becomes more itchy and inflamed than usual).
Atopic dermatitis may be divided according to the age of onset into three different types.
Infantile atopic dermatitis
Infantile atopic dermatitis usually starts between four and six months of age. The baby develops a red rash, which may weep. It appears on the cheeks and may spread to the forehead, scalp and the backs of arms and legs. In severe cases it may involve the whole body. This type of dermatitis usually disappears between the ages of three and five years.
Childhood atopic dermatitis
Childhood atopic dermatitis may follow infantile atopic dermatitis, or it may start for the first time between the ages of two and four years. It tends to occur in the creases of the elbows, behind the knees, across the ankles and also may involve the face, ears and neck. This form of dermatitis usually disappears by the age of 10, but may continue into adulthood.
Adult atopic dermatitis
Adults with atopic dermatitis usually have large areas of itchy, reddened, weeping skin. The elbow creases, wrists, neck, ankles and behind the knees are areas especially affected. The condition tends to improve in middle life and is unusual in elderly people.
Allergic contact dermatitis
This is a skin reaction which results from contact with something you are allergic to. Common substances that cause allergies include hair dye, nickel in jewellery, sticking plasters, latex in rubber gloves, plants, cosmetics, dyes or chemicals in clothing. The area that has been in contact with the allergen usually develops a very red lumpy rash.
Irritant contact dermatitis
Irritant substances such as soaps, disinfectants, chemicals, detergents and solvents can remove natural oils from your skin. Repeated contact can make skin red, itchy and dry and lead to scaling, cracking and roughness. Hands are the area most commonly affected.
Seborrhoea dermatitis
This is a common, harmless, scaling rash which can affect the face, scalp, eyebrows, and eyelid edges. It is more likely to occur in places where the skin is oily. You may need to discuss treatment with a doctor or pharmacist as often this type of dermatitis can be hard to manage.
Cradle cap
Cradle cap is a scaly, crusty, patchy, greasy skin rash that commonly appears on the scalp of recently born babies. It is not usually itchy and most babies are not bothered by it. It is uncertain whether it is the same condition as seborrhoeic dermatitis.
Nobody really knows what causes cradle cap but may be due to either overactive sebaceous glands in the skin of new-born babies, or a yeast infection. In most babies the rash clears up by the time the baby is one year old.
See Your Pharmacist or Medical Professional
If you have a weakened immune system, serious medical condition, or the person with the eczema/dermatitis is a young child, you should always talk to a pharmacist. Also talk to a pharmacist if:
The skin is broken, weeping or painful or is making you very uncomfortable
There are signs of infection, such as pus, swelling, redness or warmth
There are any vesicles, which look like small blisters filled with clear fluid
The area has white patches or silvery scales
The skin has become tough and leathery
You have tried treating your skin but it has not improved
Your skin problem is related to your occupation or a regular habit (such as washing hands)
The rash has spread, worsened or lasted for more than three weeks
The cradle cap has worsened or is bothering your baby
You are not sure what type of skin problem you have
If you have allergies to topical medicines.
Treatment Tips
Tips for atopic dermatitis/eczema:
Use a moisturiser or emollient frequently
Try to avoid scratching – keep fingernails short
Anti-itch products may be helpful
Choose a mild soap or soap substitute
Use lukewarm water in baths or showers
Pat your skin dry – do not rub it – then apply a moisturiser or emollient
Choose cotton clothing and bed linen
Using a laundry detergent formulated for sensitive skin and avoiding fabric softeners may help.
Tips for allergic contact dermatitis:
Try to identify the substance causing the allergy and avoid it in future
Your doctor can arrange for you to have allergy tests if necessary.
Tips for irritant contact dermatitis:
Avoid contact with substances you know irritate your skin
Use a barrier cream or gloves to protect your hands
Use a mild soap or soap substitute to prevent loss of natural skin oils since normal soap is very drying on the skin.
Tips for seborrhoeic dermatitis
Use an antifungal shampoo or lotion (see dandruff) and occasionally topical corticosteroids
Ask for further advice if the condition persists.
Tips for cradle cap
Use a mild baby shampoo and brush baby's hair softly with a soft baby brush
Baby oil or mineral oil can also soften scales allowing easier removal – leave on for 5 to 10 minutes then brush off
Do not use olive oil as this can cause overgrowth of naturally occurring yeast thought to be associated with cradle cap.
Treatment Options
Always discuss treatment options with your pharmacist to ensure the best outcome.
Products to use instead of soap
[GENERAL SALE] or [PHARMACY ONLY]
e.g., Aqueous Cream, Alpha Keri range, Arrowcare Derma Soap-free Wash, Emulsifying Ointment, Epaderm, QV Gentle Wash
Use these whenever you would use a normal soap
Soap substitutes can help people with dermatitis avoid skin flare-ups
If you use aqueous cream or emulsifying ointment put a small knob in a jar, add hot water and shake for a liquid soap substitute.
Products to moisturise and soften skin
[GENERAL SALE] or [PHARMACY ONLY]
e.g., Aveeno Skin Relief, Epaderm, Lipobase Cream, QV Cream or Skin Lotion
Apply these products frequently
Lotions feel lightest on skin and are suitable for use on the scalp and other hairy areas – they can also be used to treat mild dryness on other parts of your body
Creams are the next lightest type of product – they are usually easily absorbed into your skin and are pleasant to use
Ointments feel much heavier on your skin and some people may find them too greasy
Ointments can be useful for thicker or more scaly areas of dry skin, and for use overnight, or on feet.
Products to protect hands from chemicals or moisture loss (barrier creams)
[GENERAL SALE]
e.g., Silic 15, Ungvita cream, Vaseline petroleum jelly, zinc and castor oil
Barrier creams are useful if you frequently have your hands in water, or if you have contact dermatitis
They may make your hands slippery
If applied before getting hands dirty, they make it easier to wash off dirt and stains later.
Products to use in the bath or shower
[GENERAL SALE] or [PHARMACY ONLY]
e.g., Alpha Keri Oil, Aveeno Soothing Bath Treatment, Oilatum Plus, QV range
These products leave a thin layer of oil on your skin, which helps to hold moisture in
Use no more than the recommended amount
These products can make the bath or shower slippery.
Products to stop itching
[GENERAL SALE]
e.g., Pinetarsol range
Use in the bath or shower to help reduce itching
If itching is severe, oral antihistamine tablets or syrups may help – ask your pharmacist for advice.
Products to reduce redness or itching
[GENERAL SALE]
e.g., Egoderm Cream, Egoderm Ointment
These products reduce inflammation and itching
Can reduce flare-ups associated with eczema.
Topical steroids to reduce redness and itching
Mild steroids
[PHARMACY ONLY]
e.g., DermAid 0.5%, Skincalm 0.5%
[PHARMACIST ONLY]
e.g., DermAid 1%, Skincalm 1%
Steroid creams treat inflammation and reduce itching
Do not apply to broken or infected skin
Do not use on your face except on medical advice
They can cause permanent thinning of the skin if overused – apply sparingly and do not use more often than recommended
Do not use for longer than one week.
Products for cradle cap
[GENERAL SALE]
e.g., Egozyte Cradle Cap lotion
Loosens and removes the crusts due to cradle cap.
Natural/herbal products/supplements
e.g., Eczema Comp cream, Bifidobacterium, Lactobacillus, fish oil, Mebo Anti-itch, Rice-bran, XmaEase cream
Contain natural ingredients that help comfort the skin and reduce the urge to scratch
Some probiotics (e.g., Bifidobacterium, Lactobacillus) can reduce the severity of eczema, especially in children
Fish oil provides beneficial omega-3 fatty acids and helps to keep the skin moist.
More Information
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
