Eczema and Dermatitis Explained:
The differences and similarities between eczema and dermatitis can be quite confusing and therefore we have put together this useful pack of information on everything you need to know about these conditions. Firstly lets start with allergic dermatitis:
What is it?
Allergic contact dermatitis occurs when you come into contact with an allergen which causes your immune system to react abnormally. Your immune system is the body’s natural defence system that usually protects your body against infection and illness. During an allergic reaction, the immune system can attack healthy cells and tissue as well. This is what causes your skin to be sore and inflamed.
The first time you come into contact with a type of allergen, your body becomes sensitised to it. It’s only when you touch that substance again, that your skin reacts with an itchy red rash.
Common allergens that can cause allergic contact dermatitis include:
- metals, such as nickel or cobalt in jewellery
- cosmetics, such as fragrances, hair dye and nail varnish
- preservatives added to certain medicines (including medicated creams)
- rubber, including latex, a type of naturally occurring rubber
- textiles, particularly the dyes and resins that are contained in them
- strong adhesives (glue), such as epoxy resin adhesives
- Some plants, such as chrysanthemums, daffodils, tulips and primula.
- Some topical medicines (medicines that are applied directly to the skin), such as topical corticosteroids and topical antibiotics.
Signs and Symptoms:
It causes skin to become: red, inflamed, blistered, dry, thickened and cracked as well as itchy. It may take hours or several days for your symptoms to appear after coming into contact with the allergen.
In most cases, the area of skin which came into contact with the allergen will be the area which is affected. For example, if you are allergic to an eye shadow or blusher, your eyelids or cheeks may be affected. However, sometimes other areas of skin may also be affected, even if they did not come into contact with the allergen.
You can use emollients, topical corticosteroids or oral corticosteroids:
Pharmacy OTC examples:
Cortopin Hydrocortisone cream (topical corticosteroid): apply sparingly 1-2 times daily. Don’t use on eyes, face and broken or infected skin.
Eurax HC cream (topical corticosteroid): apply sparingly twice a day, for a maximum of 1 week. Same cautions as above.
Oilatum Emollient Cream(emollient): Apply to affected area as often as required.
Antihistamine: Cetrizine, loratidine (make sure they are non-drowsy), as it is an allergic reaction antihistamines can be given along with the choice of cream.
The best way to prevent contact dermatitis is to avoid contact with the allergens that cause your symptoms. However, this is not always possible.
If you cannot avoid contact, you can take steps to reduce the risk of the allergens causing symptoms:
Washing or cleaning your skin
If you come into contact with an allergen, rinse the affected skin with water or wash it using a soap substitute (an emollient). Do this as soon as possible after coming into contact with the allergen.
Using protective clothing
You can wear protective clothing to reduce contact you have with the allergens.
If you know a certain product causes your contact dermatitis, such as a type of make-up or soap, try changing to a different product. Check the ingredients to make sure it does not contain any irritants or allergens you know will affect you. In some cases, you may need to contact the manufacturer or check on-line to get this information.
When to refer:
- When the skin appears infected.
- Pregnant women or children requesting steroids.
- If the skin does not improve after a week of steroid treatment.
Eczema and dermatitis are used interchangeably to describe range of inflammatory conditions where principle symptoms are: dryness, erythema (redness/rash), itch, weeping and crusting.
Term ‘eczema’ is not used for conditions with an endogenous cause and ‘dermatitis’ is used for reactions to external agents.
- Atopic eczema (fluctuating inflammatory condition of skin with no known cause)
- Contact dermatitis:
– Irritant: direct damage to skin by provoking agent on first exposure or repeated. When outer layer is damaged the agent can enter epidermis and cause inflammation. Agents include: detergents, cleaning products, gardening products.
– Allergic: hypersensitivity to sensitising agents. Agents include: rubber, nickel in jewellery, zips, bra clips: resins in glue, ingredients of cosmetics and toiletries.
Signs and Symptoms:
- Eczema: dry, scaly, redness. Usually on inside of elbows, behind knees and on cheeks, forehead and outer limbs. Very itchy prone to secondary infection. Can bleed and be painful
- Irritant dermatitis: itchy, inflamed, red and swollen, lesions appear within 6-12 hours.
- Allergic: inflammation and itchy with weeping, dryness and scaling.
When to refer:
- Severe condition, badly cracked skin and bleeding
- Weeping skin – infection
- Failure of OTC medication
- No identifiable cause
- >2 weeks
- Moisturiser and emollients: used regularly and liberally to keep skin hydrated, prevent flare ups. The greasier the preparation the better for dry, cracked skin applied thickly at night.
- Thinner creams and lotions rub in better, to be effective need to be reapplied several times daily. Emollients should be used in bath and soap substitutes.
- Corticosteroid creams: 1% HCortisone and 0.05% Clobetasone (more potent and effective for flare ups) for short term treatments. Not to be used on face or in eyes or anogenital areas. Not on broken or weeping skin. Contraindicated in pregnancy and during lactation.
- Not for use in children <10y.o. can be used for children under 12 under GP advice.
- Oral Antihistamine: can cause drowsiness, may be benefit for evening use (promethazine and chlorphenamine). Can use non-sedating oral antihistamines; loratidine and cetrizine.
· Dermatitis: Try to identify irritant or allergen and avoid
· Eczema: use moisturisers and emollients liberally and often, avoid bubble bath products, soaps, shower gels and sensitise skin and cause dehydration of skin.
So there you have it a complete guide to these skin conditions. As you can see there is a lot of information here and if you do have any questions or concerns it would be best advised to seek help from an appropriately qualified doctor or pharmacist.