Dermatitis:
treatment, types and causes

Dermatitis is a form of acute or chronic inflammation of the skin. It is also often referred to as eczema.

The following symptoms are typical:

• Itching
• Redness
• Burning sensation
• Crust formation
• Scaling
• Blisters
• Wetness
• In chronic cases, dry, chapped and thickened skin

In principle, eczema can occur on all possible parts of the body, e.g. on the face, scalp, eye and eyelid, hands, feet, arms, legs, genitals or anus.

Some other forms of dermatitis:

• Nummular dermatitis (nummular eczema) manifests itself in itchy, coin-shaped skin rashes on the body, arms and legs. It is thought to be caused by an allergic reaction, a reaction to medication or dry skin.
• Perioral dermatitis usually occurs around the mouth, the corner of the nose and the eye. The use of preparations containing cortisone and excessive skin care are possible causes.
• Sandbox dermatitis is a rare childhood disease associated with itchy papules (round nodules) – especially on the hands, knees and elbows. It occurs mainly in summer and is probably caused by the skin rubbing against sand or rough materials.
• Dyshidrotic hand and foot eczema (dyshidrotic dermatitis) manifests in highly itchy blisters on the hands and feet.
• Stagnation dermatitis often leads to skin inflammation on the lower leg, caused by chronic venous insufficiency, which impedes blood flow.
• Lichen simplex chronicus is caused by frequent scratching – especially on the neck, arms, legs, scalp and genitals. As the inflammation is itchy, an itch-scratch cycle develops that is difficult to break.

Dermatitis needs to be treated differently depending on its cause. Ideally, triggers can be avoided (e.g. contact dermatitis) and the underlying disease can be cured.

Dermatitis medications are usually applied to the skin. In severe cases, systemic treatments (such as medications or infusions) are also required.

• Moisturising ointments are used to relieve eczema and strengthen the skin’s barrier.
• Antihistamines are used for allergy-related symptoms and atopic dermatitis.
• Ointments containing cortisone can help to control severe inflammation. This is usually not the case with perioral dermatitis, of which cortisone is a common trigger.
• For atopic dermatitis, other anti-inflammatory drugs that can be used are calcineurin inhibitors (pimecrolimus, tacrolimus), biologics (e.g. dupilumab) or the relatively new Janus kinase inhibitors (JAK inhibitors).
• Severe cases of atopic dermatitis may be treated with the immunosuppressant ciclosporin.
• UV light therapy may also help with atopic dermatitis.
• Seborrheic dermatitis is usually treated with antifungal agents. Severe inflammation can also be briefly treated with cortisone. Ointments and care products should not be too high in fat.
• Fat-free skin care is also recommended for perioral dermatitis. Zero therapy with discontinuation of all cosmetics and ointments may also be useful. Dermatitis can often be healed by omitting the skincare products that trigger it.
• Zinc ointment has anti-inflammatory effects.
• If patches of eczema have become infected by bacteria, it may be necessary to administer antibiotics.
• In one study, probiotic baths showed promising therapeutic success in atopic dermatitis.

Home remedies for dermatitis:

Washes and baths with Dead Sea salt have the desired drying effect in seborrheic dermatitis. Poultices with oak bark extract or black tea can also help. Black tea compresses have also proven their worth in perioral dermatitis.
Wet dressings (wet wrap therapy), which are laid over the applied care creams or medicinal creams for neurodermatitis, allow active substances to be absorbed more effectively and relieve itching.

The dermatologist (skin doctor) is the right person to contact in the case of skin inflammation. After a discussion about the patient’s medical history, the doctor will assess the appearance of the dermatitis.

This may be followed by further examinations, such as:

• Allergy tests (skin and blood tests)
• Microscopic examinations of a skin swab to rule out, for example, fungal disease
• Skin biopsy: this involves removing tissue to rule out psoriasis, for example.