What Is Dermatitis?

Dermatitis is a general term for skin inflammation. With dermatitis, your skin will typically look dry, swollen, and red. Depending on the type of dermatitis you have, causes vary. However, it’s not contagious.

Dermatitis can be uncomfortable for some. How itchy your skin feels can range from mild to severe. Certain types of dermatitis can last a long time, while others may flare up, depending on the season, what you’re exposed to, or stress.

Some types of dermatitis are more common in children, and others are more common in adults. You may find relief from dermatitis with medications and topical creams.

Contact your doctor for an appointment if your skin is infected, painful, or uncomfortable, or if your dermatitis is widespread or isn’t getting better.

Symptoms of dermatitis

The symptoms of dermatitis range from mild to severe and will look different depending on what part of the body is affected. Not all people with dermatitis experience all symptoms.

In general, the symptoms of dermatitis may include:

• rashes
• blisters
• dry, cracked skin
• itchy skin
• painful skin, with stinging or burning
• redness
• swelling

Types of dermatitis

There are several different types of dermatitis. Below are the most common:

• Atopic dermatitis. Also called eczema, this skin condition is usually inherited and develops during infancy. Someone with eczema will likely experience rough patches of dry, itchy skin.
• Contact dermatitis. Contact dermatitis happens when a substance touches your skin and causes an allergic reaction or irritation. These reactions can develop further into rashes that burn, sting, itch, or blister.
• Dyshidrotic dermatitis. In this type of dermatitis, the skin can’t protect itself. This results in itchy, dry skin, often accompanied by small blisters. It occurs mainly on the feet and hands.
• Seborrheic dermatitis. Also known as cradle cap in babies, this type is most common on the scalp, though it can also occur on the face and chest. It often causes scaly patches, red skin, and dandruff.

Other types

Some other types of dermatitis include:

• Neurodermatitis. This type involves an itchy patch of skin, often triggered by stress or something irritating the skin.
• Nummular dermatitis. Nummular dermatitis involves oval sores on the skin, often occurring after a skin injury.
• Stasis dermatitis. This type involves skin changes due to poor blood circulation.
• Dermatitis neglecta. Dermatitis neglecta refers to a skin condition that results from not practicing good hygiene habits.

The causes of dermatitis

The causes of dermatitis vary depending on the type. Some types, like dyshidrotic eczema, neurodermatitis, and nummular dermatitis, may have unknown causes.

Contact dermatitis

Contact dermatitis occurs when you come in direct contact with an irritant or allergen. Common materials that cause allergic reactions include:

• detergents
• cosmetics
• nickel
• poison ivy and oak

Eczema

Eczema is caused by a combination of factors like dry skin, environmental setting, and bacteria on the skin. It’s often genetic, as people with eczema tend to have a family history of eczema, allergies, or asthma.

Seborrheic dermatitis

Seborrheic dermatitis is likely caused by a fungus in the oil glands. It tends to get worse in the spring and winter.

This type of dermatitis also appears to have a genetic component for some people.

Stasis dermatitis

Stasis dermatitis occurs due to poor circulation in the body, most commonly in the lower legs and feet.

Triggers

The trigger is what causes your skin to have a reaction. It could be a substance, your environment, or something happening in your body.

Common triggers that cause dermatitis to flare include:

• stress
• hormonal changes
• the environment
• irritating substances

Risk factors for dermatitis

Factors that increase your chances of getting dermatitis include:

• age
• the environment
• family history
• health conditions
• allergies
• asthma

Some factors increase your risk for certain types of dermatitis more than others. For example, frequent washing and drying of hands will strip your skin’s protective oils and change its pH balance. This is why healthcare workers typically have hand dermatitis.

Diagnosing dermatitis

Your doctor will perform a physical exam and discuss your medical history before making a diagnosis. In some cases, a dermatologist can diagnose the type of dermatitis just by looking at the skin.

If there’s reason to suspect you might have an allergic reaction to something, your doctor might do a skin patch test. You can also ask for one yourself.

In a skin patch test, your doctor will put small amounts of different substances on your skin. After a few days, they’ll check for reactions and determine what you may or may not be allergic to.

In some cases, your dermatologist may perform a skin biopsy to help figure out the cause. A skin biopsy involves your doctor removing a small sample of the affected skin, which is then looked at under a microscope.

Other tests can be done on the skin sample to help determine the cause of your dermatitis.

At-home and medical treatment options

Treatments for dermatitis depend on the type, severity of symptoms, and cause. Your skin may clear up on its own after one to three weeks.

If it doesn’t, your doctor or dermatologist may recommend:

• medications to reduce allergies and itching, like an antihistamine such as diphenhydramine (Benadryl)
• phototherapy, or exposing affected areas to controlled amounts of light
• topical creams with a steroid, like hydrocortisone, to relieve itchiness and inflammation
• creams or lotions for dry skin
• oatmeal baths to relieve itching

Antibiotics or antifungal medications are usually given only if an infection has developed. Infections can occur when the skin is broken due to intense scratching.

Home care for dermatitis may include applying cool, wet cloths to the skin to reduce itching and discomfort. You can try adding baking soda to a cool bath to help reduce symptoms. If your skin is broken, you can cover the wound with a dressing or bandage to prevent irritation or infection.

Dermatitis can sometimes flare up when you’re stressed. Alternative therapies may be helpful in reducing stress such as:

• acupuncture
• massage
• yoga

Dietary changes, like eliminating foods that trigger a reaction, may help you manage eczema symptoms. In some cases, dietary supplements like vitamin D and probiotics can help as well.

Awareness is the first step in avoiding dermatitis. The only way to prevent an allergic reaction is to avoid contact with allergens or substances that cause rashes, like poison ivy. But if you have eczema — which isn’t always preventable — your best option is to prevent a flare-up.

To prevent flare-ups:

• Try to avoid scratching the affected area. Scratching can open or reopen wounds and spread the bacteria to another part of your body.
• To prevent dry skin, by taking shorter baths, using mild soaps, and bathing in warm water instead of hot. Most people also find relief by moisturizing frequently (especially after a shower).
• Use water-based moisturizers after washing hands and oil-based moisturizers for extremely dry skin.

Outlook

While dermatitis isn’t often serious, scratching hard or too frequently can lead to open sores and infections. These can spread, but they rarely become life-threatening.

You can prevent or manage potential flare-ups with treatment. It might take some time to figure out the right treatment or combination of treatments, but it’s out there.

One of the major plot points in the story of becoming an adult is swapping your guardian-approved pediatrician for a general practitioner. Eventually, you recognize the need for a primary care physician and, despite dreading making your own doctor’s appointments, you oblige.

So why not see one for the outside, too? We mean your skin, of course. And like finding your own GP, choosing the right dermatologist doesn’t come naturally.

Without a pressing reason like skin allergies as a child, dermatology is often an afterthought — but it definitely shouldn’t be.

From routine skin cancer screenings to hormonal acne treatment (which is something women from ages of 20 to 29 to 40 to 49 encounter), your dermatologist can help with balancing your skin health — or at least, the right one will, which is why choosing the best person for the job is so important.

If you’ve never been to the dermatologist before but feel ready, able, and willing to take this step now, here are a few tips to get you started:

1. Determine if your dermatology needs are medical, surgical, or cosmetic

Chances are you have a concern you want to solve, but not every dermatologist is suitable.

Dermatologic care, like any other type of medical care, must be specific to your needs as a patient. This is a transactional service after all.

Dr. Adarsh Vijay Mudgil, a board-certified physician in dermatopathology, says you should start by asking yourself if your needs are:

• medical (e.g. cystic acne or rosacea)
• surgical (e.g. removal of a benign growth or nodular melanoma)
• cosmetic (e.g. facial sculpting)

They can even be all the above or a combo of two. For example, eye bag removal is both cosmetic and surgical.

Regardless, Dr. Mudgil says this self-assessment is essential because dermatology expertise is such a diverse medical field. “For instance, my practice focuses on cosmetic dermatology, medical dermatology, and skin pathology but I don’t perform skin cancer surgeries,” he explains.

Ideally, you should choose a dermatologist whose specialty most closely aligns with your needs. When in doubt, call the doctor’s office and ask if the dermatologist you’re likely to see is experienced in treating your specific areas of concern.

If they imply that they may not be right for you or that you require a specialty service they don’t offer, don’t be afraid to keep looking.

2. If applicable, identify dermatologists who treat people of color

Your natural skin color affects your dermatology needs.

Dr. Saya Obayan, a board-certified clinical dermatologist who specializes in the care of skin, hair, and nail diseases, says, “If you are a person of color, the first thing to do would be to find someone who has experience treating skin of color.”

“I tend to notice that skin of color forms pigment very easily, so when a person with an olive skin tone or with a darker complexion is looking for a dermatologist, they should look for someone who is familiar [with] treating hyperpigmentation,” she reveals. “[Find someone] who will be able to treat underlying conditions as well as formulate a plan to treat the dark spots.”

If you can, Dr. Obayan suggests finding a dermatologist who has also published credible work on the topic.

Expertise by skin type and color is especially important when it comes to scar treatments, like microneedling and lasers.

You may be tempted by Instagram results, but not all skin is the same. Dark skin tones react differently and have a higher risk of excessive scarring or keloids. The risk goes up when the procedures are done by someone who lacks experience managing such complications.

And Dr. Obayan says it’s not just about skin, either.

A good dermatologist should be interested in your hair and scalp routine too, which is different for someone with type 3 or type 4 hair. All of these factors, as well as your medical history and lifestyle, are important when it comes to receiving optimal dermatologic care.

3. Plan out how you will be paying

Will your current health insurance plan cover your dermatology costs or will you be paying out of pocket? The answer, which depends a lot on your reason for seeing a dermatologist, may significantly influence who you choose.

To get covered by your insurance, the dermatologist will first have to be in-network. You can often find in-network dermatologists online through your insurance’s website, or you can contact the dermatologist’s office directly to see if they’re contracted with your insurer.

Next, you’ll need to find out if your specific needs are covered.

For your insurance to cover something, it would have to be a medical or surgical need. While what insurance covers (and what it takes to get it covered) can vary by company, here’s a helpful guide:

Anyone who’s uninsured or who will be paying out of pocket should be upfront about this, asking about approximate costs and payment plan options available to them.

4. Verify the dermatologist’s credentials

This is crucial when seeing any medical professional for the first time. Don’t overlook it.

Typically doctors will list their certification and credentials on their website. You can also verify a doctor’s board certification (which means they’ve been trained extensively and exclusively in dermatology) with the American Academy of Dermatology or the American Board of Dermatology.

The former also allows you to search by zip code for certified dermatologists in your area.

But don’t shy away from consults with physician assistants and nurse practitioners

Physician assistants and nurse practitioners are available in many dermatology offices alongside dermatologists and typically have several years of experience with treating skin concerns. They’re trained by the dermatologist to provide care.

Jennifer Winter, diplomate of the Society of Dermatology Physician Assistants, has spent the last 19 years working with board-certified dermatologists providing general and surgical care to patients.

“As long as the dermatologist is available for consultation, don’t shy away from PA and NP visits,” she says. “You may get an appointment [with them] much quicker than with the physician.”

5. Scour reviews with a grain of salt

By this point, you already know this person is professionally qualified. Now you need to know if they’re right for you.

Most doctors’ offices are searchable online and offer Google and Yelp reviews, as well as reviews on websites like HealthGrades.com, Vitals.com, and RateMDs.com, by former clients. But while credentials are a good way to verify qualifications, you ultimately want a practitioner who makes you feel good about being you.

Red flags should include anything that might be a deal breaker for you, for example:

• an unwelcoming office
• hostile bedside manner
• hidden fees
• non-specific treatments
• unsatisfactory results
• sales-driven behavior

LOOK AT THE ONLINE PRESENCE OF THE OFFICES

• Winter tells us that each state maintains a database of actions that have been taken against physicians, physician assistants, and nurse practitioners that might be worth reviewing. All you have to do is Google your state’s department of health and look for the disciplinary and administrative actions tab.
• If suggestions about changing your facial features makes you feel uncomfortable, you may also want to avoid offices that heavily market cosmetic surgeries on their website or social media.

And while reviews can shed light on these flags, keep in mind that medical reviews are risky business for two primary reasons.

Firstly, most patients who’ve had a positive or satisfactory experience have no real motivation to leave a review, unless such reviews are solicited by the dermatologist themselves. Someone who’s had a negative experience, on the other hand, is primed to air their grievances online and it’s often difficult for physicians to respond due to privacy protection laws.

The second more pertinent reason you should be careful when reading online reviews is that everyone has different levels of satisfaction and medical needs. If you can, identify reviews by people who are most like you.

Online reviews are helpful, but don’t discount a recommendation by a primary care physician, family member, or friend who knows you and your needs well, either.

6. Check in with yourself after your first appointment

Just because you’ve been to one appointment doesn’t mean you’re locked into this doctor-patient relationship forever.

Ask yourself a series of questions during and after your appointment:

• Did you feel heard?
• Were you able and encouraged to share all the information you think is important?
• Did the dermatologist examine you thoroughly?
• Were you able to ask — and did you understand the answers to — all of your questions?
• Did the dermatologist give you multiple treatment options, explaining the risks and success rate of each?
• And if necessary, were you able to schedule a follow-up appointment?

Still not convinced a dermatologist is the right fit? That’s OK

If the closest derm is too expensive for surface concerns, or your treatments are more cosmetic than disorder, think about seeing a licensed cosmetic or medical aesthetician.

These skin experts can often be more accessible than a dermatologist, especially for issues like mild acne and dry, dull, or damaged skin. Their approach is often more about maintenance and support and can help your skin by recommending a personalized routine, facials and peels, and other noninvasive procedures.

Sarah Nicole Payne, licensed aesthetician of nine years, says, “Aestheticians work with their clients in a personalized, in-depth way that many doctors don’t have the time to commit to.”

But she admits it’s not always one or the other.

“Let’s say your dermatologist prescribes you a medication that dries out your skin and possibly increases sensitivity. They may suggest a cleanser or facial cream to use while on your medication, but an aesthetician would be able to support your skin through the treatment with healing facials and education about how to care for your skin through the process.”

Whatever your decision when it comes to all things skin, your health is your responsibility and you owe it to yourself — and no one else — to do what’s best for you.