Dermatitis is an inflammatory condition of the skin that manifests itself with redness, itching, dryness and sometimes scaling. This disorder can affect any area of the body and can affect people of all ages and with different skin types. In this article, we will explore the main types of dermatitis, the possible causes and the treatments available to alleviate the symptoms and improve the quality of life of people with this condition.
Types of dermatitis and main causes
There are different forms of dermatitis, each with specific characteristics and causes:
- Atopic dermatitis or atopic eczema: is a chronic condition characterised by dry skin, itching and inflammation. It is common in children, but can also occur in adulthood. In adults, the symptoms are often more persistent and difficult to manage. It manifests itself with erythema and blisters in skin folds, such as those of the elbows, knees and neck, where moisture tends to promote skin irritation. It can also give rise to the formation of scabs on the head. The causes are not entirely clear, but the following factors are believed to play a significant role:
- Genetic factors: genetic predisposition is one of the main risk factors. People with mutations in the filaggrin genes have a weaker skin barrier because this protein plays a key role in the formation and maintenance of the stratum corneum of the skin. Moreover, atopic dermatitis is often present in individuals who have a family history of atopic diseases, such as asthma, allergic rhinitis or other forms of eczema.
- Dysfunction of the skin barrier: the skin of people with atopic dermatitis has an impaired skin barrier, which reduces the skin’s ability to retain moisture and makes it more vulnerable to irritants, allergens and microorganisms.
- Alterations of the immune system: atopic dermatitis is linked to an exaggerated immune response, which causes chronic inflammation of the skin. The immune system of people with this condition tends to overreact to environmental allergens and other external factors, triggering inflammation and itching.
- Environmental factors: Environmental allergens such as pollen, dust mites, moulds and animal hair can contribute to the development or worsening of atopic dermatitis. Contact with irritants, such as harsh soaps, detergents, synthetic fabrics or perfumes, can also worsen the condition.
- Climate and humidity: extreme temperatures, both hot and cold, and dry air can further dry out the skin and worsen symptoms. Conversely, excessive humidity can encourage sweating, which further irritates already inflamed skin.
- Stress and lack of sleep: Lack of sleep leads to increased levels of the stress hormone cortisol in the body, promoting skin inflammation. Increased cortisol, in turn, can hinder collagen and lipid synthesis, weakening the skin’s protective barrier and promoting loss of moisture, resulting in increased vulnerability to irritants.
- Diet and food allergies: Foods such as milk, eggs, peanuts, soya and wheat may be associated with atopic reactions.
- Seborrhoeic dermatitis: this is a very common form of dermatitis that mainly affects areas of the body rich in sebaceous glands, such as the scalp but also the face, particularly the sides of the nose and the upper chest, and is characterised by redness, itching and flaking caused by excessive sebum production. An overproduction of sebum can encourage the proliferation of inflammation-causing microorganisms such as Malassezia, a yeast that normally lives on the skin but proliferates under conditions of excess sebum, causing inflammation. Several elements that contribute to excess sebum production have been identified:
- Hormonal imbalances: hormones influence the activity of the sebaceous glands, and hormonal changes can aggravate seborrheic dermatitis. For this reason, the condition is more frequent during periods of hormonal changes, such as puberty, pregnancy or menopause, but also seasonal changes.
- Stress: as we have seen, stress can lead to an increase in the production of hormones such as cortisol, resulting in increased sebum production.
- Alterations in the skin microbiome: these imbalances can lead to a greater growth of pathogenic microorganisms than beneficial ones, contributing to skin inflammation.
- Diet: Foods with a high glycaemic index, such as refined sugars and carbohydrates, dairy products, fried foods or foods rich in saturated fats can promote sebum production.
- Contact dermatitis: occurs when the skin comes into contact with irritants or allergens, causing redness and itching. Common causes include:
- Chemicals used in industry, such as formaldehyde or acrylic monomers, used in products such as textiles, paints, printing inks, adhesives and sealants
- Latex, found in gloves, condoms and balloons
- Cosmetics, such as deodorants, nail polish removers
- Dyes used in hair dyes and textiles
- Perfumes in bath products and soaps
- Plants such as poison ivy and oak
- Metals such as nickel, cobalt and mercury, used in the production of belt buckles, watch buckles and jewellery
Symptoms and clinical manifestations
Symptoms vary according to the type of dermatitis and its severity, but generally include:
- Reddening of the skin. Often accompanied by sensations of heat and itching, and sometimes even localised swelling, it is one of the first visible signs of dermatitis, indicative of ongoing inflammation.
- Intense itching, which may lead to scratching. Scratching, although it may temporarily relieve itching, further damages the skin barrier, worsening inflammation and increasing the risk of infection.
- Desquamation of the skin, particularly evident in seborrhoeic dermatitis, with the formation of whitish or yellowish scales. When scaling affects the scalp, it may cause dandruff, characterised by greasy or dry scales accompanied by redness and itching.
- Dry, thickened skin, a typical feature of chronic forms of atopic dermatitis, often accompanied by annoying and painful cracks in the skin, known as fissures.
- Blisters. In contact dermatitis, exposure to allergens or irritants can cause bullous lesions to appear on the skin. In people who perform manual work or are frequently exposed to harsh detergents, it often occurs on the hands.
How to treat dermatitis
The treatment of dermatitis depends on the type and severity of the symptoms. Pharmacological remedies include topical corticosteroids, but also antihistamines and antibiotics. The main non-pharmacological approaches, on the other hand, include applying topical products such as creams, taking supplements and using other products to relieve itching, moisturise the skin and restore the skin barrier:
- Soothing and protective creams. Creams with moisturising and soothing ingredients, such as glycerine and panthenol, are essential to rebalance the skin microbiome and restore the protective barrier, relieving itching.
- Food supplements. In some cases, the use of supplements can help improve skin health. Vitamin D3, L-histidine and probiotics based on Bifidobacterium lactis UABla-12 and Lactobacillus acidophilus DDS-1 are useful to support the immune system and contribute to skin health.
- Creams and shampoos adjuvant in seborrhoeic dermatitis, formulated with zinc gluconate, nicotinamide, cyclopirox and salicylic acid. These products can help normalise sebum production and reduce yeast proliferation, thus alleviating the symptoms of seborrhoeic dermatitis. Thanks to their sebum-regulating action, they also help improve the oily appearance of the skin.
- Phototherapy, meaning ‘light therapy’, harnesses the benefits of sunlight to reduce skin inflammation, relieve itching and improve skin regeneration in patients with moderate to severe forms of this condition.
Tips for prevention and daily management
Dermatitis can be an annoying and sometimes difficult condition to manage, but by adopting good daily practices, it is possible to significantly improve symptoms and prevent their recurrence. Let’s take a look at some useful daily habits to keep your skin healthy:
- Moisturise regularly. Daily application of specific emollient creams helps retain moisture and keep the skin soft, preventing dryness and the reappearance of dermatitis. It is also advisable to drink enough water. An adequate intake of water is indeed indispensable to keep the skin hydrated and promote the elimination of toxins.
- Avoid irritating products. It is advisable to limit the use of harsh soaps, foaming cleansers and products containing alcohol, which can alter the natural balance of the skin, increasing dryness, redness and irritation. Instead, opt for gentle cleansers and fragrance- and allergen-free formulas.
- Protect your skin. It is recommended to wear clothes made of natural fabrics, such as cotton or linen, which allow the skin to breathe. In contrast, synthetic materials and rough materials, such as untreated wool, can trap heat and moisture or cause irritation.
- Follow a balanced diet. A diet rich in vitamins and minerals not only contributes to the general well-being of the body, but also helps keep the skin supple, moisturised and protected from external agents. In particular, B vitamins promote cell regeneration, while selenium and zinc support the skin’s natural defences, improving its resistance to inflammation and irritation. Supplementation with omega-3 fatty acids, found in oily fish, walnuts and linseed, can also reduce skin inflammation.
Dermatitis can leave temporary or persistent spots on the skin, often red or dark in colour, due to inflammation or the healing process of lesions. A thorough examination by a dermatologist is essential to make an accurate diagnosis and, if necessary, prescribe specific tests and examinations to identify the underlying causes. Based on the results, the specialist will be able to propose a targeted therapy, which may include topical or systemic drugs, to help the skin heal. A customised approach is essential to ensure the best outcome for patients and to prevent possible complications.
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