Dermatitis

Dermatitis

The Irritation That Shows

Chances are you've had it.

Maybe you're a full-time mom, a chef or an artist, and you're up to your elbows every day in soapy water. Or maybe you work in a hospital and wear latex gloves when you treat patients. Or maybe you try a new cosmetic every now and then, wear jewelry or take diuretics. Or you exercise, perm your hair or brush your teeth.

If you do any of these things, you may have had dermatitis, a red, rashlike inflammation that occurs when your skin gets irritated or when you're allergic to something.

Dermatitis is so common, in fact, that most people get it at some point or another, says Elizabeth Whitmore, M.D., clinical director of dermatology at Johns Hopkins University in Baltimore. The most common type is irritant dermatitis, she says, which usually appears as a patch of rough, red, cracked skin. Generally more women than men get this type of dermatitis because we tend to do more "wet work," says Dr. Whitmore.

Another type of dermatitis is allergic contact dermatitis, with nickel allergy being a common cause in women. That's primarily because of the nickel posts commonly used in inexpensive pierced earrings. An estimated 10 percent of women have nickel allergy, compared to 1 percent of men. Allergic contact dermatitis generally appears as a patch of tiny red bumps that itch. Both types of dermatitis may range from mild to severe.

It's Tough to Avoid--But You Can

Because our lives are full of situations that can trigger dermatitis, it seems we are constantly playing roulette with our skin.

But there are ways to prevent dermatitis. The first step is to identify what factors cause problems for you. Then do your best to avoid these things and protect your skin. Finally, there are some things you can do to take better care of your skin and make it less susceptible to dermatitis. Here are some suggestions.

Watch out for soap and water. Hand dermatitis from overexposure to water and detergents is what dermatologists see most in women, says Dr. Whitmore. It appears quite often in 25- to 40-year-old women who've left their careers to be home with their children and constantly have their hands in water, adds Marianne O'Donoghue, M.D., associate professor of dermatology at Rush Presbyterian-St. Luke's Medical Center in Chicago.

So whenever possible, wear gloves when taking the plunge, and put on moisturizer afterward. If your hands are already irritated, wear a cotton liner inside the vinyl gloves, says Dr. Whitmore. Never do your dishes without gloves, and make sure you put them on when working with foods in the kitchen, says Dr. O'Donoghue.

Be gentle with the soap. When it comes to dermatitis, all soaps and dishwashing liquids are not the same, experts say. Choose milder soaps such as Dove, Tone and Oil of Olay Beauty Bar, says Karen K. Deasey, M.D., attending dermatologist at Bryn Mawr Hospital in Pennsylvania. And reconsider your dishwashing liquids, too. Dawn and Joy can be on the harsh side; try Dove instead, she says.

Hold on to the bar. If you have a choice between liquid and bar soap, go for the bar, says Dr. O'Donoghue. "The latest rage is these pump soaps. But with the exception of Dove, liquid soaps are more drying," she says.

Consider your cosmetics. If you develop dermatitis on your face, you may be allergic to your makeup. Usually it's fragrances or preservatives that cause the reaction, says Dr. O'Donoghue. Also, she says, "it's usually not the foundation that is so much of a problem as the moisturizer you use." Consider hypoallergenic products such as Clinique, Neutrogena, Almay and Allercreme, experts say. If you think you have a problem with fragrances, look for labels that read "fragrance-free," says Dr. Whitmore. Products marked "unscented" usually contain a "masking" fragrance to cover up the natural smell of the product.

Say no to nickel. If you develop a rash in an area where you've worn jewelry, it may be an allergic reaction to nickel. Ask retailers about the content of the jewelry you buy, and be aware that studs in jeans, belt buckles and clasps on bras may also contain nickel.

Beware the toothpaste connection. Do you often have fine red bumps or a blotchy red rash around your mouth? It might be what doctors call peri-oral dermatitis. "We're tending to see this quite a bit in women," says Thomas Helm, M.D., a dermatologist in Williamsville, New York, and assistant professor of dermatology at the State University of New York at Buffalo. The cause? It might be something as simple as tartar-control toothpaste, says Dr. Helm. Try switching to a nontartar toothpaste and give the rash a couple of weeks to clear up, says Dr. Helm. If it doesn't go away by then, your doctor may prescribe antibiotics.

Nail it down. Hand dermatitis sometimes occurs when women have allergic reactions to the glue used for fake nails, says Dr. O'Donoghue. To prevent it, try a patch test, applying a small sample of glue on your skin first to see if it reacts.

Pretest your perm. Common causes of dermatitis at the hairline are chemicals in permanent solutions and hair dyes. Again, you can head off this type of allergic dermatitis by patch-testing yourself with the solution or by asking your hair stylist to do so. If you're doing the test yourself, home kits usually have instructions on the box.

Be a good sport. Some exercise equipment contains materials that trigger allergic contact dermatitis. Things that can be troublesome include the rubber additives in tennis shoes, masks and mouthpieces, swim caps, swim goggles, diving suits, nose clips, earplugs and swim fins. Athletic tape can also be a problem for people allergic to formaldehyde resins. Also, some of the over-the-counter ointments used for sore muscles contain menthol and methyl salicylate, which can cause allergic dermatitis. So if you have a rash in an area that one of these products touches, consider finding an alternative.

Look out for latex. Those innocuous rubber gloves--and even condoms--can cause dermatitis if you're allergic. You may want to try gloves or condoms that are not made of latex.

Pay attention to creams and ointments. Topical anesthetics like benzocaine (found in some sunscreens, insect bite ointments and hemorrhoidal creams) and neomycin can sometimes cause dermatitis, according to Metta Lou Henderson, Ph.D., professor of pharmacy at the Raabe College of Pharmacy at Ohio Northern University in Ada.

Watch the sun and your cycle. Women with premenstrual syndrome who take a diuretic before their periods may develop dermatitis if they get too much sun. Cover up with sunscreen, Dr. Henderson advises.

Consider your patch. If you wear an estrogen or nicotine patch and develop dermatitis in that area, the patch may be the cause. Consult your doctor.

What to Do When You Get It

Besides avoiding things that may trigger dermatitis, you may also do the following to prevent it or ease the discomfort of a flare-up.

Keep skin moist. Keeping your skin well-lubricated is the key to preventing dermatitis. "It's the one thing most people get lazy about. Women often don't look after their skin enough," says Dr. O'Donoghue. Remember to apply your lotion immediately after a bath or shower to trap the moisture, experts say. For severe dermatitis, many doctors recommend Vaseline Pure Petroleum Jelly, Nivea, Eucerin, Neutrogena Hand Lotion or Aquaphor.

Make it lotion, lotion everywhere. Buy several bottles of your favorite moisturizer and place each one in a different location so you'll remember to use it often. "I tell my patients to put one bottle beside the bed, another by the phone, another in the kitchen, one by the sofa and one by their favorite reading chair," says Dr. O'Donoghue.

Try OTCs. If you develop a patch or two of dermatitis, try 1 percent hydrocortisone cream, which is available over the counter. "If it's really dry, try the ointment over the cream," says Dr. O'Donoghue. "It's a nice way to start." If OTCs don't do the trick for you, consult your dermatologist.