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| The second type, contact dermatitis, results from exposure to a skin irritant like detergent. |
Save your skin: Dermatitis an itchy fact of life in Southern Colorado - Red, swollen and itchy is unpleasant skin to be in. Inflammation of the skin, or dermatitis, can have many causes and occur in many forms. It can make life miserable but isn’t contagious and usually isn’t life-threatening. It’s a scourge that plagues dry-skinned people — which is just about everybody at this time of year in arid Southern Colorado.
Dermatitis occurs in two basic types, says Dr. Sharon Kessler, a Pueblo dermatologist. There’s atopic, from the Greek for “hypersensitivity,” and there’s contact. “Atopic dermatitis is also called eczema; it’s exactly the same disease,” Kessler says. “It tends to be genetic, tends to cluster in families. There are three genes for it, all closely linked on the same chromosome.” People with atopic dermatitis often have asthma or hay fever as well. While there’s a genetic predisposition, exposure to environmental factors such as dryness, dust and pets, especially cats, can trigger atopic dermatitis.
The second type, contact dermatitis, results from exposure to a skin irritant like detergent or an allergen like poison ivy. Again, it’s not totally clear-cut, Kessler says, as some people may be genetically predetermined to be sensitive to nickel, for example, and break out in a rash if they wear nickel-containing jewellery.
Harsh climate a factor
Dr. Michael Babcock, a dermatologist who practices both in Pueblo and Colorado Springs, says he sees more people with atopic and dry skin dermatitis than contact dermatitis. “A lot of people who relocate here from elsewhere, from the South or the coasts, come in with a weird rash that’s a form of eczema. They’ve been susceptible to it all along but it didn’t appear until they were here” in Colorado’s harsh climate.
For people with mild eczema, some education and over-the-counter products often are the answer, he says. More severe cases may require medication. Babcock says he likes to joke with patients that he has a cure for their dermatitis: a first-class trip to Hawaii once a month.
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| Skin is a good barrier. If intact, it keeps out toxic agents, but if it’s broken, “all sorts of things can be a problem.” |
Skin as barrier
Kessler says the three main offenders in contact dermatitis are grease-cutting dish detergent, furniture polish with lemon oil and window cleaner with ammonia.
“I see a lot of hand dermatitis, usually in women and particularly in winter before Christmas when they’ve been cleaning house like crazy,” Kessler says. “I always ask them if they’re using (brand name) detergent or any lemon-scented products or ones with ammonia. These change the environment so much it allows the skin to crack.”
Skin is a good barrier. If intact, it keeps out toxic agents, but if it’s broken, “all sorts of things can be a problem,” she says.
So what’s a person to do? Keep the skin from getting excessively dry. Kessler advises drinking lots of water; taking cooler showers — even though hot water may feel soothing to irritated skin; minimizing the use of soap — “Water is the universal solvent”; and applying a good-quality moisturizer right after bath or shower while the skin is still well-hydrated. She recommends using a thick cream rather than a thin lotion and choosing a product that contains alpha hydroxy acids.
Preservatives a problem
Babcock says people have become more aware that chemicals in products can cause skin problems, but they always think it’s the fragrance or because they changed products. “The most common cause of contact dermatitis is preservatives — parabens and formaldehyde derivatives,” he says. “Fragrance is the next most common.”
Antibiotic ointments also can cause problems. “One of the things everyone says is, ‘I’ve used X, Y or Z product forever.’ What you have to remember is a company can change its product ingredients at any time, and a person can develop sensitivity over time. You have to have exposure in order to have sensitivity.”
Dermatitis data
Atopic dermatitis or eczema is a chronic skin disease that’s most common in babies and children but can occur at any age. This red, itchy rash occurs on the face, scalp, hands and feet in infants, and where the skin flexes inside the elbows or behind the knees in older people. Skin changes can include blisters that ooze and crust, dry skin all over, raw skin from scratching, and leathery areas that occur after long-term irritation and scratching. Atopic dermatitis can be caused by both genetic and environmental factors. It can get worse, improve and then flare up again.
Contact dermatitis is caused by exposure to an irritant or an allergen and it causes red, sore or inflamed skin. Itching — sometimes severe — is common and a rash can occur; the rash may have bumps that become blisters. It often shows up on the hands, although hair products, cosmetics and perfumes can lead to reactions on the face, head and neck. Skin may become inflamed with long-term exposure to an irritant.
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