Atopic dermatitis

Related Terms

Allergic dermatitis, cercarial dermatitis, chronic pruritic skin condition, contact dermatitis, dandruff, dermatitis herpetiformis, discoid dermatitis, duck itch, Duhring's disease, dyshidrotic dermatitis, facial erythema, hand and foot dermatitis, ichthyosis vulgaris, keratoconus, keratosis pilaris, nummular dermatitis, papules, pilaris, rash, seborrhoeic dermatitis, skin disorder, swimmer's itch.

Background

Dermatitis literally means "inflammation of the skin." There are several different forms of dermatitis.
Atopic dermatitis, also known as eczema, occurs when the skin is abnormally sensitive to allergens, causing the skin to become red, flaky and itchy. This disease is chronic and recurrent. While there currently is no cure for atopic dermatitis, symptoms can be managed with a variety of treatments.
The disease is especially common among young children. Atopic dermatitis often affects individuals who have other atopic diseases like hay fever, asthma, or conjunctivitis (pinkeye).
According to the Asthma and Allergy Foundation of America (AAFA), about one percent of all children's visits to doctors is for atopic dermatitis. The disease is estimated to affect 1-10% of infants in the United States. In addition, about 27% of infants whose mothers have allergies develop atopic dermatitis. While atopic dermatitis can be a lifelong disease, it usually goes away by age 25. In fact, about 50% of infants who have eczema before they are one year old have no symptoms by age two.

Author information

This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

American Academy of Allergy Asthma & Immunology. Atopic Dermatitis. .
Asthma and Allergy Foundation of America. Atopic Dermatitis (Eczema). .
Bath-Hextall FJ, Birnie AJ, Ravenscroft JC, et al. Interventions to reduce Staphylococcus aureus in the management of atopic eczema: an updated Cochrane review. Br J Dermatol. 2010 Jul;163(1):12-26. Epub 2010 Mar 5.
Boguniewicz M, Leung D (1998). Atopic dermatitis: A question of balance. Archives ofDermatology, 134: 870:871
DermNet NZ. Dermatitis. .
Huang JT, Abrams M, Tlougan B, et al. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009 May;123(5):e808-14.
Leung DYM, Bieber T. Atopic dermatitis. Lancet. 2003 Jan 11;361(9352):151-60.
Natural Standard: The Authority on Integrative Medicine. .
The National Eczema Society. Eczema. .
U.S. Food and Drug Administration (FDA) .

Causes

According to researchers, several different factors can potentially trigger atopic dermatitis, including allergies and emotional stresses. Researchers have discovered that atopic dermatitis is related to the development of other allergies, such as allergic rhinitis and asthma, in most children.
In one study of adults who had atopic dermatitis as children, about 35% had no skin problems but had asthma or hay fever. In addition, only 20% still had atopic dermatitis and about 15% had both atopic dermatitis and asthma or hay fever.
In some cases, inhaled allergens (like dust mites or animal dander) may cause flare-ups. A bacterial, fungal or viral infection can also result in a flare-up. Food allergies may trigger an episode in children, but rarely in adults.

Symptoms

Atopic dermatitis is a chronic disease, and symptoms can disappear and recur over time.
The skin of an infected individual is flaky, red and itchy. The skin covering the joints and face is most commonly affected. The skin also becomes susceptible to bacterial infections. Scratching the affected areas of the skin can increase the risk of bacterial infection.

Diagnosis

Most cases of atopic dermatitis can be diagnosed from a medical history and a physical examination.
Skin testing may help confirm that a food allergy is triggering dermatitis flare-ups. During a skin test, an extract of the suspected allergen is used to prick the skin. If the area on the skin that was pricked becomes red and swollen, the patient is allergic to the substance. However, some individuals have a positive reaction to a food that is not causing the eczema.
Also, skin tests can be difficult if the patient has an existing rash. In such cases, a blood test, like the RAST (radioallergosorbent test) is used to detect food-specific antibodies in the blood. Another lab test then analyzes a blood sample for the presence of eosinophils, cells, which cause inflammation.
A food challenge can also determine whether a specific food is triggering dermatitis. The suspected food is removed from the diet and then gradually added back into the diet. The healthcare provider monitors to see if the patient's symptoms recur.

Treatment

Atopic dermatitis is a chronic disease and symptoms can disappear and recur over time. While there is currently no cure for atopic dermatitis, symptoms can be managed with medical treatments. Also, minimizing contact with known allergens can reduce the severity of symptoms.
Anti-anxiety medications: Anti-anxiety medications may help patients handle the chronic itching associated with atopic dermatitis.
Antibiotics: Antibiotics have been used to treat complicating skin infections, which can be the result of scratching infected areas.
Antihistamines: Antihistamines, like diphenhydramine (e.g. Benadryl?) and hydroxyzine (e.g. Atarax?), have been used to help relieve itching associated with atopic dermatitis.
Bleach baths: Dilute bleach baths (prepared by adding bleach to bathwater), alone or in combination with antibiotics, have been shown to reduce the severity of atopic dermatitis in those with secondary bacterial infections.
Calcineurin inhibitors: Calcineurin inhibitors have been applied to the skin to relieve redness, itching and inflammation associated with atopic dermatitis. However, the U.S. Food and Drug Administration (FDA) recommends using pimecrolimus (Elidel?) and tacrolimus (Protopic?) cautiously because of a potential cancer risk. The FDA also emphasizes that these medications should only be used as directed and only after trying all other treatment options. Calcineurin inhibitors are not approved for children younger than two years old.
Immunosuppressants: Cyclosporine or interferon is occasionally used in adults when other treatments are unsuccessful.
Oral corticosteroids: Oral corticosteroids like prednisone and prednisolone have been used to treat severe cases of atopic dermatitis when the rash covers large areas of the body, such as the arms and trunk of the body.
Topical corticosteroids: Topical corticosteroids (like hydrocortisone, betamethasone or fluticasone propionate) are the most common and effective treatments for atopic dermatitis. They are used until the rash clears up. Low-strength topical corticosteroids should be used on the face. Over-the-counter hydrocortisone (like Bactine?, Cortaid?, Dermolate? or Aveeno Anti-Itch cream?) is a low-strength corticosteroid cream that has been used to treat young children.

Integrative therapies

Strong scientific evidence:
Probiotics: Probiotics show promise for preventing atopic dermatitis (eczema) in children. Infants benefit when their mothers take probiotics during pregnancy and breastfeeding. Direct supplementation of infants may reduce the incidence of atopic eczema by as much as half. It may also reduce cow's milk allergy and other allergic reactions during weaning. Probiotics may stabilize intestinal barrier functioning and decrease gastrointestinal symptoms in children with atopic dermatitis. Children do differ, however, in their responsiveness to specific probiotics. The effectiveness of probiotics for the treatment of eczema is still under investigation.
Probiotics are generally considered safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant. Caution is advised when using probiotics in neonates born prematurely or with immune deficiency.
Good scientific evidence:
Aloe vera: Early study of aloe lotion suggests effectiveness for treating seborrheic dermatitis when applied to the skin. Further study is needed in this area before a strong recommendation can be made. Individuals should avoid aloe vera if allergic to garlic, onions, tulips, or other plants of the Liliaceae family. Individuals using aloe gel for prolonged times have developed allergic reactions including hives and eczema-like rash. Pregnant or breastfeeding women should avoid oral use of aloe vera.
Evening primrose oil: Several small human studies of atopic dermatitis suggest benefits of taking evening primrose oil by mouth. Large well-designed studies are needed before a strong recommendation can be made. Evening primrose oil is approved for atopic dermatitis in several countries outside of the United States. Individuals who are allergic to plants in the Onagraceae family, gamma-linolenic acid or other ingredients in evening primrose oil should avoid the substance. Individuals with seizure disorders and pregnant or breastfeeding women should also avoid evening primrose oil.
Unclear or conflicting scientific evidence:
Acupuncture: Acupuncture plus point-injection has been found beneficial for obstinate urticaria (rash), although more research is needed to confirm these findings. Needles must be sterile in order to avoid disease transmission. Avoid with valvular heart disease, infections, bleeding disorders or with drugs that increase the risk of bleeding (anticoagulants), medical conditions of unknown origin, neurological disorders. Avoid on areas that have received radiation therapy and during pregnancy. Use cautiously with pulmonary disease (like asthma or emphysema). Use cautiously in elderly or medically compromised patients, diabetics or with history of seizures. Avoid electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers.
Aromatherapy: Aromatherapy is a loosely applied term that refers to several modalities that deliver essential oils to the body. It is unclear whether aromatherapy may be of benefit in pediatric atopic eczema. Essential oils should be administered in a carrier oil to avoid toxicity. Avoid if history of allergic dermatitis. Use cautiously if driving/operating heavy machinery. Avoid consuming essential oils. Avoid direct contact of undiluted oils with mucous membranes. Use cautiously if pregnant.
Borage seed oil: The evidence for borage oil in the treatment of atopic dermatitis is mixed. Additional study is needed in this area. Seborrheic dermatitis is a type of inflammatory skin rash. Currently, there is insufficient evidence to support borage in the treatment of seborrheic dermatitis.
Avoid if allergic or hypersensitive to borage, its constituents, or members of the Boraginaceae family. Use cautiously in patients with bleeding disorders or taking warfarin or other anticoagulant or antiplatelet (blood thinning) agents. Use cautiously in patients with epilepsy or taking anticonvulsants. Avoid in patients with compromised immune systems or similar immunological conditions. Avoid in pregnant patients as borage oil may be contraindicated in pregnancy given the teratogenic and labor-inducing effects of prostaglandin E agonists, such as borage oil's GLA. Avoid if breastfeeding.
Bromelain: Bromelain has been shown to decrease inflammation, regulate the immune system, and have antiviral effects and may help treat skin rash. Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, birch pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, wheat flour, or members of the Bromeliaceaefamily. Use cautiously with a history of bleeding disorders, stomach ulcers, or heart, liver, or kidney disease. Use caution before dental or surgical procedures or while driving or operating machinery. Avoid if pregnant or breastfeeding.
Butterbur: Preliminary research suggests that butterbur may not suppress allergic skin disease reactions when compared to the prescription drug fexofenadine (Allegra?), which does suppress these reactions. Additional study is needed. Use caution if allergic or sensitive to Petasites hybridus or other plants from the Asteraceae/Compositae family (like ragweed, marigolds, daisies and chrysanthemums). Raw, unprocessed butterbur plant should not be eaten due to the risk of liver or kidney damage or cancer. Avoid if pregnant or breastfeeding.
Calendula: Limited early research suggests that calendula extracts may reduce skin inflammation. Human studies are lacking in this area. Avoid if allergic to plants in the Aster/Compositae family such as ragweed, chrysanthemums, marigolds, and daisies. Use cautiously in patients taking sedatives, blood pressure medications, cholesterol medications, blood sugar-altering agents, and immunomodulators. Use cautiously with diabetes and in children. Avoid if pregnant or breastfeeding.
Chamomile: The German Commission E authorizes the use of topical chamomile for diseases of the skin. However, little research has been done on topical chamomile for eczema. Topical chamomile preparations have traditionally been used to soothe skin inflammation. The existing human evidence shows that chamomile may be of little, if any, benefit while animal studies support its anti-inflammatory action. Additional human research is needed in this area.
Avoid if allergic to chamomile. Anaphylaxis, throat swelling, skin allergic reactions and shortness of breath have been reported. Chamomile eyewash may cause allergic conjunctivitis (pinkeye). Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk, and do not use immediately after these procedures. Use cautiously if driving or operating machinery. Avoid if pregnant or breastfeeding.
Euphorbia: Early study of Euphorbia acaulis has demonstrated an effect on patients with both wet and dry eczema. More trials are needed in this area. Avoid if allergic or hypersensitive to pollen from Euphorbia fulgens. Use cautiously with history of Epstein Barr virus infection or stomach conditions. Avoid if pregnant or breastfeeding.
Gamma linolenic acid (GLA): Clinical studies have used GLA to treat atopic dermatitis in adults, children, and infants. Changes in linolenic acid metabolism have been related to eczema where conversion of linolenic acid to GLA is inhibited in persons with atopic dermatitis. However, studies in the past 20 years reveal minimal therapeutic improvements with GLA as therapy for atopic dermatitis, noted by only marginal to no improvement in inflammation and itching. GLA is generally considered nontoxic and well tolerated for up to 18 months. Use cautiously with anticoagulants (blood-thinners), and avoid if pregnant or breastfeeding.
Grapefruit: There is early, but inconclusive evidence to support the use of grapefruit seed extract in the treatment of atopic eczema. Additional study is needed to confirm these findings. Avoid if allergic/hypersensitive to grapefruit or its constituents. Use cautiously if taking cytochrome P450 3A4 substrate drugs. Use cautiously if drinking red wine, tonic water, or if smoking. Use cautiously with liver cirrhosis, if at risk for kidney stones, if have undergone gastric bypass surgery, and with diabetes. Use cautiously if pregnant or breastfeeding.
Honey: The evidence supporting the use of honey in the treatment of dermatitis and dandruff is limited. Further investigation is needed to make a conclusion. Avoid if allergic or hypersensitive to honey, pollen, celery, or bees. Honey is generally considered safe in the recommended doses. Avoid honey from the genus Rhododendron because it may cause a toxic reaction. Avoid in infants younger than 12 months of age. Use cautiously with antibiotics. Potentially harmful contaminants (like C. botulinum or grayanotoxins) can be found in some types of honey and should be used cautiously in pregnant or breastfeeding women.
Hydrotherapy: There is preliminary evidence that hydrotherapy in an acidic hot spring bath may reduce the severity of symptoms in atopic dermatitis. Evidence from controlled trials is necessary before a clear conclusion can be drawn.
Sudden or prolonged exposure to extreme temperatures in baths, wraps, saunas, or other forms of hydrotherapy should be avoided, particularly with heart disease, lung disease, or if pregnant. Avoid with implanted medical devices like pacemakers, defibrillators, or hepatic (liver) infusion pumps. Vigorous use of water jets should be avoided with fractures, known blood clots, bleeding disorders, severe osteoporosis, open wounds, or during pregnancy. Use cautiously with Raynaud's disease, chilblains, acrocyanosis, erythrocyanosis, and impaired temperature sensitivity, such as neuropathy. Use cautiously if pregnant or breastfeeding. Hydrotherapy should not delay the time to diagnosis or treatment with more proven techniques or therapies, and should not be used as the sole approach to illnesses. Patients with known illnesses should consult their physician(s) before starting hydrotherapy.
Jewelweed: Jewelweed has been used traditionally as a treatment for various types of contact dermatitis, including poison ivy/oak rashes and allergic dermatitis, however, human study indicates that it may not be effective for this use. Avoid if allergic or hypersensitive to jewelweed (Impatiens biflora), its constituents, or members of the Balsaminaceae family. Use cautiously if taking calcium supplements and with kidney stone disorders. Avoid consuming excess amounts of jewelweed due to reports of high mineral content, particularly calcium oxalate. Avoid if pregnant or breastfeeding.
Lavender: In limited clinical study, essential oils were used in combination with massage to treat childhood atopic eczema. It was found that there was deterioration in the patient's eczema, which may have been due to possible allergic contact dermatitis provoked by the essential oils themselves. More study on the effect of lavender essential oil alone is needed before any firm conclusions can be made. Avoid if allergic or hypersensitive to lavender. Avoid with a history of seizures, bleeding disorders, eating disorders (anorexia, bulimia), or anemia (low levels of iron). Avoid if pregnant or breastfeeding.
Licorice: Topical licorice extract gel has been shown to be effective in the treatment of atopic dermatitis in preliminary human study. Further research is needed to confirm these results. Avoid with a known allergy to licorice, any component of licorice, or any member of the Fabaceae (Leguminosae) plant family. Avoid with congestive heart failure, coronary heart disease, kidney or liver disease, fluid retention, high blood pressure, hormonal abnormalities or if taking diuretics. Licorice may cause abnormally low testosterone levels in men or high prolactin or estrogen levels in women. This may make it difficult to become pregnant and may cause menstrual abnormalities.
Marshmallow: Marshmallow extracts have traditionally been used to treat inflammatory skin conditions. Several laboratory experiments, mostly in the 1960s, reported marshmallow to have anti-inflammatory activity but limited human study is available. Safety, dosing, and effectiveness compared to other anti-inflammatory agents have not been examined. Historically, marshmallow is generally regarded as being safe in healthy individuals. However, since studies have not evaluated the safety of marshmallow, proper doses and duration in humans are not known. Allergic reactions may occur. There is not enough scientific evidence to support the safe use of marshmallow during pregnancy or breastfeeding.
Massage: Massage may be of benefit in pediatric atopic dermatitis. More studies are needed for a conclusion to be made. Avoid with bleeding disorders, low platelet counts, or if on blood-thinning medications (such as heparin or warfarin/Coumadin?). Areas should not be massaged where there are fractures, weakened bones from osteoporosis or cancer, open/healing skin wounds, skin infections, recent surgery, or blood clots. Use cautiously if history of physical abuse or if pregnant or breastfeeding. Massage should not be used as a substitute for more proven therapies for medical conditions. Massage should not cause pain to the patient.
Omega-3 fatty acids, fish oil, alpha-linolenic acid: Dietary sources of omega-3 fatty acids include fish oil and certain plant/nut oils. Fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), while some nuts (English walnuts) and vegetable oils (canola, soybean, flaxseed/linseed, olive) contain alpha-linolenic acid (ALA). Several studies evaluating EPA for eczema do not provide enough reliable evidence to form a clear conclusion.
Avoid if allergic or hypersensitive to fish, omega-3 fatty acid products that come from fish, nuts, linolenic acid or omega-3 fatty acid products that come from nuts. Avoid during active bleeding. Use cautiously with bleeding disorders, diabetes, low blood pressure or drugs, herbs or supplements that treat any such conditions. Use cautiously before surgery. The Environmental Protection Agency (EPA) recommends that intake be limited in pregnant/nursing women to a single 6-ounce meal per week, and in young children to less than 2 ounces per week. For farm-raised, imported, or marine fish, the U.S. Food and Drug Administration recommends that pregnant/nursing women and young children avoid eating types with higher levels of methylmercury and less than 12 ounces per week of other fish types. Women who might become pregnant are advised to eat 7 ounces or less per week of fish with higher levels of methylmercury or up to 14 ounces per week of fish types with about 0.5 parts per million (such as marlin, orange roughy, red snapper, or fresh tuna).
Peony: Peony root may have beneficial effects on immune function. These effects may help decrease inflammation associated with allergic skin reactions such as allergic dermatitis. There is currently not enough evidence to recommend for or against the use of peony in allergic skin conditions.Avoid if allergic or sensitive to peony. Avoid with bleeding disorders or if taking drugs, herbs, or supplements that increase bleeding risk. Use cautiously with estrogen-sensitive cancers or if taking drugs, herbs, or supplements with hormonal activity. Avoid if pregnant or breastfeeding.
Polypodium leucotomos extract and anapsos: Laboratory and animal studies report that Polypodium leucotomos extract (anapsos) may reduce inflammation. However, there is little information about the effectiveness of anapsos taken by mouth in people with atopic dermatitis. Avoid if allergic to ferns (family Polypodiaceae) or if pregnant or breastfeeding.
Psychotherapy: Atopic dermatitis is a skin disease associated with an increased anxiety level. Psychotherapy may be helpful for atopic dermatitis patients with high levels of anxiety. However, more research is needed before recommendation can be made.
Psychotherapy is not always sufficient to resolve mental or emotional conditions. Psychiatric medication is sometimes needed. The reluctance to seek and use appropriate medication may contribute to worsening of symptoms or increased risk for poor outcomes. The client or patient should seek referrals from trusted sources and should also inquire of the practitioner's training and background before committing to work with a particular therapist.
Sanicle: Sanicle (Sanicula europaea, Sanicula europa) has been studied for use in atopic eczema. More studies are needed. Avoid if allergic or sensitive to sanicle. Use cautiously with stomach problems. Use cautiously if taking blood pressure-lowering or diuretic drugs. Avoid if pregnant or breastfeeding.
Schisandra: There is a currently a lack of available sufficient evidence to determine if schisandra is an efficacious treatment for eczema. Results from limited study, which investigated the effect of schisandra in combination with other herbs, suggested a potential benefit. Further study is required before conclusions can be drawn.
Use cautiously during pregnancy or lactation due to insufficient available evidence. Use cautiously in patients with bleeding disorders, seizure disorders, high intracranial pressure, high blood pressure, gastoeseophageal reflux or peptic ulcer disease, neurological disorders, and diabetes. Avoid in patients allergic to schisandra, any of its constituents, or other members of the Schisandraceae family. Allergic skin rashes and urticaria has been reported in some patients.
Sea buckthorn: Study results about the effectiveness of sea buckthorn for atopic dermatitis (skin rash) are mixed. More study is needed in this area before a conclusion can be made. Avoid if allergic or hypersensitive to sea buckthorn, its constituents, or members of the Elaeagnaceae family. Use cautiously if taking angiotensin converting enzyme (ACE) inhibitors, anticoagulants and antiplatelet agents (blood thinners), antineoplastics (anticancer agents), or cyclophosphamide or farmorubicin. Avoid higher doses than food amounts if pregnant or breastfeeding.
Spiritual healing: There is limited research on the use of spiritual healing for eczema. Further research is needed. Spiritual healing should not be used as the only treatment approach for medical or psychiatric conditions, and should not delay the time it takes to consider more proven therapies.
St. John's wort: Early study of Hypericum-cream in the topical treatment of mild to moderate atopic dermatitis shows positive results. Further studies are needed before a firm recommendation can be made. St. John's wort has generally been well tolerated at recommended doses for up to three months. St. John's wort may cause psychiatric symptoms such as suicidal and homicidal thoughts. Avoid if pregnant or breastfeeding.
Tea tree oil: Early small studies show that tea tree oil applied to the skin may reduce allergic skin reactions caused by histamine-induced inflammation. Further research is needed to confirm these results. Avoid allergic or hypersensitive to tea tree oil (Melaleuca alternifolia), any of its constituents, balsam of Peru, benzoin, colophony (rosin) tinctures, eucalyptol, or members of the Myrtle (Myrtaceae) family. Avoid taking tea tree oil by mouth. Avoid if taking antineoplastic agents. Use tea tree oil applied to the skin cautiously in patients with previous tea tree oil use. Avoid if pregnant or breastfeeding.
Thyme: Historically, thyme has been used topically for a number of inflammatory skin disorders. Results are mixed. Additional study is needed in this area. Avoid if known allergy/hypersensitivity to members of the Lamiaceae (mint) family or to any component of thyme, or to rosemary (Rosmarinus officinalis). Avoid oral ingestion or non-diluted topical application of thyme oil due to potential toxicity. Avoid topical preparations in areas of skin breakdown or injury, or in atopic patients, due to multiple reports of contact dermatitis. Use cautiously in patients with gastrointestinal irritation or peptic ulcer disease due to anecdotal reports of gastrointestinal irritation. Use cautiously in patients with thyroid disorders due to observed anti-thyrotropic effects in animal research of the related species Thymus serpyllum. Avoid if pregnant or breastfeeding.
Thymus extract: Preliminary evidence suggests that thymus extract has no clinical effect in patients with atopic eczema, despite anecdotal evidence suggesting the use of thymus extract for dermatological uses. Further well-designed clinical trials are required.
Avoid if allergic or hypersensitive to thymus extracts. Use bovine thymus extract supplements cautiously due to potential for exposure to the virus that causes "mad cow disease." Avoid use with an organ transplant or other forms of allografts or xenografts. Avoid if receiving immunosuppressive therapy, with thymic tumors, myasthenia gravis (neuromuscular disorder), untreated hypothyroidism, or if taking hormonal therapy. Avoid if pregnant or breastfeeding; thymic extract increases human sperm motility and progression.
Witch hazel: Based on human study, witch hazel was less effective than hydrocortisone cream, and no more effective than placebo in relieving inflammation associated with atopic eczema. Although witch hazel has been commonly used to relieve minor skin irritations, there are few human studies evaluating its use for this purpose, especially in children. Witch hazel as an oil based formulation may be safe and well tolerated when applied to the skin in children with minor skin irritations. High quality human study is needed for a conclusion to be made. Avoid if allergic or sensitive to witch hazel. Avoid if pregnant or breastfeeding. Use cautiously in patients with liver or kidney disorders, diabetes, and in children.
Zinc: There is conflicting data regarding the correlation of zinc serum levels and eczema. One study noted that zinc might have caused an increase in itching after several weeks of supplementation. Additional information is needed to help clarify these results. Zinc is regarded as a relatively safe and generally well tolerated when taken at recommended doses, and few studies report side effects. Zinc should only be given to pregnant or breastfeeding women under the supervision of a qualified healthcare provider.

Prevention

Avoid exposure to known allergens.
Avoid chemicals and extreme temperatures, which can worsen symptoms.
Avoid stress, which can trigger or worsen flare-ups.
Wash bedding in hot water to reduce indoor allergens such as dust mites.

Other types of dermatitis

Cercarial dermatitis (swimmer's itch or duck itch): Cercarial dermatitis is a short-term immune response to water-born trematode parasites. Symptoms include itchy, raised papules, which usually occur within hours of infection and last about one week.
Contact dermatitis (allergic dermatitis): Contact dermatitis is a term for a skin reaction resulting from exposure to allergens, like dust mites or animal dander.
Dermatitis herpetiformis: Dermatitis herpetiformis, also called Duhring's disease or herpes circinatus bullosus, is usually associated with celiac disease (sensitivity to gluten). It is a chronic, extremely itchy rash that forms papules and vesicles on the skin.
Dyshidrotic dermatitis: Dyshidrotic dermatitis causes small blisters on the hands or feet. It was onced believe that the condition was the result of extreme sweating. However, the cause remains unknown today. While the condition is not contagious it is usually recurrent and chronic.
Nummular dermatitis (discoid dermatitis): Nummular (meaning "coin" in Latin) dermatitis is a recurrent and chronic skin disorder, which may appear at any age. It causes round, coin-shaped itchy lesions on the skin. It does not appear to be a genetic condition. It is not related to food allergies, and it is not contagious. Flare-ups of this condition are linked to dry skin.
Seborrhoeic dermatitis (dandruff): Seborrhoeic dermatitis is a skin disorder that causes scaly, flaky, itchy red skin on the scalp, face and trunk of the body. Researchers believe that the disorder is the result of a fungal infection caused by the yeast Malassezia furfur (formerly known as Pityrosporum ovale) in individuals with decreased immunity and increased sebum production.
Urushiol-induced contact dermatitis (rhus dermatitis): Urushiol-induced contact dermatitis is the medical term for skin rashes that are caused by urushiol oil. The oil is present in many plants, including plants of the genus Toxicodendron (like poison ivy, poison sumac and poison oak), as well as other plants in the Anacardiaceae family (like mango, the Rengas tree and the Burmese lacquer tree).