A question from Junie
Hi My doctor whi is also a dermatologist says I have dermatitis. On my face and eye lids, the cream he gave me made it worse, the next cream he suggested I refused as it contained steroid, which I am told it should not be put on eyelids. Please can you help, I am just covering it up at the moment but I really would like to clear it up Thanks Junie
I am afraid I am not qualified to give medical advice, and if I were I wouldn’t do so over the internet. But hopefully I can give a bit of background information that might help a little.
Dermatitis simply means inflammation of the skin. There are various causes. Contact dermatitis for example is being regularly exposed to materials that compromise the skin. A good example would be people who do a lot of dishwashing often find their skin becomes inflamed where it comes into contact with the harsh detergents used to wash plates.
All forms of dermatitis have fairly similar symptoms. The skin is usually dry and sometimes cracked. The skin often has a red colour – partly because it is thinner than normal and partly because the blood supply is elevated. It is usually itchy as well, and that often leads to yet another symptom. If you scratch it too hard the skin easily breaks and bleeds.
All in all it is not much fun. It is bad enough when you know what is causing it, but often dermatitis is a spontaneous thing that just develops. Dermatologists often refer to this as atopic dermatitis. The word atopic comes from the greek word for strange, and simply indicates that there is no known cause. (In cases where the dermatitis can be traced back to a specific allergy, it is still usually called atopic dermatitis. The specific cause might be known, but we still don’t know why the skin reacts to it.)
Eczema and atopic dermatitis are the same thing.
As to treating it, a good moisturising skin cream is invaluable. Dermatologists often refer to these as emollients. Generally speaking the oilier the better. There are plenty of options to choose from. The best known ones here in the UK are Oilatum Cream and Crookes E45.
I would not be so dismissive of steroids. The dermatologist would probably have prescribed something like hydrocortisone at a low level which is pretty mild by any standards. The great advantage of a steroid is that it can calm down the inflammatory reaction of the skin. For sure a steroid is not something you want to put onto healthy skin, but if you have dermatitis you don’t have healthy skin. The amount that will get into the bloodstream from a typical dermatological steroid cream is trivial and will have no effect. There are drawbacks to using steroids for long periods of time, but for a quick fix they can be jus the ticket. In particular anything that reduces itch is going to make it a lot more manageable. You are, very wisely, getting medical supervision. They will know when you ought to stop.
Other things to avoid are the various forms of stress, all of which can make it worse. Emotional stress can make dermatitis flare up, as can extreme cold, extreme heat, excessive exposure to water and wind and very dry conditions.
I hope that was some help.