There are numerous forms of dermatitis (inflammation of the skin) which are from external causes. These red, itchy and burning rashes are frequently seen in chronic disorders such as eczema or psoriasis. Many rashes are related to viral infections, or a developing allergy to a medication, often Ibuprofen. However, we will cover rashes caused by external factors unrelated to underlying disorders or allergy.
These are typically redness and itching caused by damage to the skin’s outer layer. This damage can have a mechanical cause, such as friction, or it can be caused by contact with harsh chemicals. It can occur immediately after the skin is abraded or exposed to severe irritants, or it can occur after repetitive injury or exposure. Simply excess moisture and heat can cause irritant dermatitis. We’ll examine a few of the common causes of skin irritation and how they are treated.
Irritant dermatitis occurs when the skin is damaged by chemicals, such as household cleaners, or by physical irritation such as friction or shaving. It is often the result of repeated exposure to the irritant over hours, days, or weeks, in situations where the skin can not repair its damaged cells rapidly enough to keep up with the continued irritation.
The main predictor for irritant dermatitis is occupational exposure. It commonly occurs on the hands of people doing so-called “wet work,” including hairdressers, cleaners, food processing workers, dental, and healthcare personnel.
When the skin barrier is damaged, foreign matter penetrates the outermost layers of the skin. This triggers an inflammatory response by the immune system as it tries to ward off the foreign body. The result is inflammation, evidenced by redness, itching, and a rash that resembles those caused by chronic skin conditions. Because their skin barrier is already damaged, people with atopic dermatitis are more prone to irritant dermatitis.
Acute damage caused by a single, severe exposure to an irritant will typically result in a well-defined, localized rash with raised papules. Blistering is possible. Burning and pain often accompany the rash with this kind of irritant dermatitis.
In cases where the dermatitis is caused by chronic exposure to a mild irritant or to repetitive irritation, rashes are often preceded by dryness and cracking. This is followed by redness, burning, and itching. Over time, the affected skin may harden and tolerance may develop. Examples of this kind of dermatitis such as “dishpan hands” or the dribble rash a teething infant might experience.
Rashes between the fingers, or Interdigital dermatitis, are often the ‘sentinel sign’ of the irritant dermatitis of the hand, an early stage of more widely diffuse dermatitis across the hand.
The treatment of irritant dermatitis involves, first and foremost, removal or avoidance of the source of irritation, as well as other potential irritants. Some chemical irritants demand specific treatments. Topical treatments can include anti-inflammatory agents such as calcineurin inhibitors and topical steroids.
Moisturization is vital in any case of irritant dermatitis–most especially chronic cases. The skin cells need rehydration to heal adequately, and they need protection from moisture loss. Healing reams or ointments such as CeraVeⓇ are helpful in severe cases. Recovery for acute cases is usually quick. Chronic cases may improve more slowly as the skin barrier repairs itself.
With its anti-inflammatory, barrier repairing qualities, SmartLotion is well designed for irritant dermatitis. Because it can be used long-term with little risk of adverse effects, SmartLotionⓇ can be used to reduce inflammation and itching caused by chronic and recurrent irritant dermatitis. It is formulated with prebiotics and emollients that help the damaged skin barrier repair itself, as well as a low dose (0.75%) of hydrocortisone to reduce inflammation and itching.
Proper moisturizing is essential when using any eczema cream.
Anyone who shaves has more than likely encountered some form of shaving-related irritation; this can include short-lived razor burn (traumatic folliculitis), razor bumps (pseudofolliculitis barbae), or infection (folliculitis barbae). All involve inflammation in the skin around the hair follicle, and (with the exception of razor burn) they can occur anywhere there is hair–though they are more likely to occur in areas where the hair has been removed through shaving, waxing or plucking.
We’ll start with razor burn. It is noticeable shortly after shaving, with a red, blotchy rash that stings or burns. It can last for as little as an hour or linger for days. As with irritant dermatitis, razor burn is the result of inflammation subsequent to damage to the skin barrier.
Dry shaving, or shaving without any water or shaving cream or gel, can cause razor burn. Other causes include shaving too fast, using a dull razor blade, and shaving against the direction of hair growth.
Applying cool compresses or aloe vera gel can soothe irritation. The skin should be moisturized thoroughly to prevent further drying and damage to the skin barrier. Dr. Steve Harlan, the board-certified dermatologist who developed the aforementioned SmartLotionⓇ, recommends CeraVeⓇ and AveenoⓇ moisturizing lotions creams. SmartLotionⓇ can be applied twice a day after moisturizing for itching, burning, and redness. Initially, shaving rashes are best treated twice daily with SmartLotion for 7-14 days. Then once daily after shaving, or once daily at bedtime prevents shaving rash. Tapering to three times weekly, and yearly dermatology visits are the long term goal.
Razor bumps are small, raised bumps occurring in areas where the hair has been shaved or plucked. They are the result of the ends of the hair curving back to penetrating the skin as it grows, creating a “pseudofollicle.” The immune system responds to the ingrown hair as if it were a foreign body, giving rise to redness and the formation of papules and pustules (the razor bumps) on or around the hair follicle. It occurs frequently in places (like the front of the neck) where the hair grows at an oblique angle to the skin, and it is more common among those with thick or curly hair. It may be necessary to stop shaving for a period of time, and then use only an electric razor made for razor bump sufferers. A clean toothbrush can be used daily to “train the hairs” to grow more in one direction, while SmartLotion is used to treat the inflammation problem.
As with razor burn, dry shaving increases the risk of razor bumps. Moisturizing before shaving and using warm water lowers the risk. Dull razors should not be used. Do not shave upwards or against the hair direction.
To treat razor bumps, Dr. Harlan usually has his patients apply SmartLotionⓇ to the affected area two times a day for up to two weeks. He advises them to apply the lotion in a single, downward movement to reduce irritation of the follicles.
Folliculitis, or inflammation of the hair follicle, can look like razor bumps. The associated rash is more likely to be tender, warm, with pustules. or pustulent, however. It can occur anywhere there is hair, although it is more likely to occur in places where hair has been removed. Folliculitis barbae can be the result of yeastfungal or bacterial overgrowth around the hair follicle; staphylococcus aureus (staph) is a frequent contributor. Unresolved, folliculitis barbae can lead to infection of the entire hair follicle, a condition called sycosis barbae. These infections must be diagnosed and treated by a Dermatology provider, or a Primary care physician with special interest in Dermatology.
After treating infection, Dr. Harlan has his pustular folliculitis patients apply SmartLotionⓇ twice daily for up to two weeks. He advises them to reduce activities that contribute to perspiration while recovering, and he stresses the importance of moisturizing dry skin at least once a day. He instructs his patients to apply moisturizer in a single, downward direction to reduce further irritation of the hair follicles.
For patients with severe cases, he prescribes an antibiotic to be used initially, and then along with the routine mentioned above. He suggests combining SmartLotionⓇ treatment with an antimicrobial wash for the best results for preventing pustular folliculitis.
Genital irritant dermatitis and male friction rash
Heat, sweat, and skin-on-skin friction make the groin and genital areas especially vulnerable to irritation and rash. Compounding the issue is the thin and sensitive nature of skin on the genitals, groin creases, and perineum. Strong topical corticosteroids are usually ill-advised in this area, as topical steroids can cause atrophy (thinning) of the skin and striae or stretchmark-like changes..
Rashes in these areas can be distracting and embarrassing; left untreated, patients are more likely to scratch, exposing the skin to bacterial infection, and setting up a more chronic itching problem called “lichenified skin.”
Irritant dermatitis is a common cause of itching in the perigenital region. The large number of sweat glands in the area, as well as the lack of exposure to the air, mean that skin is exposed to both moisture and the salt from perspiration. Urine leakage likewise contributes to irritation. Older people and people with nerve damage need to clean themselves a second time
during the day for stool leakage that causes irritant dermatitis, itching, and burning. For itching
and burning of the perineum and perianal areas, SmartLotionⓇ is ideal.
Excessive bathing can aggravate genital irritation and should be avoided. Drying soaps should be eliminated, as should detergents and hygiene products containing fragrances and preservatives such as Methylisothiazolinone MI and Methylchloroisothiazolinone MCI. Exchanging these products for gentler, hypoallergenic alternatives gives the irritation time to calm. Dr. Harlan recommends Dove bar soap and white Dial bar soap. Moisturizer should be applied after washing.
Loose-fitting clothing in soft, breathable fibers allows perspiration to dry and minimizes friction.
Vulvar itching and rash at any time warrant a doctor’s visit. If the irritation is caused by yeast, treatment is called for–otherwise the irritation will continue. Caution is warranted; many over-the-counter vaginal itch products do not address the root cause of the itching. If it is caused by a yeast infection, the infection will continue and so will the itching. They often contain Benzocaine, a numbing agent that makes the itching less noticeable. Use of these products can sensitize a patient’s immune system to Benzocaine, leading to allergy. allergy.
Once infection is ruled out, SmartLotionⓇ can be used for itching of the vulva, the perineum, and perianal skin. SmartLotion’s pre-biotic qualities make it especially suited for this area. It can be used three or four times a day for the first two weeks, and then tapered to three times a week, under Medical supervision.
Douching should be avoided; its benefits are dubious at the best of times, and it can aggravate existing irritation. Clean the area carefully with clear water or with a hypoallergenic soap (such as DoveⓇ bar soap). Moisturize with a thin layer of CeraVeⓇ lotion, CurelⓇ lotion, or CetaphilⓇ lotion.
Scrotal and penile itching
Itching and redness of the scrotum is extremely common in males with Atopic eczema. Redness and itching of the penis can have many causes, including heat, eczema, and psoriasis. Friction during intercourse can aggravate eczema or psoriasis of the penis; it can also cause redness and blisters. Yeast transferred by a sex partner can contribute to rash and irritation, also. Any persistent rash that does not clear on the penis should be examined by a doctor to rule out carcinoma in situ of the penis.
Hypoallergenic products should be used for cleaning the area. When washing, the foreskin should be retracted for thorough cleansing. Cleansing with a solution of water and diluted vinegar once a day and after intercourse can help with yeast overgrowth and irritation from contact with vaginal yeast. After washing, SmartLotionⓇ can be applied in a thin, disappearing layer.
Those with friction rashes on the penis should avoid intercourse until the friction rash has subsided. Care should be taken with washing, just as with other kinds of genital irritation. Moisturizer should be applied as the skin heals.
Rashes on the scrotum are frequently caused by irritation from heat, contact with urine leakage, driving or sitting for long periods, and tight clothing.
If rashes do not respond to treatment, patients should return to the doctor. It is possible for eczema or psoriasis to flare along with friction rash or irritant dermatitis. These conditions should be diagnosed and treated appropriately.
SmartLotionⓇ is an excellent candidate for treating most genital itching on exterior skin. Most people can use it long-term with very little risk of adverse effects–it will not cause atrophy or topical steroid withdrawal. Under a physician’s supervision, it can be added safely to most prescription regimens, when prescriptions don’t completely take care of the problem.
To treat any of the above-mentioned sources of irritation, SmartLotionⓇ can be applied in a thin, disappearing layer twice daily after cleansing and moisturizing. After a week, it can be applied once a day; after another week, the patient can taper to three times weekly.
SmartLotionⓇ was not formulated for use in mucous membranes, and it should never be applied directly to vaginal skin. When mixed with pure petrolatum, it can be applied carefully to the outer mucous membranes of the vagina.
Factors beyond atopic eczema or other disorders can cause skin irritation and rashes. Atdifferent stages of life, the skin may react more to noxious stimuli and irritants, and simply be more sensitive. Irritant dermatitis, folliculitis, and male friction rashes are a few examples of how rashes can result from external damage to the skin barrier. In each of these cases, the skin benefits from gentler treatment, moisturization, and treatment with SmartLotionⓇ.