Rashes & Skin Allergies

Rashes are a very broad topic, but this Advisory has a narrow focus: dry skin and eczematous rashes. Dry skin is a problem faced by almost all of us on occasion, but it’s always a problem if you have eczema.

What is Eczema?

Eczema is a term used for a group of skin conditions having several things in common: dryness, itching, inflammation and thickening of skin, and recurrence. See the table below for descriptions of the usual types.

Type Location Symptoms Appearance
Atopic dermatitis (common in kids with allergies or asthma, often gone by adulthood) See body map Itching Thickened, red, dry skin; sometimes crusty and oozing.
Contact dermatitis (skin allergy or sensitivity to a substance) See body map Itching, dry skin Dry, thickened, cracked skin.
Hand dermatitis (usually caused by irritants) Hands, sides of fingers Itchy, dry, painful; sometimes small blisters at sides of fingers Dry, red, skin; sometimes cracked and bleeding.
Dry (chapped) skin Backs of hands, lower legs, or entire body None or sometimes itching Scaly, flaky; not thickened. Sometimes cracked if severe.


What Causes It?

Nobody knows exactly why some people are affected by these rashes and others with the same exposure aren’t. Those with atopic dermatitis often have non-skin allergies (like hay fever and asthma) but their rashes aren’t caused by skin allergies. On the other hand, those with contact dermatitis do have true skin allergies, but usually not other allergic problems like someone with atopic dermatitis. Contact dermatitis occurs at all ages, whereas atopic dermatitis is most often a problem in kids. Hand dermatitis is caused by skin irritants such as detergents or chemicals. Dry (chapped) skin occurs because of lack of water in the stratum corneum (outermost layer of skin). If your skin surface doesn’t have enough oil, there’s more evaporation of water which contributes to the dryness.

The Itch/Scratch Cycle

sites of rashes and skin allergies
Characteristic sites of atopic dermatitis.

Scratching can actually trigger eczematous rashes. Initial mild itching makes you want to scratch, of course. But scratching damages the skin, worsens inflammation, irritates surface nerves, and leads to even more intense itching than you had before. This cycle aggravates and prolongs all of these rashes. In fact some eczematous rashes completely disappear without any treatment if you just stop scratching.

As you can tell, these rashes differ in many ways. So why do we lump them together? Because the underlying chronic inflammation makes them all look, feel and respond to treatment in the same ways.

If you have eczema or dry skin, you’ll probably have it again unless you take preventive steps. Advice below applies to all varieties of eczema and dry skin.

Avoiding Eczema and Dry (chapped) Skin



Eczematous dermatitis (contact) (a) Airborne allergens (plants, pollens, sprays;
(b) jewelry, clothing, furs; (c) clothing straps; (d) deodorant, antiperspirant;
(e) metal tags; (g) trunks and panties; (h) shoes or hose.

The Do’s and Don’t in the Prevention section are really the key to minimizing your eczema or dry skin, but there are medications and other products that help further.

When treating eczematous skin, always keep the old dermatologist’s refrain in mind: "If it’s wet, dry it. If it’s dry, wet it." Translation: solution or gel forms of medications are better to dry out puffy, moist or oozing skin. Lotion and cream types are for neutral or slightly dry skin, and ointments (greasy petrolatum-based products) are the ultimate for "wetting" your extremely dry or cracked skin problems.

Many cases of eczema are too severe for self-care. Prescription steroid creams and other techniques can be a far more effective addition to the above measures if your rash gets out of control. Here are some signs that you are losing the battle:

More than rashes and skin allergies on our Self Care Home Page



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