Itchy? It may be time to schedule an appointment with a dermatologist.
Skin conditions can be hard to identify. Is it dermatitis or hives? A breakout or an infection? Because rashes may need to be treated a certain way, if you don't know what you have, you may inadvertently be making it worse. Whether it’s a minor nuisance or an epidermis nightmare, there are ways to soothe your skin — once you know what you’re dealing with.
“With most skin conditions, you either have a genetic predisposition to them or not,” says Ranella Hirsch, MD, a board-certified dermatologist based in Cambridge, Massachusetts. “They can be exacerbated by stress — either emotional, such as meeting your future in-laws, or environmental, such as an allergen.”
Some skin conditions (athlete’s foot, for instance) can be cured, but most are chronic or recurring. They can be triggered by anything from weather (as in the case of atopic dermatitis) to perfume (as with contact dermatitis). Many of these rashes come and go.
Read on to learn about eight common skin conditions and their symptoms and triggers. You’ll find photos of each, to assist in identification, as well as some simple soothing tips courtesy of experts. Remember: It’s important to see a doctor if you’re dealing with a concerning skin issue, especially if lifestyle and over-the-counter treatments don’t provide relief.
Eczema (Atopic Dermatitis)
The most common type of eczema is atopic dermatitis, and the terms are often used interchangeably to describe the same skin condition. Symptoms of atopic dermatitis are often confused with those of psoriasis; but they aren’t the same. Both can cause red, raised, itchy patches of skin on the hands and scalp, but eczema tends to come with really intense itching, according to Penn Medicine. They’re also caused by different things. Psoriasis is an autoimmune disease, while eczema could be the result of genetic or environmental factors.
With eczema, “the barrier of your skin is damaged and you’re losing moisture,” says Katie Rodan, MD, a board-certified dermatologist and cofounder of Rodan + Fields based in Oakland, California. She compares the condition to a leaky roof: When you have eczema, “anything irritating and allergenic can enter [the skin] more easily, making you more prone to rashes and infections.” About 20 percent of infants have eczema, according to Johns Hopkins Medicine. Many kids outgrow eczema, though it sometimes sticks around into adolescence or adulthood.
Commonly affected areas include the eyelids, elbows, hands, feet, knees, and ankles, according to the Mayo Clinic. Triggers for eczema include environmental factors, such as hot weather, according to Penn Medicine, or contact with certain products, such as chemicals or drying detergents, says Joyce Davis, MD, a board-certified dermatologist based in New York City. “It is vital to wear gloves when working with chemicals and be sure to use a laundry detergent that is hypoallergenic and gentle on skin, like the Arm & Hammer Sensitive Skin, Free & Clear laundry detergent,” she says.
First, stop scratching!
“Eczema creates a vicious itch-scratch cycle,” Dr. Hirsch says. “The skin’s dryness [causes] itchiness, which makes you scratch. Scratching makes your skin thicker, which itches more.”
- Use an anti-itch lotion, such as a topical steroid with 1 percent hydrocortisone, which is available over the counter. If over-the-counter products don’t work, a dermatologist can prescribe creams that control the itching and help repair the skin. But long-term use of steroid treatments isn’t recommended, because they can thin the skin.
- Choose mild soap that doesn’t include dyes or fragrances, and be sure to thoroughly rinse it off the body.
- Buy skin-care products that are unscented, not fragrance free. “Fragrance free means they’ve used a chemical to mask a scent, and those chemicals can be irritating,” Hirsch says.
- Avoid long, hot showers and instead take a bath with baking soda, uncooked oatmeal, or colloidal oatmeal. Pat the skin dry afterward, and apply moisturizer while the skin is still damp. “If you put a thin layer on damp, not dry, skin, it will penetrate quickly,” Hirsch says.
Contact dermatitis is a different type of eczema, triggered by physically touching something that irritates or causes an allergic reaction, according to the American Academy of Dermatology Association (AAD). Intense itching, accompanied by a rash with fluid-filled blisters, is the hallmark of the disorder, according to AAD. There are two types of contact dermatitis: irritant, which is more common and occurs when your skin reacts to something chemical (like a perfume or detergent), and allergic contact dermatitis, which is caused by a reaction to a substance, according to the Mayo Clinic. Common contact dermatitis triggers include nickel jewelry, hair dye, cosmetics, skin-care products, nail polish, formaldehyde, rubbing alcohol, and poison ivy.
“It is usually not immediate; it takes a few days for contact dermatitis to appear on your skin the first time around,” Dr. Davis says. “The second time, it may appear sooner.”
For both irritant and allergic contact dermatitis, use over-the-counter or prescription topical cortisone, Davis says.
“Unfortunately, there is no ‘cure’ for an irritant or allergic sensitivity, although some can improve with time,” says Lisa Anthony, MD, a board-certified dermatologist at Westmed Medical Group in Westchester, New York. Preventing contact dermatitis, however, can be simple: Avoid what’s making you break out — if you’re able to identify the culprit yourself, says the Mayo Clinic. Dr. Anthony says that’s not always easy.
Seborrheic dermatitis on the scalp is often treated with over-the-counter dandruff shampoos with ingredients that reduce the skin’s fungal population, Anthony says. Look for shampoos with zinc, selenium, or ketoconazole, and leave the shampoo on the scalp for five minutes before rinsing, recommends Harvard Health Publishing. “Depending on your individual hair type, try to shampoo daily until the condition improves,” Anthony says. “For thicker scale, one can add mineral oil to soften and comb out stubborn flakes.”
If that doesn’t work, your doctor can prescribe stronger shampoos and medications. Outbreaks on the face and body can be treated with topical corticosteroids or antifungal medications, notes the Cleveland Clinic. Try lifestyle changes too, including de-stressing tactics. Stress is one factor that can trigger seborrheic dermatitis, according to the AAD.
Jock itch, athlete’s foot, ringworm: These all belong to a family of infections known as tinea, involving fungus that thrives in warm, moist areas, such as in the groin, toes, and underarms, according to Johns Hopkins Medicine. “These warm, dark, moist areas create the perfect environment for fungus to breed,” says Crystal Murray Holmes, DPM, a podiatrist in Canton, Michigan, and an associate professor at the University of Michigan. The symptoms depend on where on the body the infection appears, according to MedlinePlus. A red ring-shaped rash may be — you guessed it — ringworm, while athlete’s foot and jock itch appear as itchy, burning rashes on the skin. How do you contract it? By coming into contact with an infected person or pet or infected surface, such as a communal shower floor, per MedlinePlus. They can also be passed through things like shoes and towels, Anthony says. Fungus that causes jock itch, for example, thrives on damp towels and sweaty workout gear and is easily picked up in a locker room, MedlinePlus says.
Your best bet for treating fungal infections are antifungal creams and oral medications, according to Cedars Sinai. Be sure to wash your hands before and after applying the creams to keep the fungus from spreading further.
Bacterial infections can start small but grow into a big problem if left untreated. An untended wound, insect bite, or other break in the skin can allow bacteria to creep into your skin and fester, according to Merck and Co. The resulting infection can be the size of a tiny spot or can spread across the entire body, and the severity of the infection can also range from no big deal to life-threatening.
If it’s a small infection, an antibiotic ointment can be applied to the area to clear it up. But if it affects a larger area of the skin, oral or intravenous antibiotics may be needed, according to Merck and Co. Unfortunately, the World Health Organization notes, overuse of antibiotics has created super-strains of bacteria that don’t respond to those drugs anymore. “Because of antibiotic resistance, bacterial infections are becoming more virulent,” Dr. Rodan says. In a worst-case scenario, the infection can get into the blood and be fatal. “People really do die of cuts,” Hirsch says.
Your doctor will likely start with oral antibiotics, according to the nonprofit health system Fairview. Expedite your visit and see a doctor immediately if you spot yellow pus or foul-smelling drainage from a wound, increased redness and pain at the site of the wound, changes in color or size, red streaks in the skin surrounding the wound, or if you come down with a fever. Hirsch says those symptoms are cause for concern.
A mysterious, sometimes random skin condition that may come and go, hives (also known as urticaria) have many triggers, including certain foods (such as peanuts, eggs, nuts, and shellfish), extreme cold or heat, some medications and illnesses, and insect bites, according to the American College of Allergy, Asthma, and Immunology. Genetics can also be to blame. “There can be a genetic component to hives where individuals are more prone to allergy, asthma, and eczema,” Anthony says.
In response to the trigger, the cells in your body release histamine, a chemical that makes the body go into inflammatory overdrive to get rid of the allergen, according to the Cleveland Clinic. Hives and swelling result as your body responds to the flood of histamines.
If hives are accompanied by swelling of the eyes, mouth, hands, feet, or throat, or difficulty breathing, you may have angioedema. “It is similar to hives, but it can be more severe and often affects the eyes and lips,” Anthony says. “In the most severe cases, internal organs such as the respiratory tract and gut can be involved.”
Sometimes hives disappear on their own without any treatment, though applying a cold washcloth to the area can help soothe the skin, the Mayo Clinic says.
If not, try an over-the-counter oral antihistamine to reduce itching and swelling. Still not getting relief? See your doctor for an anti-inflammatory medication such as prednisone, advises the Mayo Clinic.
“Like all allergic skin reactions, each subsequent exposure can get worse” and may even be life-threatening, Rodan says. Of course, the best remedy is prevention. Try to identify your trigger for hives and avoid it.
Though herpes simplex virus (HSV) infections can be transmitted through sex, that’s not the only way the virus is passed between people, according to the CDC. “At least 80 percent of us are exposed to the herpesvirus by the time we enter kindergarten,” Rodan says, thanks to shared toys, kisses from relatives, and slobbering, germy friends. Our immune systems usually fight off the disease, but about 20 percent of people break out in sores, Rodan says. Oral herpes, usually HSV type 1, is usually the culprit behind cold sores and originates during childhood through nonsexual contact, according to the CDC. “Any close contact like kissing, sharing utensils, or using a department store lipstick tester can cause it to spread,” Hirsch says. But HSV type 1 can also be transferred to the genitals during oral sex, according to the CDC. A herpes outbreak can be triggered by stress, illness, fatigue, and sun exposure, according to Harvard Health Publishing. Though it’s rare, laser and injectable procedures (such as lip filler) at a doctor’s office can also trigger outbreaks, Davis says. Herpes infections tend to recur in the same spot on your body because the virus lives in the nerve beneath the skin, Davis says. “When it gets triggered back to skin, it’s within the same vicinity,” she says.
HSV can be tricky to diagnose since it oftentimes looks like an allergic reaction, according to Cedars Sinai. Your doctor may take a virus culture, blood sample, or biopsy to confirm the presence of HSV. There is no cure, but prescription antiviral medication like Valtrex can reduce the number of herpes outbreaks, according to the Mayo Clinic. Taken in pill form, it can reduce the severity and duration of outbreaks. A doctor can prescribe topical treatments, such acyclovir and hydrocortisone, to help lessen the symptoms, says the University of Michigan.
Shingles, another viral rash, is a reactivation of the chicken pox virus, according to the CDC. These painful, itchy, and tingly rashes tend to appear on the torso and will follow the path of a nerve on just one side of the body. “It picks one nerve on either the left or the right side of the body,” Davis says. “It goes around the rib, one part of the face, and it’s very easy to diagnose.”
People with shingles won’t spread shingles to other people, but they can infect others with chicken pox if the person on the receiving end hasn’t had it, according to the Mayo Clinic. Shingles can occur among people who’ve had chicken pox before, and since most adults in the United States did have chicken pox as kids, they’re at risk, especially if they’re over 50 and have compromised immune systems, according to the Mayo Clinic.
A shingles rash usually goes away within five weeks, and most people will only get shingles once, according to the National Institute on Aging. Sometimes, however, the pain will linger, especially among older people. Known as postherpetic neuralgia (PHN), it can lead to depression, trouble sleeping, and weight loss.
There are two shingles vaccinations, which should prevent an infection in the first place, according to the CDC. And, as with herpes, an antiviral medication can reduce the severity and duration of a shingles outbreak, especially when taken within three days of the rash appearing, according to MedlinePlus. If you have mild pain, an over-the-counter pain reliever, cool washcloth, calamine lotion, and oatmeal baths may help.