Irritant dermatitis
Introduction
Irritant dermatitis is a common skin condition that occurs when something irritates your child’s skin, making it look red and feel itchy. It occurs when chemicals or irritants in the environment come into direct contact with your child's skin, causing damage to the surface of their skin. It can affect anyone, is not dangerous, and can be treated.
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Baby with red and peeling skin on the cheeks from irritant dermatitis
Who gets it?
Irritant dermatitis can affect anyone exposed to something that irritates the skin. It is common in young children who are more exposed to natural irritants, as well as older children and teenagers who are exposed to irritants as part of their day-to-day lives. Children with eczema are particularly susceptible to irritant dermatitis.
What causes it?
Irritant dermatitis is caused by contact with an irritant, particularly in someone who has sensitive skin because of other factors. This irritant disrupts the natural moisture barrier of the skin, causing dryness and a rash.
Natural irritants: Bodily fluids can be very irritating to skin, and can cause dermatitis. This can include saliva in babies who dribble (sometimes when they suck on dummies), young children who lick their lips. Other common natural irritants are urine (wee) and faeces (poo) which can cause irritant dermatitis in children who wear nappies
Other irritants: Common irritants such as soaps, bubble baths and detergents can affect children of any age group
Genetics and immune system factors: Children who have sensitive skin, or who have other types of eczema, may be more likely to experience irritant dermatitis
What does it look and feel like?
Looks like…
Irritant dermatitis looks like a pink or red rash in the area that has been exposed to the irritant. The rash will have clear borders, and may have overlying dry flaky skin. Sometimes there maybe blistering. The size of the rash will reflect the area that was exposed to the irritant.
In young children it may appear around the mouth if caused by dribble or lip licking, or in the nappy area if caused by wet nappies. In older children, it often affects the hands (due to soap or hand washes). In most cases, it appears slowly and worsens with more exposure to the irritant.
Feels like…
Irritant dermatitis can feel itchy and dry. It is not usually painful unless there is blistering or cuts on the skin.
What tests might be needed?
Most of the time, your GP or dermatologist will be able to diagnose the condtion without the need for any tests. Sometimes, your child's dermatologist may do a patch test if it is unclear what is causing the dermatitis – different children will find different things irritating.
What treatments are available?
What can I do?
As much as possible, removing the cause of the irritation is important. This may be difficult with young children who have sensitive skin and irritant dermatitis due to natural irritants, but regular cleaning of dribble and changing of nappies, in addition to the medical therapies below, will help. If another irritant (such as soap or body wash) is the cause, then this should be changed and a gentle alternative for sensitive skin found.
Medical therapies
All medical therapies for dermatitis should be prescribed by a doctor, usually a dermatologist.
Moisturising creams: Emollients are a special type of thick moisturiser that help to restore the skin’s barrier, which is disrupted in irritant dermatitis. Some emollients are available over-the-counter (without a prescription), but it is best to see a doctor for advice
Steroid creams: In some circumstances, prescription creams, such as steroids to reduce inflammation, may be necessary
Antibiotics: bacterial infection of the dermatitis may require either antibiotic by mouth or as creams
What happens after treatment?
Irritant dermatitis should improve and resolve with treatment, but may come back if your child’s skin is in contact with the same or a similar irritant in the future. If your child has had irritant dermatitis, it might indicate that they have sensitive skin, and will need to use gentle products in the future. Your child may also experience other types of dermatitis (eczema) in the future.
What support is available?
Your GP and dermatologist will work together to look after your child and improve their dermatitis. Eczema Australia is a patient support group that provides information about eczema and treatments for patients and their families, and can be found here: https://www.eczema.org.au
Authors/Reviewers:
Author: Dr Imogen Kate Thompson
Paediatric Reviewer: Dr Mayuri Sivagnanam
Editor in Chief: Dr Tevi Wain
