Expert Diagnosis, Treatment and Prevention of Skin Rashes

rashesRashes are a symptom of the modern age.  Our skin is exposed to myriad external substances, both natural and synthetic, which can cause rashes.  And the skin is a window on the internal workings of the body, producing rashes in a variety of illnesses.  An accurate diagnosis is essential, but many patients are told they have “eczema”, which is not a single diagnosis, but rather a broad group of skin diseases.  Skin biopsies of rashes often also fail to narrow down the possibilities.  Our extensive clinical experience with rashes, and unique and comprehensive array of skin allergy testing can often find a cause, and a solution, for patients who thought they had to live with their “eczema”.  It’s one way we practice preventive medicine.

A Symptom of the Modern Age

product marketingRashes are increasingly common in our practice.  In the 21st century, we are inundated with clever marketing from every angle for skin care products which promise youthful and healthy skin.

The latest marketing angle is that “all natural” products are good for your skin.  This would be true if they really were natural for our bodies.  However, the only substances that are all natural for humans are human substances.  Something that is “all natural” in a field or forest is not all natural on you.  Poison ivy is “all natural”.  Human beings were not meant to be rolling around in fields of lavender or lubing up with beeswax.  Despite the marketing, “all natural” is not the same as hypoallergenic.  This is not to say that synthetic substances are any better.  Your skin doesn’t care about that distinction.  The point is, that the only thing that is all natural for you is you.

Despite what all the marketing would have you believe, “all natural” does not mean “hypoallergenic”.

Eczema?  Dermatitis?  Rash?

confusion about rashesDo these terms seem identical to you?

It’s because they are.   And they indicate very little about the cause or proper treatment for your skin rash. Let’s look at the definitions of these common “diagnoses”.

Eczema – From Ancient Greek “ἔκζεμα” (ekzema) 1.  An acute or chronic inflammation of the skin, characterized by redness, itching, and the outbreak of oozing vesicular lesions which become encrusted and scaly.

Dermatitis – From Ancient Greek “δερματίτις” (dermatitis) 1.  Inflammation of the skin.

Rash – From Middle English “rasch” (rash) 1.   An area of reddened, irritated, and inflamed skin.

“Eczema” or “dermatitis” may sound like an educated diagnosis, but to say you have one is to say you have a “rash”.  You probably already knew that.  To a dermatologist,  “eczema” and “ dermatitis” are used interchangeably.  These are chapter headings in any textbook of dermatology, not specific diagnoses.  There are many types of eczema/dermatitis, including, to name only a few :

All of these conditions look different to a dermatologist, have very different causes, and different treatments.

Why does this matter?  Many patients who have been “diagnosed” with “eczema” have required many appointments, tried many medications, incurred significant cost, but still have not attained long-term relief.  At Rustad Dermatology PC, as a great mid-westerner once said, “The Buck Stops Here”.  The right treatment begins with the right diagnosis.

Allergic Contact Dermatitis

skin allergy testingSkin allergies are one of the most frequent causes of rashes, and increasing in importance as our skin is exposed to more and more foreign substances, both natural and synthetic.  But an accurate diagnosis often eludes both patient and physician.

In our experience, allergic contact dermatitis is vastly underdiagnosed.

An experienced dermatologist can occasionally recognize the cause of a skin allergy based on the pattern of the rash on the body.  For example, nickel allergy often produces rashes on the abdomen, behind a jeans button, and clothing-related allergy often occurs where clothing binds tightly, such as around the neck, underarms, or waist.  However many forms of contact dermatitis occur in areas where the list of possible causes is endless, such as on the hands and arms.  All of the discussion in the world may not reveal the cause.

There are three aspects of contact dermatitis which run contrary to popular opinion, and make it difficult for non-dermatologists to diagnose the cause:

  1. Most skin allergies develop due to repeated exposure, rather than being inherited at birth.  Nurses become allergic to latex.  Hairdressers become allergic to hair dye.  Cement workers become allergic to chromates.  The process of developing an allergy often requires years of repeated exposure.  In other words, the fact that one has not changed skin care products is often exactly why one develops an allergy.  And one can change from one product to another that still contains the allergen.
  2. Only occasional exposure to an allergen is necessary to keep an allergic rash going.  One can be avoiding the allergen, such as lavender fragrance, most of the time, but one use of lavender soap in the guest bathroom can trigger a rash if you are allergic to it.  A good example is poison ivy allergy.  One brush with poison ivy every few weeks would be enough to cause a rash that never goes away.
  3. There is a delayed reaction of hours or days between exposure to an allergen and the development of a rash from it.  A good example of this is lip balm allergy.  The lip balm feels soothing immediately after applying it, but days later one has “dry” or itchy lips again, leading one to want to put on still more lip balm.

Your Experts in All Types of Eczema

board certified in dermatologyRustad Dermatology was the first dermatology practice in our area to offer comprehensive skin allergy testing, and we remain among a very few dermatologists in Nebraska who perform this advanced diagnostic procedure.  We are one of very few who maintain membership in the American Contact Dermatitis Society, which gives added benefits to our patients.  We see patients from all over Nebraska and surrounding states because of our unique expertise with unsolved rashes.  Let us serve you to find a solution to your chronic rash.

If you have a rash that just won’t go away, we’d be delighted at the chance to evaluate, treat, and even prevent it from recurring.   We can accurately diagnose and effectively treat your rash in fewer visits, at less cost than any other type of “provider”.  To schedule a consultation with our board-certified dermatologist, call us at 402.484.6222.