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Health condition · Clinically reviewed

Dermatitis, an umbrella term - and a treatable one.

From atopic and contact through to seborrhoeic, stasis and perioral - each type has its own story, and its own ladder of care.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, BAD and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance including emollient-led care, topical calcineurin inhibitors, dupilumab and JAK inhibitors.

Key facts

Dermatitis at a glance.

The essentials, in plain English - what it is, the main types, and how it is treated in the UK today.

  • What it is

    An inflammatory skin condition and umbrella term - dermatitis and eczema are often used interchangeably.

  • Main types

    Atopic, contact (irritant and allergic), seborrhoeic, stasis, dyshidrotic, nummular, neurodermatitis and perioral - among others.

  • Presentation

    Pruritus, erythema, vesicles, oozing and crusting when acute; lichenification and fissuring when chronic.

  • Foundation therapy

    Emollients used liberally - Doublebase, Zerobase, QV, Cetraben, Aveeno, Diprobase, Epaderm - often 500g a week.

  • Topical steroids

    Matched to site and severity - hydrocortisone 1% on the face, betamethasone 0.1% on the body.

  • Modern options

    Dupilumab, tralokinumab, oral JAK inhibitors and phototherapy for moderate-to-severe atopic dermatitis.

Why this guide matters

Name the type, choose the ladder.

Dermatitis is not one disease - it is a family of conditions with overlapping features. The first job is to name the type; the treatment ladder follows from there.

  • Emollients are the foundation

    Applied liberally and often, they repair the skin barrier and reduce the need for stronger treatment.

  • Steroids used properly work

    Match potency to site, use for long enough to settle the flare, then step down - not the other way round.

  • Modern options exist for severe disease

    Dupilumab, tralokinumab and oral JAK inhibitors have transformed moderate-to-severe atopic dermatitis.

How the diagnosis is made

From history and pattern to a plan.

The steps a UK GP or dermatologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History

    Onset, duration, triggers, occupation, hobbies, products, medications, family history and atopy - the story usually points to the type.

  2. 02

    Assessing

    Examination

    Pattern and distribution are often diagnostic - flexures suggest atopic, oily areas seborrhoeic, lower legs stasis.

  3. 03

    Assessing

    Clinical diagnosis

    Most dermatitis is diagnosed on history and examination alone - no investigations needed for a straightforward case.

  4. 04

    Confirming

    Skin biopsy - selective

    Reserved for atypical or refractory rashes where the diagnosis is uncertain.

  5. 05

    Confirming

    Patch and scrape testing

    Patch testing for suspected allergic contact dermatitis (specialist) and KOH scrapings when fungal infection is possible.

  6. 06

    Escalating

    Bloods when indicated

    Total IgE, eosinophils, inflammatory markers and allergen-specific IgE in selected cases.

  7. 07

    Escalating

    Specialist dermatology referral

    Refractory, severe or complex disease, suspected internal cause or when systemic therapy is being considered.

Typical timeline: most cases diagnosed in a single visit, with a treatment plan the same day.

Symptoms

What dermatitis actually looks like.

Presentation varies by type - itch, redness, blisters and oozing in acute disease; thickening and fissuring when chronic.

  • Pruritus

    Itch is the dominant symptom in almost every type of dermatitis and often the driver of skin damage.

  • Erythema

    Redness in acute flares - subtler and browner on darker skin, where inflammation can be underestimated.

  • Vesicles and oozing

    Small blisters and weeping in acute disease - classic in dyshidrotic and severe contact reactions.

  • Crusting

    Yellow or honey-coloured crust often signals secondary bacterial infection needing antibiotic cover.

  • Lichenification and fissuring

    Thickened, leathery skin and painful splits in chronic disease - the mark of long-standing scratching.

  • Pattern by type

    Flexures in atopic, oily areas in seborrhoeic, lower legs in stasis, hands and feet in dyshidrotic.

  • Life impact

    Sleep loss, low mood and social withdrawal are common and often under-recognised.

  • Red flag - eczema herpeticum

    Sudden painful monomorphic vesicles and systemic symptoms - a dermatological emergency needing oral aciclovir.

Treatment

How dermatitis is treated in the UK.

Trigger avoidance and emollients first; topical steroids and calcineurin inhibitors next; phototherapy, systemic immunosuppression, biologics and JAK inhibitors for severe disease.

  • Identify and avoid triggers

    Detective work on soaps, fragrances, metals, occupational exposures and heat is often as effective as any prescription.

  • Emollients - the mainstay

    Applied liberally and often - Doublebase, Zerobase, QV, Cetraben, Aveeno, Diprobase or Epaderm - typically 500g a week.

  • Topical corticosteroids

    Mild for the face, moderate to potent on the body, very potent short courses for severe flares - matched to site and severity.

  • Topical calcineurin inhibitors

    Tacrolimus and pimecrolimus for face and folds - steroid-sparing and safe for longer-term maintenance.

  • Treat infection

    Flucloxacillin or fusidic acid for bacterial superinfection - oral aciclovir for eczema herpeticum.

  • Seborrhoeic care

    Ketoconazole shampoo, selenium sulphide, mild hydrocortisone and tacrolimus for scalp, face and chest disease.

  • Stasis dermatitis

    Compression, treatment of venous insufficiency, emollients and a moderate steroid for flares.

  • Phototherapy

    Narrowband UVB for chronic, widespread or refractory disease - specialist-delivered.

  • Systemic immunosuppression

    Methotrexate, azathioprine, ciclosporin, mycophenolate or short-course oral steroid for severe disease.

  • Biologics

    Dupilumab (anti-IL-4Rα), tralokinumab (anti-IL-13) and emerging lebrikizumab for moderate-to-severe atopic dermatitis.

  • Oral JAK inhibitors

    Upadacitinib, abrocitinib and baricitinib for moderate-to-severe atopic dermatitis - specialist-led.

  • Perioral and herpetiformis care

    Perioral dermatitis needs oral tetracycline and steroid withdrawal - dermatitis herpetiformis needs dapsone and a gluten-free diet.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or dermatologist knows your skin and history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Eczema - atopic: management (CKS).

  • NICE. Dermatitis - contact: management (CKS).

  • British Association of Dermatologists (BAD). Guidelines and patient information leaflets on eczema and dermatitis.

  • NICE TA534, TA814, TA819, TA875 and TA906. Dupilumab, tralokinumab, upadacitinib, abrocitinib and baricitinib for atopic dermatitis.

Red flags

When dermatitis needs urgent attention.

Most dermatitis is managed in primary care. These are the situations that are not - and where a specialist opinion or emergency care is needed.

  • Eczema herpeticum

    Sudden painful monomorphic vesicles, fever and malaise - an emergency needing urgent oral or intravenous aciclovir.

  • Widespread bacterial superinfection

    Weeping, honey-crusted skin with systemic symptoms - needs prompt oral antibiotics and dermatology input.

  • Erythroderma

    More than 90% of the skin red and inflamed - a medical emergency with real risks of dehydration and sepsis.

  • Perioral dermatitis

    Do not use topical steroids on the face here - they worsen it. Stop the steroid and start oral tetracycline.

  • Dermatitis herpetiformis

    Intensely itchy vesicles on elbows, knees and buttocks - screen for coeliac disease and refer for dapsone and gluten-free diet.

  • Refractory or scarring disease

    Failure of first-line therapy, deep excoriations, sleep loss or scarring - refer to dermatology for systemic options.

  • Suspected occupational cause

    Hand dermatitis linked to work needs patch testing and an occupational-health review to protect the job long-term.

  • Psychological distress

    Low mood, anxiety and suicidal thoughts can accompany chronic skin disease - ask, and refer.

  • Nappy area with satellite pustules

    Suggests superimposed candida - add a topical antifungal to barrier care rather than steroid alone.

Living with it

A treatable condition, with a clear ladder.

Four things that make the biggest difference day to day - liberal emollients, knowing your triggers, using steroids properly, and escalating when you need to.

A quiet reminder

Consistency beats intensity, every time.

Small, steady habits kept up for months do more than a heroic week that does not last.

  1. 01 Routine

    Emollients, always

    Use them liberally, often, and even when the skin looks clear - the invisible barrier is what stops the next flare.

  2. 02 Triggers

    Know your patterns

    Keep a short diary for a few weeks - soaps, metals, heat, stress and foods often reveal themselves.

  3. 03 Steroids

    Use them properly

    Under-treated flares smoulder for weeks. Match potency to site, use for as long as needed, then step down.

  4. 04 Escalate

    Ask for more when it is more

    Modern biologics and JAK inhibitors have transformed moderate-to-severe atopic dermatitis - a specialist referral is worth it.

Frequently asked

Everything we get asked about dermatitis.

Quick answers on the difference between dermatitis and eczema, the main types, emollients, steroids and modern biologics.

  • Is dermatitis the same as eczema?

    In everyday use, yes - the terms are often interchangeable. Atopic dermatitis is what most people mean by eczema. Dermatitis is the broader umbrella and includes contact, seborrhoeic, stasis, dyshidrotic and several other patterns.

  • What are the main types?

    Atopic, contact (irritant and allergic), seborrhoeic, stasis, dyshidrotic (pompholyx), nummular (discoid), neurodermatitis, perioral, nappy, autoeczematisation, radiation, dermatitis herpetiformis and drug-induced. Each has a different trigger and slightly different treatment.

  • How much emollient should I actually use?

    A lot more than most people think. Adults with widespread disease can use around 500g a week. Apply it liberally, several times a day and after washing - and keep using it when the skin looks clear.

  • Are steroid creams safe?

    Yes, when matched to the right site and used for long enough to settle the flare. Mild steroids like hydrocortisone 1% are used on the face, stronger ones on the body. Undertreatment causes more trouble than short, effective courses.

  • What is dupilumab?

    A biologic injection that blocks IL-4 and IL-13 signalling. It is approved for moderate-to-severe atopic dermatitis in adults and children from six months old and has transformed outcomes for many patients where topical treatment is not enough. See our dupilumab guide for more.

  • When should I see a specialist?

    When the diagnosis is unclear, when first-line treatment is not working, when patch testing is needed, when systemic therapy or a biologic is being considered, or when the skin is severely affecting sleep, mood or work. Your GP can refer you to dermatology.

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