Spongiotic dermatitis (SD) is a blanket term that helps describe specific histopathology (change in tissues) of atopic dermatitis, contact dermatitis, and other eczema-related conditions. Stay with me here, I am going to break it down!
The word Spongiotic is really just excess fluid, which can cause swelling.
An easy way for me to remember the term is that Spongiotic looks like it has the word “sponge” in it, which can have an excess of fluid.
Sometimes SD is just referred to as dermatitis. The National Library of Medicine defines spongiotic dermatitis as “A chronic inflammatory skin condition characterized by itchiness and a rash in the chest and abdominal areas.”
Causes of spongiotic dermatitis
Scientists have yet to find the definitive cause of SD, but here is what is known to be related. The more common causes of SD are nummular eczema, allergic/irritant dermatitis, and occasionally drug reactions.
Fun fact: SD can resemble a fungal infection, so it is important to see your doctor or a dermatologist for a proper diagnosis.
There are no specific conditions that point directly to the cause, so it is important for your provider to get a thorough medical history. Here are the triggers that may invoke spongiotic dermatitis.
List of Potential Spongiotic Dermatitis Triggers
Medications that can trigger spongiotic dermatitis include topical steroids, antimalarials, nonsteroidal anti-inflammatory drugs (NSAIDs), and immunosuppressants. When these medications are used, they can cause the walls of the skin cells to weaken, allowing fluid to leak out.
In addition, these medications can inhibit the production of substances that help to keep the skin moist and supple. As a result, the skin becomes dry, cracked, and inflamed. In severe cases, spongiotic dermatitis can lead to blistering and ulceration.
Infections are one of the most common triggers for this condition, as they can cause the immune system to go into overdrive. Once an infection has resolved, the symptoms of spongiotic dermatitis will typically resolve on their own. However, in some cases, the condition may recur or become chronic.
When a person is under a lot of stress, their immune system can become weakened, making them more susceptible to skin problems. In addition, stress can also cause hormonal changes that can further contribute to skin inflammation. As a result, managing stress levels is often an important part of treating and preventing spongiotic dermatitis.
- Metals (nickel, copper)
- Physical contact with allergens
- Exposure to dry air (low humidity)
- Extremely hot or cold environments
- Wool and polyester clothing
Skin irritants & Chemicals
- Soap/body wash
- Bubble bath
- Face wash
- Laundry detergent
- Fabric softener
Cleaners / disinfectants
Natural liquids on the skin
- Additive in some disinfectants
- Make-up removers
- Baby wipes
- Soap thickener
- Lotion thickener
- Shampoo thickener
- Leather dyes
- Temporary tattoos
What does spongiotic dermatitis look like?
Spongiotic dermatitis can look a few different ways since it is excess fluid under the skin. Overall, spongiotic dermatitis may have the following characteristics.
- Dry skin patches
- Blisters/fluid-filled bubbles
- Red rash
- Watery discharge/weeping
- Skin scaling or flaking
SD on Fingers
This seems to be a more severe case of SD, ouch! You can see that there are multiple blisters containing fluid.
SD on Forearm
This image shows us a more rash-like case of spongiotic dermatitis with some scaling and flaking of the skin.
Blistering Side View
This picture shows a side angle of a blister. The blister has spread from the palm, down the side of the pinky. Notice there is a slight cut on the blister, broken skin can make you more prone to infections.
What are the symptoms?
The symptoms of spongiotic dermatitis can vary from person to person. Symptoms are influenced by how you acquired dermatitis (immune, contact, infection, allergy). Here is a list of the most common symptoms associated with spongiotic dermatitis.
Common Spongiotic Dermatitis Symptoms
- Itchy skin
- Dry skin
- Skin hardening
- Flaking skin
- Skin sensitivity
- Pain (especially if the skin is broken or blistering)
- Swelling of the skin
What are the risk factors?
There are some risk factors that may put you at an increased risk of having spongiotic dermatitis. Knowing the risk factors may help you and your medical provider in making a proper diagnosis.
- African American
- Family history
- Hay fever
- Other forms of dermatitis
How is it diagnosed?
According to the Cambridge University Press, spongiotic dermatitis is diagnosed as follows. First, SD is excess fluid (edema) under the skin, so your doctor may diagnose simply by your symptoms, health history, and how your skin looks. To get a true diagnosis of SD a skin biopsy is usually performed. The biopsy is sent to a pathologist to be examined under a microscope.
The pathologist will be able to determine what type of skin disorder is present and its severity. SD can be diagnosed into subclasses of acute, subacute, and chronic.
Acute: Short-term condition with a sudden onset, and may or may not resolve on its own.
Subacute: A condition that is not acute, but not yet chronic.
Chronic: Long-lasting condition that doesn’t go away, or keeps coming back.
The results from the biopsy will be documented and sent to your provider. A follow-up appointment is usually required to go through the results as well as discuss any potential treatment plans.
Can Spongiotic Dermatitis Go Away?
Technically yes. Medical professionals believe that spongiotic dermatitis is caused by food allergies, insect bites, or even medications. By removing the allergen exposure your symptoms of SD should go away. But if you are exposed to that allergen again, you will more than likely develop SD symptoms again.
The outlook of SD depends on the cause, severity, and whether the condition is considered acute, subacute, or chronic. Overall, the outlook is good with most cases being manageable. Of course, there are cases where you may have a bad flare-up which can lead to other complications including infections.
Complications may arise when managing spongiotic dermatitis, here are some complications you should be aware of. Many times the cause of complications is due to symptoms that are not well managed or continue to get worse regardless of proper treatment and prevention techniques.
Complications can become quite serious, so always consult with your medical provider regarding your condition.
Scratching, trauma, and swelling can lead to the skin breaking open. When the skin is broken, you may notice bleeding, or weeping of liquid from your skin. Broken skin can cause complications by potentially limiting your range of motion (bandages, scabs, etc.) or by making you vulnerable to infections.
Infection is a possible complication from spongiotic dermatitis. Here are some signs of infection that you should be aware of.
Signs of infection
- Blister-like sores
- Crusting skin
- Excessive swelling
- Skin is hot to the touch
- Symptoms get worse, not better
- Weeping or puss
- You develop a fever
Infections are a condition that needs treatment. Seek medical assistance right away if you suspect an infection. Keep in mind this is not an all-inclusive list and you may experience different symptoms. When in doubt, see a medical professional.
How’s it treated?
The good news is there are treatment options for spongiotic dermatitis symptoms. Treatment options are something you should be discussing with your doctor. Ultimately, this is an inflammation of your skin, so knowing the cause can be great information to have when starting a treatment plan.
For example, if the known cause of spongiotic dermatitis is allergies, avoiding those allergens or taking an antihistamine (treatment) can help with removing the symptoms.
A medical provider may suggest one of these treatment options, after this list of options you will find more details for each one below.
Spongiotic Dermatitis Treatment Options
- Topical steroids
- Prescription medications
- Home remedies
Antihistamines work by lowering the amount of histamine in your body. Histamine is your body’s allergic response to something. If your dermatitis is caused by an allergic reaction, an allergy medication could help relieve your symptoms.
Creams usually contain a mix of oil-based moisturizers and a mix of water-based moisturizers. Keeping your skin moist may help in relieving itching, and dry flaky skin.
Lotions are mostly water-based and provide a short-term moisture fix for your skin. If you need a lightweight moisturizer that isn’t greasy and you are able to apply it multiple times a day, lotion may be the best option for you.
Ointments are the thickest and oil-based (usually petroleum jelly) but they provide the longest-lasting moisture. They are greasy, but they work! My recommendation would be to reserve using ointments for bad flare-ups, or as a treatment that you apply to your skin at night.
Topical steroids do really well at calming down the skin and easing inflammation. They are also good at stopping the itch while also providing some moisture to your mad skin. The strongest over-the-counter topical steroid is Cortizone 10® which contains 1% hydrocortisone. If you need a stronger topical steroid you will need a prescription.
The prescription medicine world has an overwhelming amount of choices when treating SD. According to Drugs.com, there are 161 different medications that can be used for treating spongiotic dermatitis. Here are the categories of drug treatments that you can discuss with your doctor.
Spongiotic Dermatitis Prescription Drug Classes
- Anorectal preparations
- Antihistamines, topical
- Anti-infectives, topical
- Emollients, topical
- Miscellaneous topical agents
- Rubefacients, topical
- Steroids, Topical
- Topical steroids with anti-infectives
Home remedies for Spongiotic Dermatitis
Home remedies are a great place to start when managing symptoms of spongiotic dermatitis. Here are some options that may work for you. Keep in mind that everyone reacts and has slightly different symptoms, so these may or may not work for you.
Rethink your Shower
Showering or bathing can be relaxing, but if you suffer from spongiotic dermatitis, you may dread rinsing. Here are some pointers to keep your skin calm and potentially improve your symptoms.
Showering with Spongiotic Dermatitis
- Avoid hot showers, turn down the temperature a bit
- Make it a quick shower, under 10 minutes is ideal
- Pat your skin dry, don’t drag the towel across your skin
- Immediately apply your favorite hypoallergenic moisturizer
Use a Moisturizer
Not all moisturizers are created equally, you will want to use a moisturizer that doesn’t have a laundry list of items you cannot pronounce, or that is heavily scented. Moisturizers actually have categories which are lotions, creams, and ointments.
Dermatitis has a track record of being caused by allergens (not all the time), so you may benefit from using an antihistamine as a home remedy. If you suspect that your spongiotic dermatitis is caused by an allergen, an antihistamine will help calm the immune system which should calm down your mad skin.
A topical steroid like hydrocortisone may get you the relief you need, and you may already have it on hand at home. Hydrocortisone works really fast as you directly place it on your inflamed skin. The steroid cream packs a punch to ease the inflammation.
It’s worth a shot if you haven’t tried it already, and if it doesn’t work out, luckily the cream can be used for other ailments like bug bites, itchy skin, and sunburn.
Prevention of Spongiotic Dermatitis
Preventing flare-ups to limit symptoms is a great approach when managing SD. The first step you should take is to know your triggers and avoid those triggers if possible. Above all, if it is not possible to avoid your triggers there are still some things you can do to hopefully make life a bit easier.
When managing SD, moisturizers are going to become your best friend. The goal is to keep you and your skin happy and healthy. Healthy skin leads to fewer flare-ups and more mild symptoms. Therefore, when you choose a moisturizer, the more natural and fewer additives the better. For example, moisturizers with fragrances are a big “no-no”. Fragrances smell nice, but they tend to be major skin irritants.
Lower the Shower Temperature
Interestingly, our skin is sensitive to extreme temperatures, both hot and cold. When you have SD or any other skin condition, this sensitivity is amplified. To prevent flare-ups, lower the shower temperature, especially if you usually have it hotter than the surface of the sun (ladies).
Additionally, professionals recommend limiting the amount of time in the shower and to apply moisturizer within the first two minutes of getting out. Applying moisturizer right away helps your skin lock in moisture.
Ditch Harsh Skin Products
There are so many harsh products that we expose our skin to every day, and we might not even be aware! If you haven’t heard of the Environmental Working Group (EWG), you have to check it out. They have health ratings on many daily-use products.
Our family was shocked at how many “F” graded products we were using.
We have now switched to healthier choices with better ratings. Here are some products that I recommend you look into.
Products that may be irritating your skin
- Body wash
- Dish soap
- Bar soap
- Shaving cream
- Laundry detergent
- Fabric softener
- Dryer sheets
- Face wash
- Air fresheners
- Household cleaners
For us, the worst products we were using were laundry detergent and household cleaners. Because of this, we have since switched to healthier products and we replaced ALL our household cleaners with Force of Nature Cleaner.
Quick Force of Nature Cleaner Facts
- Made at home
- Disinfects (EPA approved)
- Safe around pets and babies
You can either check it out directly from their website (forceofnatureclean.com) or one of my other articles to learn more.
We have made it to the frequently asked spongiotic dermatitis questions, which are ACTUAL FAQs from readers like you.
No. There is no cure for SD, but knowing your triggers to avoid flare-ups can keep symptoms at bay.
Maybe. Spongiotic dermatitis can be caused by many factors including physical contact, and medications. Knowing the true cause of your SD will give you a better idea of whether your condition is acute or chronic.
Yes. Spongiotic dermatitis can spread on your skin, but it cannot be spread from person to person.
No. Spongiotic dermatitis is a term to describe skin inflammation with fluid buildup under the skin.
No. SD is not contagious and cannot be spread from person to person.
No, these are two different conditions. Although the symptoms of spongiotic dermatitis (fluid in the skin cells) are seen in the early stages of psoriasis.
Atopic dermatitis. Atopic dermatitis is the most common type of dermatitis that presents spongiotic symptoms.
Yes. The major cause of SD is an inflammatory autoimmune skin disease.
Presence of intercellular edema (fluid) in the skin. NIH.gov
Yes. Dermatitis is an inflammation of the skin, and if your skin is dry, patchy, or itchy, unscented moisturizers can help calm the skin.
Yes. When we are stressed or anxious our body produces the stress hormone cortisol. This hormone can slow the healing process in the body and put your body at risk for an inflammatory response in the form of dermatitis.
L98, Other disorders of skin and subcutaneous tissues, not elsewhere classified. or L30.9, Dermatitis unspecified
That is a deep dive into spongiotic dermatitis! I hope you have picked up some helpful information. The biggest takeaways are to get with your doctor, find a good moisturizer, and investigate your household products (EWG).
Don’t forget to check out:
Thank you for stopping by. Do you have an “infrequently” asked question or an SD story you would like to share? Send me (Chris) an email at: firstname.lastname@example.org