In a healthy person, skin inflammation occurs when the skin barrier is compromised. The body will try to protect itself by sending more blood to the area to facilitate the delivery of immune cells. Along with immune cells, pruritogens (or chemicals which make us itchy) infiltrate the skin, which give us the urge to physically scratch the intruder off the skin’s surface. This manifests in warm, red, swollen, itchy and inflamed skin.

Symptoms of skin inflammation

Signs of skin inflammation include:

• Redness
• Swelling
• Increased skin temperature
• Pain/irritation

Red inflammation on skin

In skin inflammation, redness is caused by increased local blood supply (reflecting the colour of blood). This is due to blood vessel dilation (vasodilation) and increased leakiness, which helps immune cells get to the area of concern to fight off potential disease-causing pathogens.

Skin rashes with inflammation

Skin rashes can appear different for different body areas, skin types and colours. When examining a rash, the doctor will ask you questions as well as visually inspect and palpate the rash, paying attention to the following: [1] 

• How do the lesions look – are they large/small, symmetrical/asymmetrical, regular/irregular? What type of lesion are they?
• Lesion distribution – what body areas does the rash appear on?
• Number of lesions & distribution- are the lesions scattered, clustered, or in appear in a linear formation?
• Colour – what colour is the rash? Does it blanch when pressure is applied?
• Consistency- is the rash raised or flat, crusty or smooth? Are there any texture or temperature changes across the skin?

Inflammation under the skin

Swelling is a key indicator of skin inflammation and occurs due to increase in fluid volume (blood) infiltrating the affected areas to allow the delivery of immune cells. For example, after you’ve been bitten by an insect, the body responds to the foreign saliva by increasing the blood flow to the area, causing the skin to appear swollen.

Itchy skin inflammation

Itchy skin (or pruritis) is a bothersome symptom associated with skin inflammation. With greater blood flow to an area of skin, comes the delivery of pruritogens (itchy chemicals), which give us the urge to scratch. Scratching has a biological role in acute inflammation as it is a way of the body telling us to remove the triggering stimulus from our skin’s surface. Over time, however, chronic scratching can compromise the skin barrier and cause further inflammation.

What causes skin inflammation?

Immune System Dysfunction

In this article, we will briefly cover immune-mediated conditions (psoriasis and eczema) to illustrate the role of the immune system in chronic skin inflammation. 

Psoriasis & Eczema

Psoriasis is a chronic immune-mediated disease which leads to the formation of itchy, red, scaly plaques on the skin’s surface. One of the causes of psoriasis is chronic immune system activity, resulting in the rapid growth of skin cells, which fail to shed from the surface. Read our article entitled ‘Psoriasis’ for a more comprehensive overview of the condition.

Eczema manifests as patches of dry, flaky skin, linked to the presence of an otherwise harmless trigger (atopic dermatitis) or the presence of an allergen or irritant (contact dermatitis) causing an immune response [2]. In the case of possible allergies, your doctor may test different substances on your skin (through ‘patch testing’) to find out what your skin might be reacting to. 

Allergic Reaction

Allergic reactions can manifest as skin inflammation and range from mild to severe. Allergens can include perfumes, bug bites, and food products… the list goes on. Severe allergies can result in anaphylaxis, which can be life-threatening and require the administration of adrenaline via an EpiPen.

Infections

Skin inflammation can also indicate infection. Left untreated, skin infections can lead to a systemic (whole body) reaction called sepsis, which can be life threatening. Skin inflammation in addition to the following symptoms may indicate infection:

• Oozing/puss
• Odour
• Worsening skin pain
• A rash that spreads or changes quickly
• Formation of blisters
• Wound that has not healed after 10 days
• Fever

Infections are generally treated with a course of antibiotics. Even if symptoms go away, it is important to continue taking the antibiotics to prevent resistant bugs from continuing to reproduce.  Cellulitis is a common skin infection which can be life-threatening if left untreated. 

Heat Rash

Heat rash is caused by a blockage in the sweat ducts causing swelling, skin inflammation, and a short-lasting, itchy skin rash [3]. Heat rashes generally go away, however can be managed through active cooling and removing non-breathable clothing [3]. 

Photosensitivity

Photosensitivity is skin inflammation in response to sun and/or light exposure [4]. Photosensitivity manifests on sun-exposed areas including the face ears, back of the forearms neck and chest [4]. It can be caused by UVA and/or UVB rays, and there are various clinical subtypes [4]. Treatment largely involves sun avoidance and protective measures [4].

Bug Bites

Skin inflammation in response to insect bites occur due to exposure to their saliva, resulting in local skin inflammation [5]. In mild cases, treatment involves washing the area with soap and water, cooling the area with an ice pack, and using a topical anti-itch cream [5]. In the case of an allergic reaction, an injection of adrenaline (via an EpiPen) may be necessary.

Skin Inflammation Treatments: How to reduce skin inflammation

Natural remedies for skin inflammation

There are plenty of simple, natural ways to reduce skin inflammation from home, such as:

• Cool the area with a cold compress
• Avoid the heat (including hot showers or baths) and sunlight (especially if photosensitive)
• Apply sliced cucumber to reduce swelling and calm skin irritation
• Soak in a magnesium bath, a natural anti-inflammatory to calm flare-ups
• Wear light, soft, breathable, non-irritating clothing
• Use natural topical ointments and emollients to reduce skin redness, dryness, irritation, and itchiness 
• Find ways to reduce your stress levels, as stress hormones such as cortisol can increase inflammatory markers

Topical Remedies

Topical preparations are applied to the skin in the form of ointments, gels, creams, and sprays. Some over-the counter options to treat skin inflammation include:

• Antifungals/antibiotics - to reduce bacterial/fungal colonisation of the skin.
• Immunosuppressants – to suppress the immune response contributing to chronic skin inflammation.
• Corticosteroids - to reduce local skin inflammation.
• Antiseptics – to kill microorganisms present on the skin, especially when a wound/broken skin is visible.
• Anti-pruritic creams- to treat the itch.

Anti-itch creams, moisturisers and emollients are essential to breaking the cycle of itchy, red, inflamed skin. Looking for a natural option? Abundant Natural Health’s Ocean Soothe Gel and Lotion are proven to relieve skin dryness, enhance skin hydration, soothe skin, relieve inflammation and are antipruritic (anti-itch). Due to the high salt content, they have antimicrobial and antiseptic properties, which can help with minor abrasions and cuts and help to promote skin regeneration.

Oral Remedies

Topical products are not always effective on their own in reducing skin inflammation. Sometimes medication is required to treat the underlying cause of skin inflammation.

• Antihistamines - reduce the activity of ‘histamines’ which are chemicals that respond to allergens.
• Oral antibiotics - to treat an underlying infection.
• Oral corticosteroids - only used short term to reduce inflammation.
• Disease-specific treatments - these can help to mediate the immune system in conditions such as psoriasis and eczema. Depending on your diagnosis, it is best to discuss your options with a doctor or dermatologist. 

Seeking medical help

It cannot be understated the importance of seeking medical help when you are concerned about skin inflammation. If you believe you might have a skin condition, getting a medical diagnosis can get you on the right track with a treatment plan that works for you. There are plenty of natural, topical, and oral medications out there to help get skin inflammation under control.

References

1. Armstrong, A., & Levy, M. L. (2018). Approach to the clinical dermatologic diagnosis. UpToDate. Retrieved fromhttps://www.uptodate.com/contents/approach-to-the-clinical-dermatologic-diagnosis?search=approach%20to%20the%20ckinical%20dermatologic%20%20diagnosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
2. Fazio, S. B., Yosipovitch, G., Dellavalle, R. P., Callen, J., & Ofori, A. O. (2015). Pruritus: Etiology and patient evaluation. UpToDate. Retrieved from https://www.uptodate.com/contents/pruritus-etiology-and-patient-evaluation. 
3. Miller, J.L. (2021). Miliaria. UpToDate. Retrieved from https://www.uptodate.com/contents/miliaria. 
4. Elmets, C., & Callen, J. (2017). Overview of cutaneous photosensitivity: Photobiology, patient evaluation, and photoprotection. Up to Date. Retrieved from https://www.uptodate.com/contents/overview-of-cutaneous-photosensitivity-photobiology-patient-evaluation-and-photoprotection?search=Overview%20of%20cutaneous%20photosensitivity:%20Photobiology,%20patient%20evaluation,%20and%20photoprotection&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
5. Goddard, J., Stewart, P. H., Danzl, D. F., Rosen, T., & Baron, E. L. (2020). Insect and other arthropod bites. Retrieved from https://www.uptodate.com/contents/insect-and-other-arthropod-bites.