What Causes Dermatitis Herpetiformis?

If you’re like many people today, you might have cut gluten from your diet. Most people seem to do so because they’re worried about the health effects of gluten. The truth is that gluten is harmless for the vast majority of people. But for people with celiac disease or wheat-sensitivity, it can cause a huge range of problems. Like, for example, dermatitis herpetiformis.

Dermatitis herpetiformis is a painful, blistering rash that occurs on the skin as a result of gluten consumption in people with wheat-sensitivity. So, what exactly is wheat-sensitivity? How does it lead to dermatitis? And what can you do about it?

What Is Wheat-Sensitivity?

Wheat-sensitivity is, on a basic level, the inability to process a substance found in wheat products called “gluten.” Gluten is the glue that holds together the dough and it’s in everything from bread to cookies.

A small percentage of people are intolerant to gluten, which means their body can’t absorb it. This is a condition called celiac disease. When these people eat gluten, their body’s immune system begins attacking the lining of the intestines. This gradually breaks down the villi that absorb nutrients from the diet. So, over time the body loses the ability to process what you eat.

That inability to get nutrients can lead to things like anemia and even a host of medical issues like autoimmune disorders.

And of course, one of the most obvious symptoms of celiac disease is dermatitis herpetiformis, or DH.

What Causes Dermatitis Herpetiformis?

DH is a condition caused by celiac disease that leads to herpes-like lesions on the skin.When someone with celiac disease eats gluten, their body begins to release immune cells that attack gluten throughout the body including a gluten-based enzyme in the skin.

This results in the painful rash that we associate with DH. The best way to diagnose DH is with a skin biopsy. Essentially, the doctor applies a local anesthetic to the skin and cuts out a small cylinder of skin from an area next to the rash. They then inject a fluorescent dye into the skin which reveals the presence of immunoglobins.

It’s important to first get a celiac disease diagnosis first, as the symptoms of DH can often be confused with eczema if the doctor doesn’t know what to look for.

And while the lesions can be painful and unsightly, there is a way to treat them.

How Can You Treat It?

The best way to handle a DH rash is to avoid gluten. Unfortunately, people who suffer from DH and celiac disease have to maintain a strict, gluten-free diet for the rest of their lives. This can be difficult, especially given how many different foods contain gluten.

But there are a few things that you generally want to avoid. Anything made from wheat dough is likely to contain gluten. Most bread falls into this category. So do most kinds of pasta, crackers, cakes, pastries, and even beer.

Luckily, you can find many gluten-free alternatives these days. And you can check the label to make sure that the product you’re eating is gluten-free.

And if you’re preparing your own food, look out for cross-contact. Even letting the food you eat come into contact with gluten can lead to contamination and thus problems with the skin. And gluten particles can even remain aloft in the air of a bakery or kitchen for hours, contaminating other foods. Always be careful when it comes to this possibility.

For some more immediate relief, there are medications you can use. Dapsone and sulfapyridine are the most commonly prescribed. Doctors don’t yet know exactly why these medications work to treat DH, but they do seem to limit the development of lesions in the skin. In addition, some doctors prescribe UV light treatments, which do seem effective for some people.

And because celiac disease is caused by an autoimmune response, immunosuppressant drugs might be helpful for some people. Immunosuppressant drugs work by limiting the activity of the immune system. This means that your cells can’t produce as many antibodies. So fewer antibodies mean fewer antibodies attacking your cells when you eat gluten.

But again, these drugs aren’t the first line treatment for celiac disease. By maintaining the right diet, you can eliminate the symptoms of celiac disease. But that does require a life time commitment and constant vigilance towards what you eat, which can become tiring.

So, do you have celiac disease? Do you have dermatitis as well? What do you do to treat it? What works and what doesn’t? Let us know in the comments.