Dermatitis neglecta is a skin disorder that occurs when a person does not sufficiently clean the skin. It can resemble other skin conditions, but typically responds better to basic hygiene such as showering than other skin problems do.

There are a few different risk factors for dermatitis neglecta, as well as some simple treatment and prevention options.

This article explains what dermatitis neglecta is, including its symptoms, treatment options, and tips for prevention.

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Dermatitis neglecta is an inflammatory skin condition that can occur when someone does not or cannot maintain personal hygiene.

Regular bathing is vital for keeping the skin clean and the body healthy. Bathing and scrubbing the skin helps eliminate germs, oils, and dead skin cells.

Not bathing for a length of time can cause these elements to buildup on the skin and may lead to a compact, hyperpigmented crust.

Dermatitis neglecta is rarer than other skin conditions that produce similar symptoms. However, a proper evaluation of a person’s symptoms and risk factors can help diagnose and treat cases of dermatitis neglecta.

A person’s skin is constantly renewing as the body sheds dead skin cells and forms new ones. This process takes around 28–50 days.

Washing and exfoliating the skin helps to remove these dead skin cells. If a person does not wash one or more areas of the body, dead skin cells may build up in patches of skin that are hyperpigmented, scaly, and rough.

Symptoms may get worse the longer a person does not wash and more buildup occurs. Secondary infections and other skin conditions can arise if a person does not treat these patches.

Skin affected by dermatitis neglecta can involve a collection of different components, including:

  • sweat and moisture
  • oil the skin secretes called sebum
  • dirt
  • pollution, such as smoke or fumes
  • bacteria and other germs
  • dead skin cells

Although insufficient frictional washing causes dermatitis neglecta, a 2022 case series highlights that it frequently occurs alongside psychiatric conditions.

Symptoms may take a few months to develop and may affect parts of the body that are difficult to reach or painful to wash.

A rash may appear on the skin alongside the typical lesions, and the area may become very sensitive, which may lead to a further avoidance of washing and exfoliating.

Dermatitis neglecta is not like other skin conditions, though it can appear similar to other forms of dermatitis. The key difference is that gentle washing with soap and water is usually enough to resolve symptoms.

People who fall into the following categories may be more likely to experience dermatitis neglecta than others.

Mental health conditions

Research frequently associates this skin condition with psychiatric conditions, although research into a psychological aspect for dermatitis neglecta is limited. Conditions that could contribute to dermatitis neglecta occurring include:

Trauma and surgery

Symptoms may be indirectly influenced by a recent trauma or surgery. For instance, a person with injured arms may have difficulty reaching certain parts of their back. This may put the unreachable areas at risk for dermatitis neglecta.

Age

Age and age-related conditions can also influence symptoms. Many people lose mobility in the body as they age. This can lead to increased difficulty washing and performing other types of self-care.

The number of traumas, treatments, and surgeries a person has can also increase as they age, which may be another reason why dermatitis neglecta symptoms appear.

Physical disabilities

Long-lasting disabilities may increase the risk of dermatitis neglecta symptoms, regardless of someone’s age.

Anyone with a physical condition that makes it difficult to reach some areas of the body, or to wash regularly, is more at risk for symptoms of dermatitis neglecta.

Sensitive skin

Dermatitis neglecta may be more likely when a person has sensitive skin. People with sensitive skin may experience itching, irritation, and other symptoms when something comes into contact with the skin.

In some cases, people may avoid thoroughly washing or exfoliating body parts with very sensitive skin to prevent any discomfort.

Other skin conditions

In some cases, other skin conditions may increase the risk of dermatitis neglecta.

For example, a person with eczema may not wash as frequently or thoroughly as necessary out of fear of aggravating their condition, which can lead to buildups on the skin.

Diagnosing dermatitis neglecta can be challenging, as symptoms can be similar to those of other skin conditions. A doctor may refer an affected person to a dermatologist who specializes in skin conditions for a diagnosis.

A healthcare professional may ask questions about a person’s medical history and personal hygiene routines. These questions will help rule out other skin conditions and allow the doctor or dermatologist to be certain of their diagnosis.

If they suspect dermatitis neglecta, they may gently clean the skin. If this helps to remove the lesions, it can further their diagnosis.

If they remain unsure, they may take a sample of the skin to have a laboratory analysis done. However, this is usually not necessary.

Simple cases of dermatitis neglecta with no complications usually resolve after washing of the affected areas with gentle soap, warm water, and a washcloth.

A person who starts washing the area may notice immediate results, as they scrape dead skin cells and other waste particles off the body.

In some cases, doctors may recommend daily scrubbing until the lesions resolve, which could take days, weeks, or months.

Severe cases of dermatitis neglecta may require a person to use other topical agents alongside daily washing, such as skin-softening moisturizers and agents that soften or break down keratin.

Preventing dermatitis neglecta is often as simple as thoroughly cleaning the skin at least twice a week. Exfoliating healthy skin with a dry brush or loofah can help remove dead skin cells.

Taking a regular bath or shower helps prevent the buildup of dirt, sebum, and bacteria on the skin. Washing more frequently may also be necessary during warmer months or after doing physically demanding work or exercise.

Dermatitis neglecta may occur after surgery if someone’s self-care is difficult. It may be helpful for them to consider hiring a caregiver or asking a loved one for help during this time.

A caregiver may also be helpful for older adults or people with disabilities that cause difficulty washing sufficiently.

If a person has sensitive skin, choosing fragrance-free, hypoallergenic soaps may be gentler on the skin when washing.

Seeking treatment for physical and mental health conditions can also help to reduce the risk of dermatitis neglecta.

Healthcare professionals may confuse dermatitis neglecta with other skin disorders, which can lead to misdiagnosis or underdiagnosis.

Dermatitis neglecta will usually resolve with regular full-body washing. Depending on the severity of the case, it may take a few weeks or a few months to resolve.

Painful patches of skin that crack, bleed, or ooze may be a sign of an additional infection. People should report these symptoms to a doctor or dermatologist for further treatment.

With a proper diagnosis and diligent treatment, the outlook for most cases of dermatitis neglecta is good.

Dermatitis neglecta is a skin condition that can occur when a person does not or cannot thoroughly wash and exfoliate the skin.

Dead skin cells, oils, bacteria, and other factors can buildup, leading to scaly plaques that may be hard to remove. These plaques may be hyperpigmented and firm.

A doctor can usually diagnose and treat dermatitis neglecta by washing the affected skin. In some cases, it may take weeks or months for symptoms to fully resolve.