Dermatitis Herpetiformis Overview and Management
Discover dermatitis herpetiformis, its causes, symptoms, and management strategies. Learn how this chronic skin condition is linked to gluten sensitivity and treatment options available.
Written by Dr. Mohammed Kamran
Reviewed by Dr. D Bhanu Prakash MBBS, AFIH, Advanced certificate in critical care medicine, Fellowship in critical care medicine
Last updated on 1st Sep, 2025
Dermatitis Herpetiformis (DH) is a chronic, itchy skin condition that causes clusters of small blisters and red bumps, often appearing on the elbows, knees, buttocks, and scalp. Despite its name, it is not related to herpes but is instead linked to celiac disease, an autoimmune disorder triggered by gluten consumption.
DH is more common in adults, especially between the ages of 30 and 40, but it can affect people of any age. While it may look like eczema or other skin rashes, DH is unique because it is directly connected to gluten sensitivity.
Symptoms of Dermatitis Herpetiformis
The most common signs of DH include:
• Intense itching and burning before the rash appears.
• Red, raised bumps that turn into small blisters.
• Symmetrical rash (appears on both sides of the body, like both elbows or knees).
• Scratching leads to crusting and scarring.
The rash tends to come and go, but without proper treatment, it can persist and cause discomfort.
Consult a Top Specialist
What Causes Dermatitis Herpetiformis?
DH is an autoimmune reaction triggered by gluten, a protein found in wheat, barley, and rye. When someone with DH consumes gluten, their immune system attacks the skin, leading to inflammation and blistering.
Key facts about DH and celiac disease:
• Almost all DH patients have celiac disease, even if they don’t show digestive symptoms.
• The rash appears due to IgA antibodies depositing under the skin.
• Genetic factors play a role those with a family history of celiac disease or DH are at higher risk.
How Dermatitis Herpetiformis Affects Health
While DH primarily affects the skin, it can have broader health implications:
1. Nutrient Deficiencies – Celiac disease can damage the intestines, leading to poor absorption of nutrients like iron, calcium, and vitamin D.
2. Increased Risk of Other Autoimmune Diseases – People with DH may also develop thyroid disorders, type 1 diabetes, or other immune-related conditions.
3. Long-Term Skin Damage – Constant scratching can lead to scarring and skin infections.
Diagnosing Dermatitis Herpetiformis
If you suspect DH, a dermatologist or gastroenterologist may recommend:
1. Skin Biopsy – A small skin sample is taken near the rash to check for IgA deposits.
2. Blood Tests – To detect antibodies related to celiac disease (anti-tTG, anti-EMA).
3. Intestinal Biopsy (if needed) – Some patients may need an endoscopy to confirm celiac disease.
Managing Dermatitis Herpetiformis
The most effective way to control DH is through a strict gluten-free diet and, in some cases, medication.
1. Gluten-Free Diet
• Avoid wheat, barley, rye, and contaminated oats.
• Read food labels carefully—gluten can hide in sauces, soups, and processed foods.
• Opt for naturally gluten-free foods like rice, quinoa, fruits, vegetables, and lean meats.
2. Medications
• Dapsone – An antibiotic that reduces itching and rash quickly but requires regular blood monitoring.
• Topical Steroids – May help with inflammation in mild cases.
• Other Immune-Suppressing Drugs – Used if Dapsone is not suitable.
3. Skin Care Tips
• Avoid scratching to prevent infections.
• Use fragrance-free moisturizers to soothe dry skin.
• Wear loose, breathable clothing to reduce irritation.
4. Monitoring and Follow-Up
• Regular check-ups with a doctor to monitor nutrient levels and overall health.
• Annual screenings for thyroid function and bone health (due to possible deficiencies).
When to See a Doctor
Consult a dermatologist or gastroenterologist if:
• You have a persistent, itchy rash that doesn’t improve with usual treatments.
• You experience digestive issues like bloating, diarrhea, or weight loss.
• There’s a family history of celiac disease or DH.
Need Help?
If you’re experiencing symptoms of DH, consider booking a consultation with a specialist through Apollo 24|7. Early diagnosis and treatment can make a big difference in managing this condition.
Final Thoughts
Dermatitis Herpetiformis can be uncomfortable, but with the right approach, gluten-free diet, proper medication, and skin care it can be managed effectively. If you suspect DH, don’t ignore the symptoms; early diagnosis can prevent complications and improve your quality of life.
Consult a Top Specialist
Consult a Top Specialist
Dr. Mohamed Azeem
General Physician/ Internal Medicine Specialist
2 Years • MBBS,MD(Internal Medicine) CCEBDM
Karaikudi
Apollo Hospitals Karaikudi, Karaikudi
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Chethan T L
General Physician/ Internal Medicine Specialist
5 Years • MBBS, MD, DNB (General Medicine)
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
26 Years • MBBS
Kolkata
B Ghose Foundation Doctor's Chamber, Kolkata
(50+ Patients)
Dr D M Karthik
General Practitioner
4 Years • MBBS, Fellowship in Diabetes Mellitus, Advance certificate in Diabetes Mellitus, Derma Nutrition Certification
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
Consult a Top Specialist
Dr. Mohamed Azeem
General Physician/ Internal Medicine Specialist
2 Years • MBBS,MD(Internal Medicine) CCEBDM
Karaikudi
Apollo Hospitals Karaikudi, Karaikudi
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Chethan T L
General Physician/ Internal Medicine Specialist
5 Years • MBBS, MD, DNB (General Medicine)
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
26 Years • MBBS
Kolkata
B Ghose Foundation Doctor's Chamber, Kolkata
(50+ Patients)
Dr D M Karthik
General Practitioner
4 Years • MBBS, Fellowship in Diabetes Mellitus, Advance certificate in Diabetes Mellitus, Derma Nutrition Certification
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
