Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Dermatitis herpetiformis

3-minute read

Dermatitis herpetiformis causes an itchy, bumpy skin rash. It is rare, and generally associated with gluten intolerance and coeliac disease. A strict gluten-free diet usually reduces or eliminates the rash, and medication can help relieve symptoms as the diet takes effect. 

What causes dermatitis herpetiformis?

Dermatitis herpetiformis is an autoimmune disease. It’s caused by the immune system reacting to gluten. It is also known as Duhring disease or Duhring–Brocq disease. 

There is a close relationship between dermatitis herpetiformis and coeliac disease.

  • Most people with dermatitis herpetiformis have some gluten intolerance. 
  • Some people with coeliac disease have dermatitis herpetiformis. 
  • Some people with dermatitis herpetiformis have a close relative with dermatitis herpetiformis or coeliac disease. 
  • Dermatitis herpetiformis and coeliac disease can be associated with similar gene mutations.

Dermatitis herpetiformis symptoms

Dermatitis herpetiformis causes a bumpy skin rash with tiny blisters. The rash can be extremely itchy, and if you have the condition, you might feel itching or burning before it appears. The rash usually appears in a symmetrical pattern on the following areas of the body:

  • the outside of the elbows
  • the knees
  • the scalp
  • the face
  • the forearms
  • the lower back and buttocks
  • the shoulder blades

The rash appears when someone eats gluten. Their immune system produces antibodies to attack the gluten proteins. These antibodies then travel through the bloodstream and build up under the skin, causing the rash.

The rash can come and go over time and sometimes leaves pale or darker patches of skin. It is not contagious.

Dermatitis herpetiformis diagnosis

If they suspect you have dermatitis herpetiformis, your doctor is likely to refer you to a dermatologist (a skin specialist) for a diagnosis. The condition can look like herpes, eczema, scabies or contact dermatitis

You are likely to have blood tests, and might also have a biopsy

If the doctor diagnoses dermatitis herpetiformis, you may be referred to a gastroenterologist who can investigate whether you have coeliac disease. 

Dermatitis herpetiformis prevention and treatment

Most people manage the condition with a gluten-free diet and with medications to treat the rash. 

If you rely on diet alone, it can take 6 to 24 months after removing gluten from your diet for the rash to disappear. Therefore, people commonly take medication during this period to reduce the rash symptoms. 

Medications include:

You might need medication for a year or 2. Because of possible side-effects, your doctor will monitor your health while you’re taking these medications.

Although diet and medication can treat the symptoms, dermatitis herpetiformis will not go away. If you have the condition, you will need to eliminate gluten from your diet for life.

When to seek help

If you think you might have dermatitis herpetiformis, you should see your doctor to get a diagnosis and begin treatment if necessary.

Dermatitis herpetiformis might be a sign that you are at risk of coeliac disease (if you don’t already have it) or other health conditions. Since your small intestines might be damaged, you could unknowingly have a nutritional deficiency or other complications.

Being aware of your condition will help you get the appropriate treatment for any of these associated conditions if they arise.

More information

You can find out more from Coeliac Australia's website at

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2020

Back To Top

Need more information?

These trusted information partners have more on this topic.

Top results

ACD A-Z of Skin - Dermatitis Herpetiformis

A-Z OF SKIN Dermatitis Herpetiformis BACK TO A-Z SEARCH What is it? Dermatitis herpetiformis is an uncommon itchy skin condition which can occur at any age

Read more on Australasian College of Dermatologists website

Coeliac disease tests - Pathology Tests Explained

Why and when to get tested for Coeliac disease tests

Read more on Pathology Tests Explained website

How is Coeliac disease treated? - Coeliac Clinic

How is Coeliac disease treated? The gluten-free diet Currently, the only effective treatment for coeliac disease is the gluten-free diet

Read more on website

Symptoms of Celiac disease - Coeliac Clinic

Symptoms of Coeliac disease Symptoms of Coeliac disease Coeliac disease can present itself in a variety of ways, depending on the person

Read more on website

Diagnosing Coeliac disease - Coeliac Clinic

Diagnosing Coeliac disease The process of diagnosing coeliac disease typically involves a combination of serological testing (i

Read more on website

Causes of Coeliac disease - Coeliac Clinic

Causes of Celiac disease Causes of Coeliac disease Coeliac disease is caused by an abnormal immune reaction in the body which is similar to autoimmune diseases

Read more on website

Coeliac disease | Sydney Children's Hospitals Network

What is Coeliac disease? Coeliac Disease is a condition where the lining of the small bowel is damaged due to a protein in food called gluten

Read more on Sydney Children's Hospitals Network website

Coeliac Disease and Bone Health

Coeliac disease affects the ability of the bowel to absorb vitamins, minerals and other nutrients from food. This can greatly impact your bone health. A delayed coeliac diagnosis can lead to weakened bones and risk of osteoporosis.

Read more on Healthy Bones Australia website

Coeliac disease in children and teenagers | Raising Children Network

If your child has coeliac disease, his body reacts abnormally to a protein called gluten, which is in wheat, rye, barley and oats. Find out more.

Read more on website

Coeliac disease and breastfeeding | Australian Breastfeeding Association

There is very little information available for breastfeeding mothers who may be concerned about coeliac disease and their breastfed baby. ABA asked Penny Dellsperger (BSc (Nutrition), Accredited Practising Dietitian and coeliac disease expert) questions about this topic:

Read more on Australian Breastfeeding Association website

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Government of South Australia, health department logo Tasmanian government logo Victorian government logo Government of Western Australia, health department logo

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community. We pay our respects to the Traditional Owners and to Elders both past and present.