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Contact dermatitis

Updated: 9/27/2023
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13y ago

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Definition

Contact dermatitis is an inflammation of the skin caused by direct contact with an irritating substance.

See also: Poison ivy - oak - sumac

Alternative Names

Dermatitis - contact; Allergic dermatitis; Dermatitis - allergic

Causes, incidence, and risk factors

Contact dermatitis is an inflammation of the skin caused by direct contact with an irritating or allergy-causing substance (irritant or allergen). Reactions may vary in the same person over time. A history of any type of allergies increases the risk for this condition.

Irritant dermatitis, the most common type of contact dermatitis, involves inflammation resulting from contact with acids, alkaline materials such as soaps and detergents, solvents, or other chemicals. The reaction usually resembles a burn.

Allergic contact dermatitis, the second most common type of contact dermatitis, is caused by exposure to a substance or material to which you have become extra sensitive or allergic. The allergic reaction is often delayed, with the rash appearing 24 - 48 hours after exposure. The skin inflammation varies from mild irritation and redness to open sores, depending on the type of irritant, the body part affected, and your sensitivity.

Overtreatment dermatitis is a form of contact dermatitis that occurs when treatment for another skin disorder causes irritation.

Common allergens associated with contact dermatitis include:

  • Poison ivy, poison oak, poison sumac
  • Other plants
  • Nickel or other metals
  • Medications
    • Antibiotics, especially those applied to the surface of the skin (topical)
    • Topical anesthetics
    • Other medications
  • Rubber or latex
  • Cosmetics
  • Fabrics and clothing
  • Detergents
  • Solvents
  • Adhesives
  • Fragrances, perfumes
  • Other chemicals and substances

Contact dermatitis may involve a reaction to a substance that you are exposed to, or use repeatedly. Although there may be no initial reaction, regular use (for example, nail polish remover, preservatives in contact lens solutions, or repeated contact with metals in earring posts and the metal backs of watches) can eventually cause cause sensitivity and reaction to the product.

Some products cause a reaction only when they contact the skin and are exposed to sunlight (photosensitivity). These include shaving lotions, sunscreens, sulfa ointments, some perfumes, coal tar products, and oil from the skin of a lime. A few airborne allergens, such as ragweed or insecticide spray, can cause contact dermatitis.

SymptomsSigns and tests

The diagnosis is primarily based on the skin appearance and a history of exposure to an irritant or an allergen.

According to the American Academy of Allergy, Asthma, and Immunology, "patch testing is the gold standard for contact allergen identification." Allergy testing with skin patches may isolate the suspected allergen that is causing the reaction.

Patch testing is used for patients who have chronic, recurring contact dermatitis. It requires three office visits and must be done by a clinician with detailed experience in the procedures and interpretation of results. On the first visit, small patches of potential allergens are applied to the skin. These patches are removed 48 hours later to see if a reaction has occurred. A third visit approximately 2 days later is to evaluate for any delayed reaction. You should bring suspected materials with you, especially if you have already tested those materials on a small area of your skin and noticed a reaction.

Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion (see skin or mucosal biopsy culture).

Treatment

Initial treatment includes thorough washing with lots of water to remove any trace of the irritant that may remain on the skin. You should avoid further exposure to known irritants or allergens.

In some cases, the best treatment is to do nothing to the area.

Corticosteroid skin creams or ointments may reduce inflammation. Carefully follow the instructions when using these creams, because overuse, even of low-strength over-the-counter products, may cause a troublesome skin condition. In severe cases, systemic corticosteroids may be needed to reduce inflammation. These are usually tapered gradually over about 12 days to prevent recurrence of the rash. In addition to or instead of corticosteroid skin treatment, your doctor may prescribe tacrolimus ointment or pimecrolimus cream.

Wet dressings and soothing anti-itch (antipruritic) or drying lotions may be recommended to reduce other symptoms.

Expectations (prognosis)

Contact dermatitis usually clears up without complications within 2 or 3 weeks, but may return if the substance or material that caused it cannot be identified or avoided. A change of occupation or occupational habits may be necessary if the disorder is caused by occupational exposure.

Complications

Secondary bacterial skin infections may occur.

Calling your health care provider

Call your health care provider if symptoms indicate contact dermatitis and it is severe or there is no improvement after treatment.

Prevention

Avoid contact with known allergens. Use protective gloves or other barriers if contact with substances is likely or unavoidable. Wash skin surfaces thoroughly after contact with substances. Avoid overtreating skin disorders.

References

Gober MD, DeCapite TJ, Gaspari AA. Contact dermatitis. In: Adkinson NF Jr, ed. Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 63.

Habif TP. Contact dermatitis and patch testing. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 4.

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13y ago
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Wiki User

12y ago
Definition

Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. There are two kinds of contact dermatitis: irritant or allergic.

See also: Poison ivy - oak - sumac

Alternative Names

Dermatitis - contact; Allergic dermatitis; Dermatitis - allergic

Causes, incidence, and risk factors

Irritant dermatitis is the most common type. It's caused by contact with acids, alkaline materials such as soaps and detergents, fabric softeners, solvents, or other chemicals. The reaction usually looks like a burn.

Other irritants may include:

  • Cement
  • Hair dyes
  • Long-term exposure to wet diapers
  • Pesticides or weed killers
  • Rubber gloves
  • Shampoos

Allergic contact dermatitis is caused by exposure to a substance or material to which you have become extra sensitive or allergic.

Common allergens include:

  • Adhesives, including those used for false eyelashes or toupees
  • Antibiotics such as neomycin rubbed on the surface of the skin
  • Balsam of Peru (used in many personal products and cosmetics, as well as in many foods and drinks)
  • Fabrics and clothing
  • Fragrances in perfumes, cosmetics, soaps, and moisturizers
  • Nail polish, hair dyes, and permanent wave solutions
  • Nickel or other metals (found in jewelry, watch straps, metal zips, bra hooks, buttons, pocketknives, lipstick holders, and powder compacts)
  • Poison ivy, poison oak, poison sumac, and other plants
  • Rubber or latex gloves or shoes

Although you may not have a reaction to a substance when you are first exposed to it, regular use can eventually cause sensitivity and a reaction to the product.

Some products cause a reaction only when the skin is also exposed to sunlight (photosensitivity). These include shaving lotions, sunscreens, sulfa ointments, some perfumes, coal tar products, and oil from the skin of a lime. A few airborne allergens, such as ragweed or insecticide spray, can cause contact dermatitis.

Symptoms

Symptoms vary depending on the cause and whether the dermatitis is due to an allergic reaction or an irritant. The same person may also have different symptoms over time.

Allergic reactions may occur suddenly, or only after months of being exposed to a substance.

The hands are a common site for contact dermatitis. Hair products, cosmetics, and perfumes often lead to skin reactions on the face, head, and neck. Jewelry can also cause skin problems in the area under it.

Itching of the skin in exposed areas is a common symptom. In the case of an allergic dermatitis, itching can be severe. Dermatitis caused by an irritant may also cause burning or pain.

Allergic dermatitis often causes a red, streaky, or patchy rash where the substance touched the skin. The allergic reaction is often delayed, with the rash appearing 24 - 48 hours after exposure. The rash may:

  • Have red bumps that may form moist, weeping blisters
  • Feel warm and tender
  • Ooze, drain, or crust
  • Become scaly, raw, or thickened

Irritant dermatitis often shows as dry, red, and rough skin. Cuts (fissures) may form on the hands. Skin may become inflamed with long-term exposure.

Signs and tests

The diagnosis is mostly based on the skin appearance and a history of exposure to an irritant or an allergen.

Allergy testingwith skin patches (called patch testing) may determine which allergen is causing the reaction. Patch testing is used for certain patients who have long-term, repeated contact dermatitis. It requires three office visits and must be done by a health care provider with the experience and skill to interpret the results correctly.

  • On the first visit, small patches of possible allergens are applied to the skin. These patches are removed 48 hours later to see if a reaction has occurred.
  • A third visit about 2 days later is done to look for any delayed reaction.
  • If you have already tested a material on a small area of your skin and noticed a reaction, you should bring the material with you.

Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion (see skin or mucosal biopsy culture).

Treatment

Treatment includes washing with lots of water to remove any traces of the irritant that may remain on the skin. You should avoid further exposure to known irritants or allergens.

In some cases, the best treatment is to do nothing to the area.

Emollients or moisturizers help keep the skin moist, and also help skin repair itself. They protect the skin from becoming inflamed again. They are a key part of preventing and treating contact dermatitis.

Corticosteroid skin creams or ointments may reduce inflammation. Carefully follow the instructions when using these creams. Overuse, even of low-strength over-the-counter products, may cause a skin condition.

Along with, or instead of corticosteroids, your health care provider may prescribe drugs called tacrolimus ointment or pimecrolimus cream to use on the skin.

In severe cases, corticosteroid pills may be needed. You will start them on a high dose, which is tapered gradually over about 12 days. You may also receive a corticosteroid shot.

Wet dressings and soothing anti-itch (antipruritic) or drying lotions may be recommended to reduce other symptoms.

Expectations (prognosis)

Contact dermatitis usually clears up without complications in 2 or 3 weeks. However, it may return if the substance or material that caused it cannot be found or avoided.

You may need to change your job or job habits if the disorder is caused by occupational exposure.

Complications

Bacterial skin infections may occur.

Calling your health care provider

Call your health care provider if:

  • You have symptoms of contact dermatitis
  • It is severe
  • There is no improvement after treatment
References

Usatine RP, Riojas M. Diagnosis and management of contact dermatitis. Am Fam Physician. 2010; 82:249-255.

Gober MD, DeCapite TJ, Gaspari AA. Contact dermatitis. In: Adkinson NF Jr, ed. Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 63.

Habif TP. Contact dermatitis and patch testing. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 4.

Reviewed By

Review Date: 11/21/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Related questions

When can contact dermatitis occur?

Contact dermatitis can develop when the first contact occurs or after years of use or exposure.


What are common causes of contact dermatitis?

Common causes of contact dermatitis include the following: poison ivy, oak, and sumac.nickel or nickel alloys.latex


What has the author Etain Cronin written?

Etain Cronin has written: 'Contact dermatitis' -- subject(s): Contact dermatitis


Where does contact dermatitis occur?

Contact dermatitis can occur on any part of the body, but it usually affects the hands, feet, and groin.


How to effectively treat contact dermatitis?

Herbal remedies have been used for centuries to treat skin disorders including contact dermatitis. An experienced herbalist can recommend the remedies that will be most effective for an individual's condition.


Can you describe the condition contact dermatitis the symptoms and how you can prevent developing it whilst carrying out shampooing and conditioning services?

describe how to avoid contact dermatitis when shampooing and conditionering the hair ??


What to use for contact dermatitis?

Contact dermatitis is usually due to an allergic reaction to something in the environment. This allergen will come "in contact" with the skin, producing an allergic reaction, usually a rash that is itchy and red.


What are the different types of Allergies?

Atopic Dermatitis (eczema), contact dermatitis, and uticaria (hives) are the three types of skin Allergies.


Can you go swim in chlorinated pool if you have contact dermatitis?

no i would not


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Contact dermatitis usually does not spread from one person to another, nor does it spread beyond the area exposed to the irritant unless affected skin comes into contact with another part of the body.


How does one contract contact dermatitis?

You can contract contact dermatitis by exposing yourself to things that will cause an immune reaction to your body. Common causes include cheap metals such as nickel, and latex.


How does homeopathy treat contact dermatitis?

One homeopathic remedy commonly prescribed to relieve the itching associated with contact dermatitis is Rhus toxicodendron taken internally three to four times daily.