Contact Dermatitis

What is contact dermatitis?

Contact dermatitis is a skin inflammation that develop when you come into direct contact with something that causes an allergic or irritating reaction. Being the biggest organ in the body, the skin serve as a barrier protecting against all external elements. However, some substances can infiltrate the skin and provoke an immune response, resulting in contact dermatitis. 

Chemicals, fragrances, plants, metals, cosmetics, and certain drugs are the most prevalent contact dermatitis triggers. These substances may lead to itching, reddening, and swelling of the skin and can even cause blister formation. The intensity of the reaction tends to differ from one person to another, with some experiencing minor symptoms and others facing more harsh reactions.

Types of Contact Dermatitis

The two types of contact dermatitis include:

• Allergic contact dermatitis: This condition occurs when the body reacts to an unfavorable allergen or substance. Some of the most common allergens are cosmetics, jewelry metals such as nickel, preservatives, and fragrances. After exposure, it may take a few days for the itchy rash to appear.
• Irritant contact dermatitis: This painful skin rash usually develops suddenly due to irritants like soap, detergent, acid, and cleaners. Unlike allergic contact dermatitis, this condition occurs more frequently.

Symptoms of Contact Dermatitis

Contact dermatitis often appears on the skin after direct exposure to the substance triggering the reaction. For instance, the rash can develop along the leg that comes into contact with poison ivy. The rash can also take some minutes or hours to show up after exposure and could linger for 2 to 3 weeks.

Contact dermatitis can cause varying signs and symptoms, such as:

• Itchy rash
• Leathery spots that look darker than normal (hyperpigmented) and commonly seen on black or brown skin.
• Dry, scaly, or cracked skin, mostly on white skin.
• Bumps and blisters that sometimes ooze and crusts.
• Swelling, tenderness, or burning.

Causes of Contact Dermatitis

Exposure to substances irritating the skin or triggering allergic reactions is the primary cause of contact dermatitis. These substances might be among the thousands of identified allergens and irritants. In most cases, individuals exposed experience allergic and irritating reactions at the same time.

Irritant contact dermatitis is the most prevalent type. It is a non-allergic skin response that occurs when the outermost layer of the skin is damaged by an irritant.

A single encounter with strong allergens or irritants can cause a reaction in some individuals. For others, a rash may develop following recurrent exposures, even to some mild irritants like water and soap. Certain people can also become tolerant to substances with time.

Some of the common forms of irritants are:

• Solvents
• Bleach and detergents
• Rubber gloves
• Soap
• Hair products
• Airborne substances
• Pesticides and fertilizers
• Plants

Allergic contact dermatitis, on the other hand, develops when an allergen substance prompts an immune reaction in the skin. Only the part that is exposed to the allergen is usually affected. However, if something gets into the body through medications, foods, flavorings, and certain dental or medical procedures, it could also trigger the reaction (systemic contact dermatitis).

Typically, people develop allergen sensitivity following several repeated exposures over the years. After becoming allergic, even the slightest traces of allergens could trigger a reaction. The common allergens consist of:

• Nickel, commonly found in jewelry, buckles, and several other items
• Medications, including antibiotic creams
• Balsam of Peru, often used in different products like toothpaste, mouthwash flavorings, and perfumes
• Formaldehyde, found in cosmetics and preservatives, among other products
• Plants like poison ivy and mango containing an extremely allergenic substance known as urushiol
• Personal care products, including body washes, cosmetics, and hair dyes
• Airborne allergens like spray insecticides and ragweed pollen
• Products causing reactions when exposed to the sun (photoallergic contact dermatitis), including certain cosmetics and sunscreens

In children, allergic contact dermatitis can develop from typical offenders. Other possible causes are exposure to baby wipes, diapers, jewelry used in ear piercing, and clothes with snaps or dyes, among others.

Diagnosis of Contact Dermatitis

Medical providers can easily diagnose contact dermatitis by enquiring about the signs and symptoms you are experiencing. Moreover, they may ask questions to assist in identifying the cause of your reaction and find clues concerning the trigger substance or irritant. You will also possibly undergo a skin examination to evaluate the rash.

The doctor may recommend a patch test to help identify the main cause of the rash. During this procedure, small quantities of the possible allergens are applied on sticky patches and then placed on your skin, where they will remain for 2 to 3 days. Within this period, you will be required to maintain your back dry. Next, your provider will look for skin reactions beneath the patches and determine if additional testing is necessary.

Mostly, this diagnostic test can be helpful if the cause of the rash is unclear or if it frequently recurs. However, identifying the redness signifying a reaction on black or brown skin may be difficult. This could result in a missed or incorrect diagnosis.

Treatment of Contact Dermatitis

In instances where home care practices don’t relieve the signs and symptoms, the doctor can prescribe medications such as:

• Steroid creams or ointments: Your provider can recommend applying these products to your skin to soothe and relieve the rash. You could use prescription topical steroids, including clobetasol 0.05% or triamcinolone 0.1%. Discuss with your doctor the number of times you should apply per day and for how long.
• Pills: For serious conditions, your provider can recommend oral medications, pills taken by mouth, to reduce itchiness, ease swelling, and prevent bacterial infection.

Home Remedies & Lifestyle for Contact Dermatitis

Try these self-care methods to help soothe your inflamed skin and relieve itching:

• Avoid allergens or irritants: Identifying and avoiding the trigger of your rash is crucial in this situation. Your doctor can provide you with a list of all products typically containing reactive substances. You should also inquire about products that do not contain substances that affect your skin.
• Use an anti-itch cream or ointment: Apply 1% hydrocortisone ointment or cream such as Cortizone 10 on the itchy spot. It is an over-the-counter product you can purchase at any drugstore and use at least once or twice daily for several days. Alternatively, you can try the calamine lotion. But whichever product you choose, first cool it in the refrigerator before using it.
• Take an anti-itch medicine: Taking an oral antihistamine like diphenhydramine (Advil PM or Benadryl) can help improve your sleep. Loratadine (Alavert, Claritin) is an example of an over-the-counter antihistamine that won’t cause drowsiness.
• Apply cool, wet compresses: Put a cool, wet piece of cloth over your rash for about 15 to 30 minutes a few times per day to soothe the skin.
• Protect your skin: Refrain from scratching the skin and ensure that you trim your nails. Cover the itchy area with a dressing if you cannot stop scratching. Also, avoid touching or popping the blisters. As the skin heals, you should keep away from the sun or consider sun protective methods.
• Soak in a soothing, cool bath: Try soaking the affected part of the skin in cool water for about 20 minutes. You can add oatmeal-based bathing products such as Aveeno to the water for more soothing effects.
• Protect your hands: After washing, always rinse and dry out your hands thoroughly and gently. Throughout the day, apply moisturizers on top of any medicated ointment you are using. Also, select gloves depending on what you are shielding your hands from. For instance, cotton-lined plastic gloves are a suitable option if your hands are frequently wet.

Prevention of Contact Dermatitis

Contact dermatitis prevention includes taking measures to prevent triggers and protecting the skin from possible allergens or irritants. These measures involve using protective gloves when working with chemicals or irritants, using mild detergents and soap, and limiting exposure to water for longer periods.

Furthermore, it is essential to identify and stay away from particular substances that could cause an allergic reaction. You can do this through patch testing or keeping records of the possible triggers to ensure you always avoid them, even in the future.

To prevent aggravation of contact dermatitis and lower complication risks, early treatment is important. Also, visiting your doctor as soon as the symptoms appear ensures appropriate diagnosis and treatment.

Generally, prevention of contact dermatitis includes refraining from the triggers, protecting the skin, and early medical care. People can successfully manage contact dermatitis and enhance their well-being by understanding the condition and adopting the necessary precautions.

Medications for Contact Dermatitis

Sometimes, prescription drugs may be required to manage contact dermatitis symptoms. The medical provider usually prescribes these medications and, therefore, should only be taken as directed.

Topical corticosteroids are typically prescribed to ease itchiness and reduce inflammation from contact dermatitis. They work by inhibiting the immune reaction and decreasing inflammatory substances released in the skin.

On the other hand, prolonged topical corticosteroid use can result in side effects, including skin thinning, stretch marks, and higher infection vulnerability. It’s thus essential to stick to the recommended dosage and period of treatment to avoid such risks.

Calcineurin inhibitors are other prescription drugs the doctor can recommend to manage contact dermatitis by reducing inflammation. For severe allergic contact dermatitis cases, they can prescribe immunosuppressive medications.