What is contact dermatitis?
Contact dermatitis is an inflammation of the skin caused by direct contact with an irritant or allergen. This common skin condition is marked by itching, inflammation, redness and blistering, sometimes resembling a burn. Contact dermatitis itself is not dangerous, and it is not contagious.
Irritant dermatitis is the most common type of contact dermatitis and occurs when skin comes in direct contact with an irritating substance, such as soaps, detergents, and other chemicals. This skin reaction looks more like a burn. Allergic contact dermatitis is caused by coming in direct contact with substances to which you are allergic, such as poison ivy, some medications, fragrances, dyes, and preservatives.
The appearance, severity and triggers of contact dermatitis vary between individuals. With accurate diagnosis of the underlying allergy or sensitivity, contact dermatitis is treatable and curable by avoiding exposure to the substance that triggers the rash and using topical medications and other therapies.
Contact dermatitis is generally not a serious condition, but there is a potential for complications, such as a secondary bacterial or fungal infection of the rash. Seek prompt medical care if you have symptoms of contact dermatitis. Early diagnosis and treatment can help reduce the risk for complications of contact dermatitis.
What are the symptoms of contact dermatitis?
Symptoms of contact dermatitis differ in severity, frequency and duration among individuals. Symptoms may develop quickly after contact with the allergen or substance that triggers contact dermatitis, or it may take days to weeks for symptoms to appear.
Hallmark symptoms of contact dermatitis include:
Scratching the affected area generally does not relieve the itching. It can spread the allergen and the contact dermatitis rash to other areas of the body, such as contact dermatitis related to poison ivy or poison oak. Scratching can also lead to increased inflammation, more intense itching, and harder scratching.
Symptoms that might indicate a serious condition
In some cases, scratching can lead to potentially serious complications, such as a secondary bacterial or fungal infection and cellulitis. Seek prompt medical care if you have any of these symptoms:
High fever (higher than 101 degrees Fahrenheit)
Increase or change in the type of drainage from the blisters
Open sores or lesions
Redness, swelling and warmth of the skin surrounding the rash
What causes contact dermatitis?
Contact dermatitis, also called allergic contact dermatitis and irritant contact dermatitis, is often associated with allergies and is caused by direct contact of the skin with a substance to which an individual is allergic or sensitive. These substances are called allergens and irritants. Allergens and irritants that cause contact dermatitis vary between individuals. Common irritants and allergens include:
Chemicals, such as acids, solvents and dyes
Fragrances and perfumes
Latex and rubber
Nickel, a metal often used in the manufacture of jewelry, accessories and clothing
Poison ivy, poison oak, or poison sumac
Soaps and detergents
What are the risk factors for contact dermatitis?
A number of factors increase the risk of developing contact dermatitis. Risk factors include:
Existing skin conditions, such as eczema and psoriasis
Exposing the hands to wet conditions for long periods of time
Getting a lot of sun exposure while taking certain medications that cause skin sensitivity to the sun, such as tetracycline and doxycycline
History of allergies
Repeated exposure to common irritants, such as nickel
Working with the hands in hot conditions for long periods of time
Reducing your risk for contact dermatitis
Not all people who are at risk for contact dermatitis will develop the condition. In many cases, it is possible to prevent contact dermatitis. You can lower your risk of developing contact dermatitis by :
Avoiding exposure to the specific allergen or irritant that triggers a skin reaction
Avoiding situations in which your skin will be exposed to wet or hot conditions for long periods of time
Seeking regular medical care and following your treatment plan for allergies and other skin conditions
Staying out of the sun when taking certain medications, such as tetracycline and doxycycline
How is contact dermatitis treated?
In many cases, contact dermatitis can be cured. With a well-integrated, individualized treatment plan, outbreaks of contact dermatitis can be avoided, and symptoms can be effectively controlled or eliminated. A good treatment plan is individualized to your medical history, the severity of your contact dermatitis, the specific cause, and other factors.
Goals of treatment include identification and avoidance of the offending allergen, alternatives to offending products, treatment of skin inflammation, restoration of a healthy skin barrier, and ongoing skin protection.
Lifestyle changes and general treatments for contact dermatitis
Lifestyle changes and considerations for treating contact dermatitis include:
Avoiding alcohol and caffeine
Avoiding hot tubs, steam baths, saunas, and chlorinated swimming pools
Avoiding scratchy clothes
Drinking plenty of fluids
Getting skin patch testing, in which small amounts of common allergens are applied methodically to the skin to determine what substances are triggering the allergic response that leads to the contact dermatitis
Minimizing skin dryness by using lotion specifically designed for sensitive skin
Preventing flare-ups by avoiding exposure to the specific allergen or allergens that induce the condition
Using a cool mist vaporizer or home humidifier
Using a perfume-free moisturizer
Using an oatmeal-based soap, such as Aveeno, to help relieve itching and inflammation
Using ice bags or cool wet compresses to help relieve itching and inflammation
Using mild soaps and not over washing or harshly scrubbing skin
Medications used to treat contact dermatitis
In moderate to severe cases of contact dermatitis, medications may be prescribed. Medications may include:
Antibiotics or antifungal drugs, which treat secondary bacterial or fungal infections
Antihistamines, which reduce itching
Corticosteroid cream, which reduces inflammation
These medications can all have side effects, so they should only be used under the direction of a licensed health care clinician.
What are the possible complications of contact dermatitis?
When left untreated, contact dermatitis can develop into an escalating cycle of itching, scratching and inflammation. In some cases, the excessive scratching can introduce bacteria or fungus into layers of the skin, resulting in infections that can be serious in some people. Complications include: