What is contact dermatitis?
Contact dermatitis is inflammation of the skin (rash) that may result when the skin is touched by irritants or substances that cause an allergic reaction. Contact dermatitis can occur from exposure to many different compounds found both in the home and at work. There are two types of contact dermatitis:
Allergic contact dermatitis:
Occurs when skin, which has become sensitized to a certain substance (allergen), comes in contact with that substance again
Irritant contact dermatitis:
Occurs when the skin is exposed to a mild irritant (such as detergent or solvents) repeatedly over a long period of time or a strong irritant (such as acid, alkali, solvent, strong soap or detergent), which can cause immediate skin damage
Common sources of allergic contact dermatitis
Not everyone reacts to allergens. However, some people will react to an allergen which they had previously tolerated for many years. Skin can become allergic to a substance after many exposures or after just one exposure. Most people will have an allergic reaction to poison ivy after one exposure, for instance. This is a delayed skin reaction that typically develops 12 to 72 hours after exposure.
Common sources of allergic contact dermatitis include:
- Nickel (a common metal used in jewelry) and other metals. Nickel has been reported to cause contact dermatitis in up to 10 percent of women. Gold is also becoming a widespread allergen. This type of allergic contact dermatitis can begin with intermittent rashes under earrings or other jewelry.
- Fragrances -- for example, those found in perfumes, soaps, lotions, and shampoos
- Cosmetics
- Topical medications such as antibiotics or anti-itch preparations -- these cause worsening of the problem and are often misinterpreted as infection
- Preservatives, which keep topical products from spoiling
- Sunscreens -- commonly cause a hive-like rash that can appear hours or days after sun exposure
- Rubber ingredients -- common source of work-related allergy. Rubber can cause immediate allergic reactions, such as itching, burning, or welts. Some people experience itching and tearing eyes or even shortness of breath.
Common sources of irritant contact dermatitis
Detergents, soaps, cleaners, waxes and chemicals are substances that can irritate the skin. They can wear down the oily, protective layer on skin's surface and lead to irritant contact dermatitis. Irritant contact dermatitis is most common among people who regularly work with strong chemicals, such as restaurant, maintenance, and chemical workers.
Are certain occupations at greater risk?
Some occupations have more exposure to chemicals or substances that can result in sensitization and cause allergic contact dermatitis. These include dental workers, health care workers, florists, hairdressers, machinists, and photographers among many others.
What are the symptoms of contact dermatitis?
Contact dermatitis symptoms can range from mild redness and dryness to severe pain and peeling that can be disabling.
Allergic contact dermatitis
- Reddening of skin (either in patches or all over the body)
- Intermittent dry, scaly patches of skin
- Blisters that ooze
- Burning or itching that is usually intense without visible skin sores (lesions)
- Swelling in the eyes, face, and genital areas (severe cases)
- Hives
- Sun sensitivity
- Darkened, "leathery" and cracked skin
Allergic contact dermatitis can be very difficult to distinguish from other rashes.
Irritant contact dermatitis
- Mild swelling of skin
- Stiff, tight feeling skin
- Dry, cracking skin
- Blisters
- Painful ulcers on the skin
Symptoms vary depending on the cause of dermatitis.
How can I know if I have contact dermatitis?
If you have a skin rash that won't go away, visit your health care provider. If he or she suspects allergic contact dermatitis, patch testing may be performed. In this test, small samples of chemicals are placed on an area of skin to see if a rash develops. There are no needles or pricking of the skin. The areas of the skin are then evaluated after 48 hours and again at 96 hours or one week.
The advantage of patch testing is that the allergens can be identified and your health care provider can effectively treat the rash. This avoids the need for chronic medications that have many potential side effects.
There are no tests that can be done for irritant contact dermatitis. Tell your health care provider about any irritating substances or chemicals that you regularly come into contact with (including cosmetics, lotions, and nail polish).
With either type of contact dermatitis, you can avoid substances you suspect and see if the rash goes away.
How is contact dermatitis treated?
The form of treatment will depend on the cause of contact dermatitis. Common treatments include: cortisone-type creams, antihistamines, lotions and creams or oatmeal baths (to relieve itching).
How can I prevent contact dermatitis?
For allergic contact dermatitis:
- Avoid contact with substances that cause the skin rash.
- Wash any area that comes into contact with allergic substances.
- Learn to recognize poison oak and poison ivy.
For irritant contact dermatitis:
- Wear cotton gloves under rubber gloves for all wet work. Or, use petroleum jelly to the protect the skin. Reapply the petroleum jelly two or three times a day and after washing your hands.
- Avoid contact with substances that irritate the skin.
- Use mild soaps.
- Use hand creams and lotions frequently.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/12/2007...#6173
