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Diseases & Conditions

Contact Dermatitis

(Also Called 'Irritant Contact Dermatitis')

What is contact dermatitis?

Contact dermatitis is inflammation of the skin (rash) that may result when the skin is touched by chemicals or physical substances that cause an allergic or irritant 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:

  1. Allergic contact dermatitis -- occurs when skin, which has become sensitized to a certain substance (allergen), comes in contact with that substance again. This is a delayed skin reaction that typically develops 12 to 72 hours after exposure.
  2. 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. Common sources of allergic contact dermatitis include:

  • Metals, such as nickel (present in costume jewelry, snaps on jeans, buckles on belts, etc.) may elicit an allergic dermatitis in areas in contact with the metal (for example, the ears under earrings). Gold is also becoming a widespread allergen.
  • Fragrances, for example, those found in perfumes, soaps, lotions, and shampoos
  • Cosmetics
  • Topical medications, such as antibiotics (Neosporin®, for example) or anti-itch preparations, may cause an allergic reaction or even worsening of the initial 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, a 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 surface and lead to irritant contact dermatitis. Irritant contact dermatitis is common among people who regularly work with strong chemicals or detergents, such as restaurant, maintenance, and chemical workers. It is also seen in people who do a lot of housework due to contact with cleansing products, etc.

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 symptoms:

  • 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 on your back to see if a rash develops. There are no needles or pricking of the skin. These 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, if you are allergic to any chemical/product, the allergens can be identified, and your health care provider can effectively treat the rash with therapy and avoidance of the allergen(s). 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 improves.

How is contact dermatitis treated?

The form of treatment will depend on the cause of contact dermatitis. Common treatments include: oral and/or topical corticosteroids 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 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: 11/6/2009...#6173