Contact Dermatitis

What is contact dermatitis?

Contact dermatitis is your skin’s reaction to something in your environment that causes an itchy rash. “Dermatitis” is the medical term for skin irritation or swelling (inflammation). You get contact dermatitis by coming into contact with a substance, organism, object or chemical that’s irritating to your skin.

What are the types of contact dermatitis?

There are two types of contact dermatitis:

• Allergic contact dermatitis: Your body has an allergic reaction to a substance (allergen) that it doesn’t like. Common allergens include jewelry metals (like nickel), cosmetic products, fragrances and preservatives. It can take several days after exposure for an itchy rash to develop.
• Irritant contact dermatitis: This painful rash tends to come on quickly in response to an irritating substance. Common irritants include detergents, soap, cleaners and acid. Irritant contact dermatitis occurs more often than allergic contact dermatitis.

Who does contact dermatitis affect?

Contact dermatitis can affect anyone at any age, from a baby to an adult. Skin reactions can occur after a single exposure or after repeated exposures over time.

People who work in certain professions have a higher risk of developing contact dermatitis if they repeatedly encounter irritating chemicals or allergens. Professions at a high risk of developing contact dermatitis include:

• Construction workers.
• Florists.
• Food handlers.
• Hairstylists.
• Healthcare providers.
• Janitors and plumbers.
• Mechanics.
• Artists.

How common is contact dermatitis?

Contact dermatitis is common. Irritants and potential allergens surround humans. You might experience contact dermatitis more often if you have sensitive skin or chronic skin conditions.

How does contact dermatitis affect my body?

Contact dermatitis causes a rash to form on your skin. This rash can form anywhere on your body and is usually a patch of skin covered in bumps that are red, itchy and sometimes painful. The rash can last for a few days to a couple of weeks. It generally goes away quickly if you identify what caused your reaction and stay away if you can avoid that irritant or allergen.

What does contact dermatitis look like?

Symptoms of contact dermatitis include a rash on your skin that’s:

• Red to purple or darker than your natural skin tone.
• Swollen, hive-like or elevated from the skin surrounding it.
• Bumpy with a small cluster of pimples or blisters.
• Oozing fluid or pus.
• Painful with a burning or stinging sensation.
• Flaky or scaling.
• Itchy.

Scratching your rash could break open your skin and cause a wound. If this wound becomes infected, it will look red and crusty and may be painful or leak pus.

Where on my body will I have symptoms of contact dermatitis?

You can experience contact dermatitis anywhere that your skin came into contact with an allergen or irritant. The most common places that people experience symptoms include:

• Face, neck and scalp.
• Lips, eyelids and cheeks.
• Hands, fingers and arms.
• Genitals (penis, vaginal area and vulva).
• Armpits.
• Feet and legs.

What causes contact dermatitis?

Physical contact with an allergen or an irritant causes contact dermatitis.

If your body doesn’t like something that touches your skin, your immune system responds. When you see your skin swell or become inflamed, that’s a sign that your white blood cells are responding to the allergen or irritant, which can cause an itchy rash. The rash may appear in minutes if it’s caused by an irritant, or may take hours or days to appear after exposure to an allergen.

Allergic contact dermatitis causes

The most common causes of allergic contact dermatitis include:

• Plants or parts of a plant (botanicals), like poison ivy.
• Skin care products with fragrances.
• Metals, such as nickel.
• Medications, including antibiotics.
• Preservatives or chemicals.

Irritant contact dermatitis causes

The most common causes of irritant contact dermatitis include:

• Acids.
• Cleaning products.
• Body fluids, including urine and saliva.
• Plants, like poinsettias and peppers.
• Hair dyes.
• Nail polish remover or other solvents.
• Paints and varnishes.
• Soaps or detergents.
• Resins, plastics and epoxies.

Is contact dermatitis contagious?

If you encounter an allergen like poison ivy and touch someone else’s skin before you’ve washed yours, it’s possible to spread the allergen to them. They may then have a reaction if they’re also allergic. But contact dermatitis isn’t actually contagious. Your body’s reaction is unique to the material that touched it and not everyone reacts the same way.

Can contact dermatitis spread?

Depending on what caused your skin reaction, contact dermatitis can spread to other parts of your body. This is most common for allergic contact dermatitis. It happens when you touch an allergen and then touch other parts of your body before you realize that you’ve been in contact with it, or when multiple body parts touch the allergen and the reaction slowly unfolds in all areas of contact. If you notice your rash spreading to other parts of your body, contact a healthcare provider for treatment.

How is contact dermatitis diagnosed?

Your healthcare provider will diagnose contact dermatitis after taking a complete medical history, performing a physical exam and reviewing your symptoms.

There isn’t a test to identify the cause of irritant contact dermatitis, but your provider will ask questions to learn more about your environment, things you’ve come into contact with and the location and size of your rash. These questions could include:

• How long have you had a rash?
• Did you make any changes to your normal skin care routine?
• Did you come into contact with any new plants, materials or chemicals?
• Do you have regular contact with any irritants or chemicals?

For allergic contact dermatitis, your provider may offer testing, including a patch test to confirm a diagnosis. For a patch test, your provider will place a sticky patch on your skin. That patch is coated in common allergens. When your provider removes the patch, they’ll be able to see if the allergens on the patch triggered an allergic reaction on your skin.

Although uncommon, your provider might perform a skin culture or biopsy where they take a sample of the tissue from your rash and examine it under a microscope.

How is contact dermatitis treated?

Treatment for contact dermatitis is the same for both allergic and irritant types. Treatment could include:

• Avoidance: If you identify what caused the rash, avoid or minimize exposure to it.
• Taking medicine to relieve swelling and itching: Medicines could include over-the-counter anti-itch creams, topical or oral antihistamines, corticosteroid creams or prednisone, an oral steroid. Immunosuppressant medications are uncommon.

Are there complications associated with contact dermatitis?

Aside from the rash, uncommon, serious complications can happen when you have an allergy to something. Complications of an allergic reaction include:

• Hives: Discolored, raised, itchy skin welts.
• Swelling (angioedema): An area of your skin that’s larger than it was the day before. Swelling occurs deep under your skin.
• Anaphylaxis: An allergic reaction that includes your airways, causing them to swell and potentially close.

Anaphylaxis is uncommon but it’s a medical emergency. If you have trouble breathing, contact 911 immediately. Immediate epinephrine injection can counteract this allergic reaction. People with known significant allergies should carry an injectable epinephrine, like EpiPen®.

What should I do if I develop contact dermatitis on the job?

If you’re regularly exposed to irritating chemicals or allergens at work and develop contact dermatitis, ask your employer for a chemical safety data sheet. You can take this information to your healthcare provider to help determine what’s causing your symptoms.

How long does contact dermatitis last?

It can take several weeks for the contact dermatitis rash to go away with treatment. You might notice symptoms of itching decrease or go away a couple of days after treatment begins even though you still have a visible rash on your skin. Mild cases of contact dermatitis could go away within a few days with avoidance of what caused your symptoms, with no additional treatment necessary. If you experience symptoms of contact dermatitis, reach out to a healthcare provider for help with your symptoms.

How can I prevent contact dermatitis?

You can prevent contact dermatitis by:

• Avoiding known allergens.
• Choosing fragrance-free moisturizers.
• Using fragrance-free or dye-free soaps and cleansers.
• Washing your hands and skin immediately after coming into contact with a known allergen or irritant.

What can I expect if I have contact dermatitis?

There’s no cure for contact dermatitis. If your body reacted to an allergen or irritant, you’ll likely continue to have a similar reaction every time you’re exposed to it. Avoidance is the best prevention for contact dermatitis.

Many people who have contact dermatitis caused by substances they interact with in their workplace can find ways to reduce exposure. A healthcare provider can help you navigate your condition and offer recommendations.

When should I see my healthcare provider?

You should call your healthcare provider if your skin rash:

• Blisters.
• Goes away for a while and then returns.
• Looks infected (red, warm or swollen).
• Hurts.
• Itches constantly.
• Doesn’t go away in a week with treatment.

When should I go to ER?

Visit the emergency room or call 911 immediately if you have trouble breathing or have swelling of your lips or mouth.

What questions should I ask my doctor?

If you’re experiencing symptoms of contact dermatitis, talk to a healthcare provider. You may want to ask:

• What caused my skin rash?
• Should I get an allergy test?
• What steps can I take to prevent contact dermatitis?
• What are the best treatments for this contact dermatitis?
• What are the best treatments for a painful or itchy skin rash?
• What over-the-counter cleansers and moisturizers do you recommend?
• What signs of complications should I look out for?

What is the difference between contact dermatitis and herpes?

Contact dermatitis and herpes can affect similar parts of your body but they’re very different. Herpes is a sexually transmitted viral infection and spreads from person to person through physical contact. Contact dermatitis isn’t an infection and isn’t contagious.

What is the difference between contact dermatitis and atopic dermatitis or eczema?

Allergic contact dermatitis is related to atopic dermatitis or eczema because they can both affect people with allergies. Contact dermatitis occurs when you touch something that your skin reacts to. It comes from an outside source. Atopic dermatitis or eczema occurs in people who have allergies, but they’re often not related to touching a specific substance; they come from the inside.

Can tea tree oil treat contact dermatitis?

Tea tree oil has certain antibacterial components that can influence skin reactions like a contact dermatitis rash. If you experience symptoms of contact dermatitis, don’t use essential oils like tea tree oil until you contact a healthcare provider to see if it’s right for you. Adding new products to your skin during a contact dermatitis reaction can irritate your rash and make it worse.

A note from Cleveland Clinic

Contact dermatitis is your skin’s reaction to something in your environment that causes an itchy rash. A healthcare provider can help you find out what caused your skin to react negatively and work with you on ways to avoid contact with the allergen or irritant in your environment. If you experience contact dermatitis from a chemical or material that you use in the workplace, your provider can make recommendations and your employer can help you safely navigate your working environment to reduce future skin reactions.