Contact Dermatitis (Irritant Dermatitis)
What is Contact Dermatitis?
Contact dermatitis is an inflammatory disorder caused by a substance or allergen on the skin. There are two types: irritant contact dermatitis and allergic contact dermatitis.
What Causes Contact Dermatitis?
Irritant contact dermatitis, which is the more common form, is brought on by contact with solvents, water, soap, urine, saliva, stool, and cleansers that directly affect the immune system. Allergic contact dermatitis is due to an allergic sensitization that triggers the immune response.
Common allergic causes of contact dermatitis include:
- Poison ivy.
- Poison oak.
- Poison sumac.
- Metals such as nickel, cobalt or chrome.
- Fragrances and cosmetics.
- Hair dye.
- Clothing/textile dyes.
What Are the Signs and Symptoms of Contact Dermatitis?
Symptoms typically include itchy rash, which can vary from a red, bumpy rash to blisters in acute cases like poison ivy or poison oak dermatitis.
How is Contact Dermatitis Diagnosed?
A physician will examine the affected skin and ask a series of questions with a focus on solvents, paint, or chemicals used in hobbies; workplace exposure to chemicals; contact with cosmetics, fragrances, hair dye, or nail polish; exposure to jewelry and other metals. Skin patch testing may be done.
It’s vital to identify and faithfully avoid the trigger; otherwise the rash may become chronic and life-affecting.
What Can I Do About Contact Dermatitis?
To help prevent contact dermatitis:
- Avoid excessive hand washing.
- Use mild soaps, moisturizers, and detergents that are free of dyes or fragrances.
- Wear gloves to protect your hands and other body parts from exposure if contact with irritating chemicals is unavoidable. However, note that you may become allergic to chemicals in the gloves.
What Treatment is Available for Contact Dermatitis?
For brief bouts of contact dermatitis, we recommend that you:
- Apply cold compresses to soothe the itch.
- Wash skin immediately with soap and water after contact with an allergen, such as poison ivy, to limit the spread and severity of the reaction. A severe poison ivy rash is typically treated with a course of systemic steroids (pills or injection).
- Use topical cortisone creams, which are anti-inflammatory. Mild hydrocortisone is available over the counter. A more potent cream can be prescribed by a physician.
Oral antihistamines, preferably the newer, non-sedating ones, can be helpful for itch relief.
For chronic contact dermatitis:
- The first strategy for treatment is applying topical cortisone, in a strength prescribed by your doctor. This is available in foam, cream, ointment, or lotion forms.
- A course of systemic steroids (pills or injection) may be prescribed if the rash is severe. This is a short-term treatment, as the side effects, such as weight gain, increased blood pressure, or sleep disturbances, are significant.
- Other oral medications are available for hard-to-treat cases.
- Identifying the trigger and avoidance of that trigger is crucial for successful treatment.