CONTACT DERMATITIS

The sensitivity of the skin varies from individual to individual, and may vary in the same individual from time to time. A history of any type of allergies increases the risk of contact dermatitis.

What is Contact Dermatitis?

Contact dermatitis is a skin inflammation that results when the skin comes in direct contact with substances that can cause an allergic or inflammatory reaction. Over-treatment dermatitis is a form of contact dermatitis that occurs when inflammation results from treating another skin disorder.

The most common type of contact dermatitis involves inflammation that results from contact with substances that may be irritants. These include acids, alkaline materials such as soaps and detergents, solvents, and other chemicals. The reaction usually resembles a thermal (heat-caused) burn.

The second type involves exposure to a material to which the person has become hypersensitive or allergic. The skin inflammation varies from mild irritation and redness, to rash, to open sores, depending on the type of allergen, the body part affected, and the sensitivity of the individual.

What are the Symptoms of Contact Dermatitis?

  • Itching (pruritus) of the skin in exposed areas
  • Skin redness or inflammation in the exposed area
  • Tenderness of the skin in the exposed area
  • Localized swelling of the skin
  • Warmth of the exposed area (may occur)
  • Skin lesion or rash at the site of exposure
  • lesions can be of any type: redness, rash, papules (pimple-like), vesicles and bullae (blisters)
  • May involve oozing, draining, or crusting
  • Skin may become scaly, raw, or thickened

How is Contact Dermatitis Diagnosed?

The diagnosis is primarily based on the skin appearance and a history of exposure to an irritant or allergen.

Allergy testing with skin patches may isolate which of suspected allergens is causing the reaction. According to the American Academy of Allergy, Asthma, and Immunology, "Patch testing is the gold standard for contact allergen identification." Patch testing is used for patients who have chronic, recurring contact dermatitis. It requires three office visits and must be done by a clinician with detailed experience in the procedures and interpretation of results. Patients should bring suspected materials with them, especially if they have already tested those materials on a small area of their skin and noticed a reaction.

Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion (see skin or mucosal biopsy culture).

How is Contact Dermatitis Treated?

Initial treatment includes thorough washing with lots of water to remove any trace of the irritant that may remain on the skin. Further exposure to known irritants or allergens should be avoided. In some cases, the best treatment is to do nothing to the area.

Topical corticosteroid medications may reduce inflammation. Carefully adhere to instructions when using topical steroids because overuse of these medications, even low-strength OTC topical steroids, may cause a skin condition as well. In severe cases, systemic corticosteroids may be needed to reduce inflammation. These are usually tapered gradually over about 12 days to prevent recurrence of the rash.

Wet dressings and soothing, anti-pruritic (anti-itch), or drying lotions may be recommended to reduce other symptoms.

» top