Contact Dermatitis (Allergic and Irritant)

What is Allergic Contact Dermatitis?

Allergic contact dermatitis is characterized by a rash and signs of inflammation such as redness, swelling, and itching. What sets contact dermatitis apart from other inflammatory skin disorders is that it occurs when the skin comes into contact with an irritant or allergy-producing substance. One very well-known kind of allergic contact dermatitis is caused by the plant poison ivy (or poison oak). However, contact dermatitis may also be caused by contact with substances commonly encountered in the home, workplace, or general environment.

What is Irritant Contact Dermatitis?

Irritant contact dermatitis is inflamed skin caused by direct damage to the skin such as with soaps, solvents and cleansers. It is not due to an ongoing allergy. It can be caused by repetitive hand work, as an example.

Who gets Contact Dermatitis?

Allergic contact dermatitis develops in those whose skins are hypersensitive, or allergic, to a particular substance. People who develop irritant contact dermatitis may be having a reaction to a strong or mild chemical irritant. With allergic contact dermatitis, however, researchers believe that there may be a genetic factor involved. In other words, if members of your immediate family suffer from bouts of allergic contact dermatitis, there is a greater likelihood that you will, too.

Some people have chronic contact dermatitis present constantly, and others have recurring bouts of contact dermatitis each time they are exposed to an allergen.

What are the Symptoms?

In mild contact dermatitis, there may be itching and slight reddening of the skin that soon goes away on its own. In more severe contact dermatitis, there can be marked swelling, itching, and blistering of the affected skin. Any part of the body that comes into contact with an offending substance can be involved, or the allergen may be transferred to the face or other body parts by the hands.

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What are some Common Causes?

Potential causes of irritant contact dermatitis range from mild irritants like soap, detergents, and even water to strong chemicals, such as acids or alkaline.

Possible allergenic culprits include ingredients used in cosmetics (such as nail polish, fragrances, or preservatives), chemicals used in the manufacture of shoes and clothing (such as underwear, pantyhose or rubber gloves), medications applied topically to the skin, dyes, metal compounds, many industrial and household chemicals, and plants such as ragweed or poison ivy.

Another type of contact dermatitis, known as a photoallergic or phototoxic reaction, occurs when the skin is exposed to UV radiation after contact with certain chemicals. These include ingredients in sunscreens, aftershaves or perfumes, and a variety of plants and topical medications.

What is the Best Treatment?

Ideally, removal of the offending substance is the best first line of attack, but figuring out the exact cause of contact dermatitis can be complicated. For some, sensitivity develops over a long period of time; people are often surprised to learn that they have become allergic to a product or substance they have been using for years.

If the cause of your contact dermatitis is not easy to determine, your physician may wish to perform a procedure known as “patch testing”. In this diagnostic procedure, a number of common allergens are taped to the back or upper arm for 2 days and then observed for redness, blisters, swelling, and itching.

For symptom control, your physician may prescribe a topical corticosteroid cream or gel to reduce itching, redness, and swelling. In cases of very severe inflammation, a course of oral corticosteroid therapy may be needed. Ultimately, control of a contact dermatitis may require change to daily routines if there is repeated contact with the offending substances, as best as you can.