Contact Dermatitis

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Contact Dermatitis

What is contact dermatitis?

Contact dermatitis (CD) is a red, itchy rash that’s caused by contact with something that irritates your skin or you’re allergic to. There are more than 15,000 substances that can cause CD, and finding the one that’s making you uncomfortable can be a challenge. The rash usually clears up in two to four weeks after you eliminate all contact with the cause of your CD. The only way to stop the rash and keep it from happening again is to avoid the substance that caused it. 

Are there different types of dermatitis?

Yes, there are irritant and allergic types of CD.

  • Irritant contact dermatitis can happen when your outer protective layer of skin becomes damaged after being exposed to an irritating substance. This is the most common type of CD, causing 80% of cases. Irritant CD is common with people who work around chemicals such as custodians, hair stylists, healthcare workers and mechanics. The irritating substance can be one of thousands of products from cleaning products, bleach, and plants, to personal products, metal on clothing or over washing your hands. Other irritants can include foods, medicine, gasoline and diesel oil, disinfectants, fertilizers and pesticides. The Covid-19 pandemic has contributed to irritant CD cases because of the need for frequent handwashing. 
  • Allergic contact dermatitis can happen a few days after your skin surface is exposed to something you’re allergic to. Some of the most common sources of allergens are poison ivy, oak or sumac; fragrances; and items made of nickel. After exposure, your body’s immune system launches a response that includes inflammation, usually leading to a rash within an hour up to a few days. The rash is possible even if you only touch something for a few seconds. Some people don’t develop the rash until sunlight hits their skin where they had contact with the allergen, called photocontact dermatitis. Allergic CD can also be caused by foods, medicine or dental procedures, called systemic contact dermatitis. Once you develop an allergy to something, even a small amount of it can cause reactions such as CD.

 Should I worry about CD?

CD is not contagious, life-threatening, or related to family history. It’s also not related to other allergies. While it can make you very uncomfortable, most cases clear up after you stop contact with the irritant or allergen. There are two concerns to be aware of: 

  • Be sure you avoid whatever substance caused your CD. That’s why it’s important to accurately identify the substance that caused it.  
  • A skin infection can develop if you scratch the affected area, causing it to be wet and oozing, creating a perfect spot for bacteria or fungi to grow.

Causes

What causes CD?

CD is caused by either an irritant or an allergen making contact with your skin. Everyone reacts differently to irritants or allergens. Some people will develop a rash after one exposure. Others don’t have a reaction until they’ve had many exposures. Others develop a tolerance to the substance and it no longer causes CD.

Who’s at risk for CD?

Anyone of any age can get CD, but some people have a greater risk if they have a skin condition that reduces the skin’s ability to protect you from germs, such as atopic dermatitis, stasis dermatitis, or leg ulcers. Also, if your hands are in water throughout the day and/or you work with harsh chemicals

With Insurance

Dermatology

Your copay
Depending on insurance

Without Insurance

Dermatology

$89

Initial Visit

$75

Follow Up

Symptoms

What are the symptoms of CD?

CD often develops on the hands because that’s how we touch most things. The skin on eyelids is thinner than elsewhere and this is another common spot for CD to develop.

Other symptoms can include:

  • Itchy skin that can be intense
  • Burning or stinging pain
  • Rash that makes skin discolored, swollen and warm
  • Very dry skin that can crack
  • Tender skin
  • Hives -- round welts that itch intensely
  • Fluid-filled blisters
  • Oozing blisters that can develop crusts and scales
  • A rash that comes and goes may be caused by something you only touch infrequently

Diagnosis

How is CD diagnosed?

Your doctor or dermatologist (medical doctor who specializes in skin problems) can tell whether your symptoms are CD, an infection, or another skin condition. If it’s CD, they can help you get rid of it by diagnosing what’s irritating your skin or causing an allergic reaction, and by helping you avoid what caused the CD.

Your dermatologist will diagnose CD by examining your rash’s pattern and intensity. He or she will need background information to help identify the irritant or allergen that’s causing your CD. It will be extremely helpful to your doctor if you have the following information:

  • List of all your symptoms, when they started, and are symptoms continuous or occasional
  • Anything you’ve done that helps your symptoms; and anything that makes them worse
  • All the medications and dosages you take; include over-the-counter meds, vitamins and food supplements
  • All the personal-care products you use
  • Cleaning products or other chemicals you use
  • Anything new that’s come into your house or job -- new personal care products, pets, furniture, food
  • Anything related to your work or a hobby that involves products that come in contact with your skin

It’s possible to develop an allergy to a product you’ve used for years. The product may have a new formula with different ingredients, or you may have developed a new allergic reaction to it.

You may also have a patch test to determine if you’re allergic to a substance. Patch tests are especially helpful if your rash comes and goes. Small amounts of potential allergens are placed on patches that are stuck on your skin for two to three days. The doctor will remove the patches and check for skin reactions.

Treatment

How do I get rid of CD?

Most cases of CD can be stopped by stopping all contact with the irritant or allergen. 

What are the treatment options for CD? 

To reduce symptoms and clear up the rash, your dermatologist may prescribe:

  • Medication to apply to the rash that helps heal it
  • Medication that works internally to clear up widespread rashes and swelling, such as prednisone
  • Topical (on the skin) steroid cream to relieve itching
  • Oral or injectable corticosteroids if the rash is widespread and inflamed
  • Antihistamines to relieve itching
  • Antibiotics if your skin has developed a bacterial infection
  • Calamine lotion for open oozing sores
  • Methotrexate or other long-term medication that can help calm an overactive immune system, which can cause rashes to return
  • Phototherapy, a special light treatment that helps heal skin and calm the immune system

Is there anything I can do before I see the doctor?

There are several home remedies that can provide temporary relief from the rash and itching:

  • Apply cool compresses to the rash for 15 minutes several times a day.
  • Soak in a cool bath with baking soda or colloidal oatmeal.
  • Apply over-the-counter anti-itch cream with at least 1% hydrocortisone.
  • Take an oral anti-itch drug such as diphenhydramine (Benadryl).
  • Don’t scratch to avoid spreading or infecting it; cover with a loose dressing if you can’t avoid scratching.
  • Wear plastic or rubber gloves when cleaning or using chemicals. Gloves lined with cotton are great for hands that are often wet. 
  • Wash new clothes or other fabrics before wearing to remove chemicals and dyes that could cause a reaction.
  • When washing your hands, use a mild soap, rinse well and pat dry. Use fragrance-free moisturizers throughout the day. Use hand sanitizers with moisturizer.

How can I prevent future CD outbreaks?

  • Identify and avoid all known irritants and allergens.
  • Wash your skin and clothing immediately after touching a known irritant/allergen.
  • Wear gloves, protective clothing, face masks, and goggles to protect your skin from potential irritants/allergens.
  • Apply a skin barrier such as bentoquatam (IvyBlock) to lessen your reaction to plants like poison ivy.
  • Use moisturizer to restore your skin’s protective layer.
  • Be wise around pets, their bedding and other places where their fur can accumulate. If they are outside, allergens from plants can cling to their fur and transfer to you.

References

Mayo Clinic. (June 2020). Contact dermatitis. Retrieved 8-30-21, {https://www.mayoclinic.org/diseases-conditions/contact-dermatitis/symptoms-causes/syc-20352742}
Mayo Clinic. (June 2020). Contact Dermatitis: Diagnosis & Treatment. Retrieved 8-30-21, {https://www.mayoclinic.org/diseases-conditions/contact-dermatitis/diagnosis-treatment/drc-20352748}
National Eczema Association. (n.d.). Contact dermatitis. Retrieved 8-30-21, {https://nationaleczema.org/eczema/types-of-eczema/contact-dermatitis/}
Ludmann, P. (Dec. 2020). Eczema Types: Contact Dermatitis Overview. American Academy of Dermatology Association. Retrieved 8-30-21, {https://www.aad.org/public/diseases/eczema/types/contact-dermatitis}

Information

Medically reviewed by:

Dr. Javeed Siddiqui, MD, MPH

Dr. Siddiqui is the Chief Medical Officer at TeleMed2U responsible for clinical and technical program development as well as maintaining a thriving telemedicine practice in infectious diseases which includes specialized care of Hepatitis and HIV.

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Affordable –
with or without insurance

With Insurance

Dermatology

Your copay
Depending on insurance

Without Insurance

Dermatology

$89

Initial Visit

$75

Follow Up