Contact Dermatitis: Types, Causes, Symptoms, Investigations, Treatment
Contact dermatitis occurs when a person breaks out into rashes when it comes in contact with certain substances.
Irritation or allergic reaction of the skin when the skin comes in contact with some substances and resulting in inflammation of the skin is known as contact dermatitis. The rash produced is red in color and itchy, but it is not contagious or a serious condition albeit being uncomfortable for the patient.
The cause for contact dermatitis can be found in everyday things, such as jewelry, soaps, fragrances, cosmetics, plants (poison oak or poison ivy) etc. Certain occupations where the person is exposed or works with certain substances can also cause contact dermatitis.
Treatment comprises of identifying the cause and avoiding those causes upon which the rash usually resolves in 2 to 4 weeks. Other measures, such as anti-itch creams and wet compresses help in soothing the skin and bringing down the inflammation.
Types and Causes of Contact Dermatitis
Depending On The Cause, Contact Dermatitis Is Divided Into Two Groups:
1. Irritant Contact Dermatitis: This is the most commonly occurring contact dermatitis and it occurs when the skin's outer protective layer is damaged by certain substances, such as chemical solvents, cosmetics, harsh soaps, deodorant etc. The skin has dry, red patches which are itchy and are commonly found on face, hands and fingers. The severity of the condition depends upon the duration of the exposure and the strength of the offending agent. Strong irritants like acids or bleach can result in a reaction after getting exposed to it only once.
2. Allergic Contact Dermatitis occurs when an individual who is allergic to any particular substance comes in contact with it; this leads to an immune reaction in the skin producing bumps and red colored rashes. In severe conditions, there is formation of blisters also. Some of the allergens are: Hair dyes, metals (nickel), natural rubber, imitation jewelry, cosmetics, perfume and plants (poison oak/ivy).
- Once allergy is formed to a specific agent, then the person will be allergic towards that substance for his/her entire life. Even a small exposure will result in a reaction.
- There are some substances which produce allergic contact dermatitis when after their application they are exposed to sunlight. This is known as photoallergic contact dermatitis. Common substances which produce this reaction are some ingredients present in sunscreens and ointments which have NSAIDs in them.
- Certain oral medicines, such as hydrochlorothiazide can also result in a skin reaction which is caused by exposure to sunlight. This is known as photosensitivity and resembles photoallergic contact dermatitis.
- Airborne substances like insecticide sprays also can cause contact dermatitis.
- Some of the common allergens or irritants are: Nickel, poison ivy/ oak/ sumac, cashew nuts, topical antihistamines/ antibiotics/ antiseptics, flavorings, fragrances, strong soaps/ detergents, skin cleansers, cosmetics, deodorant, clothing/ shoes, household cleaning substances, latex (natural rubber), costume jewelry, fuels, dyes, wet cement, industrial solvents, cleaning agents, cement dust, paper dust, sawdust etc.
Symptoms of Contact Dermatitis
- Presence of red rash/patches/bumps.
- Red patches which are dry, fissured and resembling a burn.
- Formation of blisters in severe reactions, which drain fluid and form crusts.
- There may be pain or tenderness to touch.
Serious Symptoms of Contact Dermatitis
- If the condition is affecting your daily activities of living.
- If there is an infection with pus drainage.
- If there is extreme pain.
- If the person feels embarrassed because of the rashes and it affects his/her self esteem.
- If the dermatitis is related to the patient's occupation.
- If conventional treatment fails.
If the rash is severe and persistent in nature and the patient continuously scratches it, then it could lead to other complications, such as neurodermatitis (lichen simplex chronicus) and bacterial/ fungal skin infection. So, it's important to seek treatment if the symptoms worsen.
Investigations for Contact Dermatitis
- Medical history and physical exam.
- Contact delayed hypersensitivity allergy test (patch test) to determine which substance the patient is allergic to.
Treatment for Contact Dermatitis
- The best treatment for contact dermatitis is in prevention. Try to identify the cause or the allergen/irritant which is responsible for your condition and avoid your exposure to it.
- Application of anti-itch creams and wet compresses help with the itching and redness.
- OTC hydrocortisone creams and calamine lotion also help in alleviating the itching and redness.
- If the rash does not resolve with OTC medicines, then your doctor may prescribe stronger medicines.
- In severe cases, oral corticosteroids and antihistamines are prescribed to reduce itching and inflammation.
- Never ever scratch the rashes, as this could lead to infection. Keep your nails trimmed and wear white cotton gloves when sleeping.
- Wearing cotton clothes which have a smooth texture helps in avoiding irritation.
- Always use mild soaps, which do not have perfumes or dyes in them.
- Always rinse the soap completely from your body after a bath. Use a non scented moisturizer after bathing.
- Always use unscented and mild detergents for your laundry.
- Always wear protective gear when on your job.
- Sprinkle some baking soda or colloidal oatmeal in your bath water for some temporary relief.