What Is Contact Dermatitis?

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Contact dermatitis is inflammation of the skin either from exposure to a simple irritant (e.g., a chemical cleaner) or as the result of a true allergic reaction (e.g., to latex).

While the red, itchy rash it causes is irritating, the condition isn't contagious and will usually go away on its own in days as long as you no longer have contact with the substance that caused it.

This photo contains content that some people may find graphic or disturbing.

contact allergic dermatitis of the torso
Contact allergic dermatitis of the torso. DermNet / CC BY-NC-ND

More than 80% of contact dermatitis cases result from irritants rather than allergens.

In irritant contact dermatitis, the offending substance comes into direct contact with the skin and then physically, mechanically, or chemically irritates the skin and leads to the symptoms you experience.

In allergic contact dermatitis, an allergen activates your body’s immune system, resulting in inflammation. These reactions can occur after using a product or being exposed to a substance (such as metal) for the first time for or after many exposures.

Contact dermatitis can be difficult to treat if you (or your doctor) are not able to identify the cause and avoid it.

Contact Dermatitis Symptoms

In irritant contact dermatitis, the symptoms you experienced depend on how irritating the offending agent is. With mild irritants, you may only see small amounts of:

  • Redness
  • Dry skin
  • Small skin cracks
  • Itching

With stronger irritants, you’re likely to see:

  • Swelling
  • Pain
  • Blistering
  • Oozing

Symptoms of allergic contact dermatitis are very similar. Typically, there's a raised rash that is often intensely itchy.

The affected area is usually where the substance came into contact with the skin, but it can spread to other parts of the body on your hands. Wash your hands thoroughly if you've come in contact with a substance that gives you allergic contact dermatitis.

Causes

The most common causes of irritant dermatitis are things that you use every day. This can include, but is not limited to:

  • Soaps/cleansers
  • Lotions
  • Perfumes

While anyone can develop irritant contact dermatitis, those with fair, dry, or sensitive skin appear to be at greater risk.

Allergic contact dermatitis is most often caused by poison ivy, poison oak, and poison sumac. Other common causes seen in clinical practice include:

  • Nickel allergy (commonly seen in jewelry wearers)
  • Cosmetics
  • Antibiotic creams
  • Rubber (latex)
  • Chemicals

Occupational exposures are a common cause of contact dermatitis. Up to 40% of worker’s compensation cases involve job-induced contact dermatitis.

Diagnosis

Both types of contact dermatitis are usually diagnosed based on your history and a physical exam.

Sometimes your doctor may want to do patch testing (where small amounts of the suspected offending substance are applied to the skin), but this will only identify allergic causes, not irritant ones.

In other cases, your doctor may choose to just eliminate the suspected allergen. If symptoms improve after elimination, this supports the diagnosis of the substance causing your symptoms.

The location of the rash can sometimes help you/your doctor make a diagnosis. The thinner the skin, the more likely it'll be irritated.

Face/Eyelids

Common irritants include not only things that go on your face, like cosmetics, but other substances that may come into contact with your facial, such as sunblock or children’s toys.

Scalp

The scalp is not commonly impacted, but when it is, hair dye is often the reason. However, anything you put on your head could be the cause.

Hands

Food workers, health professionals, professional cleaners, custodians, housekeepers, and anyone else who uses their hands a lot can be impacted. Symptoms are most likely on the palm, where skin is thinner. Anything that touches your hand, from gloves to chemicals, can be the culprit.

This photo contains content that some people may find graphic or disturbing.

contact dermatitis on hands
Contact dermatitis on hands.  DermNet / CC BY-NC-ND

Neck

Jewelry, perfumes, lotions, or anything you may put on this are of the body may be to blame.

Underarms

Not only are things like deodorants and shaving products a common cause, but chemicals that come off of clothes as a result of sweating and lead to irritation can also cause contact dermatitis.

Legs

The causes here are similar to other areas of the body. Stockings can also contribute to this problem.

Genital/rectal area

Many of the previous causes (soaps, for example) can impact this area. Though this skin may not come directly into contact with some irritants, anything that your hands touch could also affect it when you clean yourself.

Unknown Causes

Sometimes, the cause of contact dermatitis can be a mystery. You can have a red, itching, and oozing rash without a sense of why. This can be really frustrating when you're doing everything your doctor recommends but your symptoms are bothersome and aren't going away.

Ask yourself if anything at work or at home has changed. You may need to become a bit of a sleuth to figure out the cause. Sharing any information with your doctor, no matter how insignificant you think it may be, can be helpful.

Treatment

Treatment for both types of dermatitis is the same. The first, and perhaps most obvious suggestion, is to avoid the irritant.

While there are a number of different ways to do this, you need to consider avoiding places where the irritant is or wearing protective gear to prevent the irritant from coming into contact with your body.

If certain lotions, soaps, or agents lead to contact dermatitis symptoms, they need to be eliminated. When you do this, the rash will often go away on its own.

Mild Reactions

If your irritant contact dermatitis rash requires further treatment, over-the-counter medications may be recommended.

Non-irritating moisturizer creams and corticosteroids can be applied to the rash to relieve symptoms. You can apply the moisturizer twice a day for one week, and then daily for another week. Oatmeal baths or calamine lotion also can be soothing.

Antihistamine medications likely won't help control itching, as contact dermatitis is not caused by a histamine response.

More Severe or Widespread Reactions

If the rash covers large portions of your body or you have severe symptoms, you may need a prescription-strength cream or a systemic steroid, such as prednisone.

It's very important to take this medication exactly as your doctor prescribes it and, in the case of a steroid, take all of the pills that are given to you.

If you have severely irritated skin with oozing or crusting lesions, your doctor may also prescribe wet dressings to help with the more severe symptoms.

Other treatments may include:

  • Antibiotics: Necessary if your doctor feels that the rash or skin is infected
  • Phototherapy: Necessary if contact dermatitis does not respond to steroid creams or systemic steroids
  • Immunosuppressant agents: Reserved for the rare cases in which people don't respond to any other treatments

A Word From Verywell

It may seem like a difficult task to avoid the triggers causing your symptoms, especially if the cause is occupational or you are not exactly sure of the cause entirely.

Then, of course, you might also need to manage a complicated treatment regimen that includes both over-the-counter and prescription treatments.

Be patient as you and your doctor work to identify the cause of your contact dermatitis and define solutions that will not only help you avoid reactions, but that are practical for you.

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Article Sources
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