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Contact Dermatitis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Written by Andrew Le, MD

UpdatedFebruary 29, 2024

Contact dermatitis is a common skin issue that can be uncomfortable and sometimes painful. It occurs when your skin reacts to something it has touched, causing an itchy and rash-like reaction.

One specific type is allergic contact dermatitis, which affects about 1 in 5 people. While it can happen to anyone, those with eczema since childhood may be more likely to get allergic contact dermatitis.

In this article, you will learn about various aspects of contact dermatitis, such as its types, causes, symptoms, diagnosis, treatment, prevention, and more.

🔑 Key Takeaways

  • Contact dermatitis, a prevalent skin condition, can cause discomfort and pain. It manifests as an itchy, rash-like reaction when the skin encounters irritants or allergens.
  • Allergic contact dermatitis is triggered by specific allergens like metals in jewelry and fragrances. Irritant contact dermatitis can affect a wide range of individuals.
  • Contact dermatitis can affect people of all ages, and certain professions involving exposure to irritants or allergens pose a higher risk.
  • Symptoms of contact dermatitis include redness, swelling, bumps, oozing, pain, flakiness, itchiness, and potential skin damage from excessive scratching.
  • The areas affected by contact dermatitis depend on the irritation or allergen exposure source.
  • Diagnosis involves a medical history, physical examination, symptom review, and sometimes patch testing or a skin biopsy, while treatment options range from avoidance of triggers to topical or oral medications, wet compresses, and home remedies.

Understanding Contact Dermatitis

Contact dermatitis is your skin's response to environmental substances, chemicals, or allergens that cause irritation or inflammation. The term "dermatitis" refers to skin inflammation or swelling. When your skin comes into contact with an irritating substance, it results in skin symptoms and discomfort.

Let’s dig into the following sections to know more about its details.

Types of Contact Dermatitis

There are two primary types of contact dermatitis:

1. Allergic Contact Dermatitis

Allergic contact dermatitis is more common than previously thought, affecting about 20% of children. Allergic contact dermatitis arises when your body reacts allergically to a particular substance or allergen.

Common allergens include:

  • Metals in jewelry (such as nickel)
  • Fragrances
  • Cosmetics
  • Preservatives

It may take several days after exposure for an itchy rash to develop in allergic contact dermatitis.

2. Irritant Contact Dermatitis

Women, infants, the elderly, and those with atopic tendencies are more susceptible. Surprisingly, up to 80% of occupational dermatitis cases are identified as irritant contact dermatitis. Irritant contact dermatitis is recognized by the rapid onset of a painful rash when exposed to irritating substances.

Common irritants include:

  • Detergents
  • Soaps
  • Cleaning products
  • Acids

Irritant contact dermatitis is more prevalent than allergic contact dermatitis and typically arises swiftly following exposure.

💡 Did You Know?

Contact with a substance can lead to irritant contact dermatitis of the vagina, resulting in redness, soreness, or irritation of the vaginal skin.

Who Does Contact Dermatitis Affect?

Contact dermatitis can affect individuals of all ages, from infants to adults. Skin reactions can occur after a single exposure or after repeated exposures.

Certain professions that involve frequent contact with irritating chemicals or allergens carry a higher risk of contact dermatitis, including:

  • Construction workers
  • Florists
  • Healthcare providers
  • Hairstylists
  • Mechanics

How Does Contact Dermatitis Affect the Body?

Contact dermatitis leads to the development of a rash on the skin. The rash may manifest anywhere, usually red, itchy, and occasionally painful bumps or blisters.

The rash may ooze fluid or pus, become flaky, and cause a burning or stinging sensation. Scratching the rash can break the skin, leading to open wounds that may become infected.

Symptoms and Causes

Symptoms of contact dermatitis can vary but often include the following characteristics:

  • Redness: The affected skin may appear red or darker than your natural skin tone.
  • Swelling: The rash can be swollen, giving it a hive-like or elevated appearance.
  • Bumps: The rash is often bumpy, with small clusters of pimples or blisters.
  • Oozing: Some rashes may ooze fluid or pus.
  • Pain: Contact dermatitis can be painful and cause a burning or stinging sensation.
  • Flakiness: The affected skin may become flaky or develop scaling.
  • Itchiness: Itching is a common symptom of contact dermatitis, which can be uncomfortable.

Excessive scratching of the rash can lead to skin damage, potentially resulting in red, crusty, painful wounds, and may discharge pus if infected.

Areas of the Body Affected by Contact Dermatitis

Contact dermatitis can manifest on any part of the body that encounters an allergen or irritant. However, some common areas where symptoms are frequently experienced include:

  • Face, neck, and scalp
  • Lips, eyelids, and cheeks
  • Hands, fingers, and arms
  • Genitals (penis, vaginal area, and vulva)
  • Armpits
  • Feet and legs

The specific areas affected depend on the irritation or allergen exposure source.

Causes of Contact Dermatitis

Contact dermatitis is triggered by physical contact with an irritant or allergen. When your skin reacts negatively to something it encounters, your immune system responds, leading to skin swelling and inflammation. The timing of the rash's appearance can vary:

  • Allergic Contact Dermatitis Causes: Common triggers include plants like poison ivy, fragrances in skincare products, metals such as nickel, certain medications (including antibiotics), and various preservatives or chemicals.
  • Irritant Contact Dermatitis Causes: Common irritants include acids, cleaning products, body fluids like urine and saliva, certain plants (e.g., poinsettias and peppers), hair dyes, nail polish removers, paints, soaps, detergents, and various resins, plastics, and epoxies.

It's essential to note that contact dermatitis itself is not contagious. While it is possible to transfer an allergen, such as poison ivy, from one person's skin to another's, not everyone will react similarly.

Can Contact Dermatitis Spread?

The potential for contact dermatitis to spread to other parts of your body depends on the cause of your skin reaction. This phenomenon is most common in cases of allergic contact dermatitis. It may occur when you touch an allergen and other areas of your body before realizing you've been exposed.

Alternatively, the reaction may slowly develop in all contact areas when multiple body parts come into contact with the allergen. If you notice your rash spreading to other body parts, it's advisable to consult a healthcare provider for proper treatment and guidance.

Diagnosis and Tests

Diagnosing contact dermatitis involves a comprehensive assessment by a healthcare provider. The diagnostic process typically includes:

  • Medical History: Your healthcare provider will gather a comprehensive medical history, including when you initially observed the rash and any alterations in your skin care regimen or exposure to potential irritants or allergens.
  • Physical Examination: A comprehensive physical examination of your skin will assess the rash's appearance, location, and characteristics.
  • Symptom Review: Your provider will inquire about your symptoms, including itching, pain, or any other discomfort associated with the rash.

There may not be a specific test to identify the cause of irritant contact dermatitis cases. Still, your provider will gather information about your environment, potential irritants, and the size and location of the rash. Questions may include:

  • How long have you had the rash?
  • Have you made any changes to your usual skincare routine?
  • Did you come into contact with new plants, materials, or chemicals?
  • Are you regularly exposed to any irritants or chemicals daily?

In allergic contact dermatitis situations, your healthcare provider may recommend testing, such as a patch test, to confirm the diagnosis.

A sticky patch containing common allergens is applied to your skin during a patch test. After a designated period, the patch is removed, and your provider will assess whether the allergens on the patch triggered an allergic reaction on your skin.

Although less common, your provider may perform a skin biopsy if the diagnosis remains unclear or if there is concern about other skin conditions. A skin biopsy entails extracting a small skin sample for microscopic examination in a laboratory.

Treatment and Management

Treatment for contact dermatitis aims to relieve symptoms, reduce inflammation, and promote healing. The treatment approach varies based on the type, severity, and cause of contact dermatitis. Let’s learn more about this below.

Managing Contact Dermatitis

In dealing with contact dermatitis, taking a comprehensive approach for effective relief and preventing future outbreaks is vital. Here are some key strategies:

1. Avoidance of the Trigger

The first and most critical step is identifying and avoiding the substance or allergen that caused the contact dermatitis. This may involve changing your daily routine, such as:

  • Using different skincare products
  • Wearing protective clothing or gloves
  • Taking precautions in your work environment

2. Topical Corticosteroids

Topical corticosteroid creams or ointments are often prescribed to reduce inflammation and relieve itching. These medications come in various strengths, and your healthcare provider will recommend an appropriate one based on the severity of your rash.

Following the prescribed instructions is essential, as excessive or prolonged use of corticosteroids can lead to skin thinning and other side effects.

3. Topical Calcineurin Inhibitors

In some cases, topical calcineurin inhibitors (e.g., tacrolimus and pimecrolimus) may be prescribed, especially when corticosteroids are unsuitable. These medications help reduce inflammation and itching and can be used on sensitive areas like the face and genitals.

4. Oral Medications

For severe cases or widespread rashes, your healthcare provider may recommend oral corticosteroids or other oral medications, such as antihistamines, to manage symptoms and inflammation.

5. Wet Compresses

Applying cool, wet compresses to the affected area can help soothe itching and reduce inflammation. Be gentle when applying compresses to avoid further skin irritation.

6. Emollients and Moisturizers

Using emollients and moisturizers can help keep your skin hydrated and prevent dryness and flakiness. It's best to choose fragrance-free products formulated for sensitive skin.

7. Antibiotics

If the rash becomes infected due to scratching or open sores, your healthcare provider may prescribe antibiotics to treat the infection.

8. Phototherapy

In some cases, ultraviolet (UV) light therapy, or phototherapy, may be recommended for stubborn or chronic contact dermatitis. This treatment involves exposing the affected skin to controlled doses of UV light under medical supervision.

Home Remedies for Contact Dermatitis

While medical treatment is essential for managing contact dermatitis, you can also try some home remedies to alleviate symptoms and promote healing:

  • Cool Compresses: Apply a cool, damp cloth to the affected area for 15-20 minutes to relieve itching and inflammation.
  • Oatmeal Baths: Taking a bath with colloidal oatmeal can help soothe itchy skin.
  • Avoid Scratching: As tricky as it may be, try to avoid scratching the rash, which can worsen symptoms and lead to skin damage.
  • Avoid Triggers: Avoid the substance or allergen that caused the dermatitis.
  • Keep Skin Moisturized: Use a fragrance-free moisturizer to hydrate your skin.
  • Cotton Clothing: Wear loose-fitting, breathable, and cotton clothing to reduce irritation.

🩺 A Doctor’s Note

You can manage mild to moderate dermatitis at home. Use over-the-counter hydrocortisone creams and establish a proper skincare routine. Explore dermatitis treatment options to discover the proper care for your needs and explore various remedies.

How Long Does Contact Dermatitis Last?

The duration of contact dermatitis can vary widely depending on its cause, severity, and how effectively it is managed.

In many cases, mild contact dermatitis may improve within a few days to weeks with proper treatment and avoidance of triggers. However, more severe or chronic cases may persist for several weeks or months.

Complications

Contact dermatitis, if not managed correctly or if you continue to be exposed to the irritant or allergen, can lead to complications, including:

  • Infection: Scratching the rash can break the skin and introduce bacteria, leading to a secondary skin infection.
  • Scarring: Repeated or severe contact dermatitis can potentially result in scarring or skin discoloration.
  • Hypopigmentation or Hyperpigmentation: Some individuals may notice changes in skin color (lighter or darker) in the affected areas after contact dermatitis has healed.
  • Chronic Dermatitis: Contact dermatitis may sometimes become a chronic condition requiring ongoing management and lifestyle adjustments.

When to See a Doctor

It's essential to consult a healthcare provider if you suspect you have contact dermatitis or if your symptoms are severe, persistent, or worsening. Seek medical attention if:

  • The rash covers a large area of your body.
  • Blisters or sores develop.
  • The rash becomes infected (signs of infection include increased redness, warmth, pain, swelling, or pus).
  • Home remedies and over-the-counter treatments do not provide relief.
  • You are unsure about the cause of your rash.

Prevention

Preventing contact dermatitis involves identifying and avoiding the substances or allergens that trigger the condition. Here are some practical steps to reduce risk:

  • Identify Allergens and Irritants: Pay attention to your surroundings and daily activities to identify potential allergens or irritants. Common triggers include certain skincare products, jewelry, cleaning agents, and plants.
  • Patch Testing: If you suspect a specific product or substance is causing your skin problems, consult a dermatologist for patch testing to identify allergens.
  • Use Protective Measures: When dealing with known irritants or allergens, wear protective clothing, gloves, and other barriers to prevent direct contact with your skin.
  • Choose Hypoallergenic Products: Opt for skincare and cosmetic products labeled as hypoallergenic and fragrance-free, as they are less likely to contain common allergens.
  • Read Labels: Review product labels for potential allergens or irritants. Look out for common ingredients like fragrances, preservatives, and known irritants.
  • Regular Handwashing: After contacting potential irritants, wash your hands thoroughly to reduce the risk of spreading the substance to other areas of your body.
  • Moisturize: Keep your skin well-moisturized to help maintain its natural barrier function. Use moisturizers that are suitable for sensitive skin.
  • Avoiding Poisonous Plants: Learn to recognize and avoid contact with poisonous plants like poison ivy, oak, and poison sumac when outdoors.
  • Protective Barriers: If you work in an occupation that exposes you to chemicals or irritants, use appropriate protective equipment, such as gloves or protective clothing.
  • Educate Yourself: Educate yourself about your environment's potential allergens or irritants and take proactive steps to minimize exposure.

Conclusion

Contact dermatitis is a common skin condition that can cause discomfort and distress. While it can be challenging to manage, identifying and avoiding the irritants or allergens that trigger contact dermatitis is crucial for prevention and treatment.

If you suspect contact dermatitis or severe or persistent symptoms, consult a healthcare provider or dermatologist for a proper diagnosis and personalized treatment plan.

With proper care and precautions, you can minimize the impact of contact dermatitis on your skin and overall well-being.

FAQs on Contact Dermatitis

What are the common symptoms of contact dermatitis on lips?

Contact dermatitis on the lips may present with redness, swelling, and itching. In severe cases, blistering or crusting may occur.

How can I identify eyelid contact dermatitis?

Red, itchy, and swollen eyelids characterize eyelid contact dermatitis. In some cases, the skin around the eyes may be flaking or peeling.

How does contact dermatitis go away?

Topical steroids and short-term oral or injectable corticosteroids in severe cases, are prescribed by dermatologists to alleviate itching and other symptoms. Prevention relies on identifying and avoiding the triggering irritant or allergen.

What does contact dermatitis look like?

It appears as a pink or red, itchy area. In severe cases, there may be raised blisters filled with clear fluid. Identifying and developing these rashes take time and don't occur with initial exposure.