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Best treatments for Contact Dermatitis

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Written by Andrew Le, MD.
Medically reviewed by
Clinical Physician Assistant, Summit Health
Last updated June 19, 2024

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Introduction

Have you ever experienced a red, itchy, or blistering rash after coming into contact with a certain substance? If so, you may have had contact dermatitis, a common skin condition that affects millions of Americans each year.

Contact dermatitis occurs when the skin becomes inflamed or irritated after exposure to a particular substance, such as a chemical, metal, or plant.

In this article, we'll explore what contact dermatitis is, common home remedies and over-the-counter treatments, when it's time to see a doctor, and most importantly, how you can prevent future flare-ups.

What is Contact Dermatitis?

Contact dermatitis is a skin reaction that occurs when your skin comes into contact with a substance. That substance either irritates the skin or triggers an allergic response. There are two main types of contact dermatitis: irritant and allergic.

Irritant contact dermatitis is the most common type, accounting for about 80% of cases.43 It happens when a substance damages the outer layer of your skin, causing inflammation and discomfort.

Common culprits include harsh soaps, detergents, solvents, acids, and even excessive exposure to water.37,38 The reaction usually occurs quickly after exposure and can range from mild redness to severe cracking and blistering, depending on the substance and length of contact.43

Allergic contact dermatitis is an allergic reaction to a specific substance, known as an allergen. This type of reaction is usually delayed, appearing 12 to 72 hours after exposure.45

Common allergens that can trigger allergic contact dermatitis include:

  • Nickel, a metal found in many jewelry, buttons, and zippers
  • Fragrances and preservatives in personal care products and cosmetics
  • Plants like poison ivy, poison oak, and mango skin
  • Latex rubber
  • Certain medications applied to the skin43,44

Symptoms of Contact Dermatitis

Both types of contact dermatitis can cause similar symptoms, including:

  • Redness and inflammation
  • Itching and burning
  • Swelling and tenderness
  • Dry, cracked, or scaly skin
  • Blisters that may ooze fluid and crust over27,28

The rash usually appears at the site of contact but can spread to other parts of the body in some cases.31 Symptoms can range from mild and be isolated to the affected area, to severe and be widespread.

Risk factors for Contact Dermatitis

Certain factors can increase your risk of developing contact dermatitis, including:

  • Being exposed at the workplace to irritants or allergens (e.g., healthcare workers, hairdressers, mechanics, cleaners)36,37
  • Having a personal or family history of eczema, asthma, or allergies36,43
  • Living in a hot, humid, or polluted environment that can compromise your skin barrier36,40

Home Remedies for Contact Dermatitis

If you have mild contact dermatitis, you may find relief with some home remedies. Here are a few methods for soothing your skin and promoting healing:

Cool compresses: Applying a cool, damp cloth to the affected area can help reduce inflammation, itching, and discomfort.14,15 You can also try soaking in a lukewarm bath with a handful of baking soda or oatmeal sprinkled in. This may help relieve itching and soften inflamed skin.16,18

Moisturizing: Keeping your skin well-hydrated helps repair its protective barrier and prevents further irritation. Look for a gentle, fragrance-free moisturizer and apply it generously to the affected area throughout the day. Ingredients like glycerin, ceramides, and hyaluronic acid can help lock in moisture and soothe dry, cracked skin.

Colloidal oatmeal: This finely ground oatmeal has anti-inflammatory and soothing properties that can help calm irritated skin. You can find colloidal oatmeal in many OTC lotions and bath products or make your own by grinding plain oats into a fine powder.

Aloe vera: Known for its cooling and healing properties, aloe vera gel may help soothe contact dermatitis symptoms. Studies suggest that aloe vera has anti-inflammatory effects and can help skin heal.19,20 However, it's important to do a patch test first, as some people can develop allergic reactions to aloe. Look for pure aloe vera gel without added fragrances or preservatives.

Over-the-Counter Treatments for Contact Dermatitis

There are several OTC treatments that can help reduce inflammation, itching, and discomfort of mild to moderate cases of contact dermatitis.

Hydrocortisone cream: This topical steroid works by suppressing the inflammatory response in your skin. This helps reduce redness, swelling, and itching.1,3 OTC hydrocortisone creams come in strengths of 0.5% to 1% and can be applied up to 4 times daily. It’s important not to use them for more than a week or two without consulting a doctor. Using them over the long term can lead to skin thinning and other side effects.2,4

Oral antihistamines: If you have allergic contact dermatitis, taking an OTC antihistamine like diphenhydramine (Benadryl) or loratadine (Claritin) can help relieve itching and inflammation by blocking the effects of histamine in your body.5 Be sure to choose a non-drowsy antihistamine during the day. If you have frequent allergic reactions, your doctor may recommend a prescription antihistamine for long-term management.9

Skin protectants: Products like calamine lotion and petroleum jelly can help soothe and protect irritated skin by forming a barrier on the surface.7,8 Calamine lotion contains zinc oxide, which has cooling and astringent properties that can help dry out blisters and ease itching. Petroleum jelly, on the other hand, helps lock in moisture and prevent irritation from external factors like friction or harsh soaps.

Look for products that are fragrance-free, hypoallergenic, and specifically designed for sensitive skin. It's also a good idea to do a patch test on a small area of skin before applying any new product to the affected area, just to make sure you don't have an adverse reaction.

When to See a Doctor for Contact Dermatitis

If you have contact dermatitis, there are times when it's important to see a healthcare provider. Here are some signs that it's time to make an appointment with your doctor or dermatologist:

Severe or widespread rash: If your rash covers a large area of your body, is extremely painful or itchy, or you have other symptoms like fever or swollen lymph nodes, see a doctor right away.21,22 These could be signs of a more serious allergic reaction or infection that requires immediate treatment.

Rash that doesn't improve: Your rash persists or worsens despite using home remedies and OTC treatments for a week or two.21,22 Your doctor can assess the severity of your condition and recommend stronger treatments if needed, such as prescription-strength corticosteroids or immunosuppressants.16,23

Recurring rash: You get frequent or recurring bouts of contact dermatitis. You doctor can help you identify if you’re having an allergic reaction and develop a personalized prevention plan to avoid flare-ups.30

Uncertainty about the cause: If you're not sure what's causing your rash, a doctor can help you pinpoint the cause. They may do diagnostic tests like patch testing or a skin biopsy.32,33 During patch testing, small amounts of potential allergens are applied to the skin, usually on the back, and left in place for 48 hours. The skin is then examined for signs of an allergic reaction. This is especially important if you suspect your rash may be related to a workplace exposure or a new medication.34,35

Signs of infection: If your rash is accompanied by symptoms like pus, warmth, swelling, or red streaks spreading from the affected area, it's important to seek medical care right away.29 These could be signs of a bacterial skin infection that requires antibiotic treatment if the rash becomes infected.29

Preventing Contact Dermatitis

Prevention is the best approach when it comes to managing contact dermatitis. By identifying and avoiding the substances that trigger your skin reactions, you can significantly reduce your outbreaks. Here are some effective strategies for preventing contact dermatitis:

Identify your triggers: Pay close attention to the products, materials, and environments that seem to cause your skin to react.37,38 Common culprits include soaps, detergents, fragrances, jewelry, and certain plants. Keep a diary of your exposures and reactions to help pinpoint the offending substances.

Avoid known irritants and allergens: Take steps to minimize your contact with your triggers. This may involve switching to gentler skincare products, wearing gloves when handling irritants, or steering clear of certain plants or metals.

Protect your skin: When working with potential irritants or allergens, create a barrier between your skin and the substance by wearing protective clothing, such as gloves, long sleeves, and pants.38,40 If you have sensitive skin, consider using a barrier cream or moisturizer to provide an extra layer of protection.

Practice good skin hygiene: Regularly washing your skin with mild soap and lukewarm water can help remove irritants and allergens before they have a chance to cause a reaction.38,42 Be sure to rinse thoroughly and gently pat your skin dry. Avoid harsh scrubbing or using hot water, as this can irritate your skin.

Moisturize regularly: Keeping your skin well-hydrated helps maintain its protective barrier function.36,38 Choose a fragrance-free, hypoallergenic moisturizer and apply it liberally, especially after bathing or washing your hands. Look for products containing ingredients like glycerin, ceramides, and hyaluronic acid, which can help lock in moisture.

Test new products before use: Before using a new skincare product, perform a patch test on a small area of skin to check for any potential reactions.47 Apply a small amount of the product to your inner forearm or behind your ear, and wait 24 to 48 hours to see if any redness, itching, or irritation develops.

Manage environmental factors: Certain environmental conditions, such as extreme temperatures, low humidity, and exposure to airborne irritants like dust or pollen, can exacerbate contact dermatitis.36,40 Try to maintain a comfortable environment by using a humidifier, keeping your home clean and dust-free, and protecting your skin from harsh weather conditions.

Be proactive in the workplace: If you work in an occupation that involves frequent exposure to potential irritants or allergens, take steps to minimize your risk of developing occupational contact dermatitis.36,37 This may include wearing appropriate protective gear, following proper safety protocols, and advocating for the use of less hazardous substances when possible.

Conclusion

Whether you're dealing with irritant or allergic contact dermatitis, the first step is to identify and avoid the triggering substance. This may require some detective work and lifestyle changes, but it will help prevent future flare-ups. Home remedies like cool compresses, colloidal oatmeal baths, and moisturizing can help soothe irritated skin and promote healing.

OTC treatments like hydrocortisone creams and oral antihistamines can provide relief. However, it's important to use these products as directed and consult a healthcare provider if symptoms worsen or do not improve.

In some cases, prescription-strength medications or other interventions may be necessary to manage contact dermatitis effectively.

Ultimately, the key to managing contact dermatitis is prevention. By taking steps to protect your skin, avoiding known triggers, and maintaining a healthy skin barrier, you can reduce your risk of developing contact dermatitis.

Citations:

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Clinical Physician Assistant, Summit Health
Jeff brings to Buoy 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medicine....
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