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Contact Dermatitis Causes and Treatment

Contact Dermatitis

What is contact dermatitis?

Contact dermatitis is a condition where the skin becomes sore, red, itchy, or swollen after contact with an irritant or allergen. These reactions are not life-threatening or contagious, but they may be uncomfortable or embarrassing. Contact dermatitis is very common. However, it is also very difficult to diagnose because reactions are usually delayed, making it harder to determine their cause.

Symptoms of Contact Dermatitis

Symptoms of contact dermatitis will usually occur on the areas of your skin that were directly exposed to the offending substance – under your watchband or where you touched the poison ivy, for example. However, some reactions do not follow this trend. One example: you use sunscreen on your whole body, but only your face may react. Also, if the offending substance is an oral medication, food, flavoring, etc., your reaction site may be less predictable.

It is important to note that reactions can occur immediately, after several hours or days, or only after years of exposure. Also, different types of contact dermatitis and different contact allergens and irritants will cause different types of symptoms.

Some possible symptoms:

  • Itching, sometimes severe
  • Tenderness, burning, or pain
  • Rash that may be warm, tender, oozing, crusty, scaly, raw, thickened, red, streaky, patchy, bumpy, and/or itchy
  • Red, dry, rough skin
  • Blisters that may weep or crust over
  • Skin rash on only the area that was exposed to the irritant or allergen
  • Redness that resembles a burn

Types

Irritant contact dermatitis is the result of damage to your epidermis (the skin's protective outer layer) by a chemical or substance. The severity of the reaction is determined by how long you were exposed and how strong or concentrated the substance is. Irritant contact dermatitis is the most common type of contact dermatitis. This is not an allergy - it is just an irritant.

Allergic contact dermatitis is when an allergen causes an immune reaction on your skin. You can be sensitized to a stronger allergen (like poison oak or poison ivy) after only one exposure. A weaker allergen may require several exposures over months or years before it will trigger an allergy. Unfortunately, once you have developed an allergy to a particular substance, you will probably be allergic to it for the rest of your life. Allergy testing by one of our allergy and asthma specialists may help identify what your allergies are. The NYC allergists at New York Allergy and Sinus Centers are experts in diagnosing what is causing your allergic reaction. Unfortunately, the only allergy cure is to avoid contact with these allergens.

Photoallergic contact dermatitis is a kind of allergic contact dermatitis where the reaction only occurs after your skin is exposed to sunlight. One example: you put on sunscreen and you are fine, but when you go out in the sun, you experience a reaction. This allergic reaction is much more difficult to diagnose.

Examples of Possible Irritants and Allergens:

  • Household cleaning products, detergents, soaps
  • Medicines applied to the skin: antibiotics, anti-inflammatory drugs (NSAIDS), antiseptics, antihistamines, etc.
  • Personal care products like soap, cosmetics, perfume, deodorant, sunscreen
  • Metal found in jewelry, zippers, watchbands, curling irons, eyelash curlers, coins, bra hooks
  • Plants (poison oak or poison ivy, for example)
  • Natural rubber or latex
  • Substances you are exposed to at work (chemicals, dyes, fuels, oils, cleaning agents, solvents, wet cement, cement dust, paper dust, sawdust)
  • Acids and bases
  • Wet diapers (long-term exposure)
  • Weed killers or pesticides
  • Poison Ivy

Allergy Testing

Allergy patch testing is the primary type of allergy testing recommended for patients with potential allergic contact dermatitis. It is usually performed by a NY allergist in office or by an NYC doctor that is a skin care specialist. In this type of allergy test, small amounts of potential allergens/irritants are applied to patches that are (carefully) taped onto your skin, usually on your back. You return to the NY doctor a couple of days later and the patches are removed. The allergist will then evaluate your back to look for raised bumps, rashes, blisters, etc. that may have developed on your skin. These reactions indicate what allergies may be causing your allergic contact dermatitis. After this second visit, your NYC doctor may ask you to come back the next day or a couple of days later to check for any delayed reactions. Remember that while the patches are on your back, you cannot get them wet and should minimize activities that cause you to sweat. Our NYC allergy clinic will delay allergy testing until cooler weather, if possible.

Treatment

The first thing you should do if you suspect you have allergy or irritant contact dermatitis is to wash your skin with soap and water – gently but thoroughly – to remove any traces of the allergen or irritant that may still be there. You should also try and wash any surfaces (like the dog, the table, etc.) that may also be contaminated. If you know or suspect what caused your reaction and can then avoid that offending substance, symptoms usually resolve in 2-4 weeks. In the meantime, you may want to try some of these measures to soothe your skin and reduce inflammation:

  • Avoid scratching.
  • Wear smooth-textured, loose, breathable clothing.
  • Take a comfortably cool bath.
  • Use lotion or moisturizer to keep the skin moist and help it repair itself.
  • Use cool compresses (moist washcloths) on affected areas of your skin.
  • Use only mild soaps and detergents. Consider stopping the use of nonessential personal care products, at least temporarily, in case they are responsible for your reaction.
  • Use an over-the-counter (OTC) anti-itch cream or calamine lotion.

If the symptoms do not resolve in a reasonable amount of time, your NYC allergy doctor may suggest the following:

  • Use of oral corticosteroids or antihistamines.
  • Use of corticosteroid skin creams or ointments.

These allergy medications will generally accelerate the healing process and help you feel better, faster.

If you are experiencing contact dermatitis, the specialists and associates at the New York Allergy & Sinus Centers want to help. We have access to the latest testing and treatments, and we have convenient allergy & asthma clinics throughout NYC: Murray Hill, Midtown, Upper West Side, Chelsea, and Queens.  We have adult and pediatric patients from around New York City, including Manhattan, Brooklyn, Staten Island, Queens, and the Bronx.  Call NYASC at 212-686-4448 for more information.

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