Contact dermatitis, as its name implies, is an inflammatory skin response triggered by direct contact with irritants or allergens present in the environment. However, it cannot occur without exposure to these substances. It’s important to note that not everyone exposed to these agents will develop contact dermatitis. Genetic factors play a significant role in determining an individual’s susceptibility to this condition and the extent of their reaction to the irritants or allergens.
Types
Contact dermatitis encompasses three main types: irritant contact dermatitis, allergic contact dermatitis, and photo contact dermatitis.
1. Irritant contact dermatitis is the most common form, often triggered by contact with acidic or alkaline substances like detergents, soaps, and cleaning materials, as well as chemicals. It resembles a skin burn and can be caused by various irritants such as cement, hair dyes, prolonged exposure to wet diapers, pesticides or weed killers, rubber gloves, and certain shampoos.
2. Allergic contact dermatitis occurs when the skin reacts to a substance it is intolerant or sensitive to. Initially, the skin may not react upon first exposure, but with repeated exposure, the skin’s immunity weakens, leading to a reaction. Common allergens include perfumes, poison ivy, nail enamels, adhesives, certain fabrics, and metals.
3. Photo contact dermatitis occurs when a substance applied to or in contact with the skin causes a reaction only upon subsequent exposure to sunlight. Common allergens in this type include certain shaving creams, ragweed, insecticide sprays, and specific sulfa ointments.
Symptoms
The primary symptom of Contact Dermatitis is typically redness in the affected skin area, often accompanied by itching of varying severity depending on the type of dermatitis. In certain instances, small red boils and similar skin eruptions may develop. Hands are particularly prone to contact dermatitis. Additional symptoms include rashes, bumps, blisters, weeping wounds, severe crusting, and dry, cracked skin resembling a burn. Allergic reactions may occur suddenly or develop gradually over months of repeated exposure to the triggering substance.
When to visit the doctor
If skin irritation significantly interferes with your daily activities and sleep, it’s advisable to consult a doctor. Contact dermatitis typically resolves within two to three weeks. However, if the triggering substance remains unidentified or unavoidable, the skin reaction may recur or take longer to heal, necessitating a doctor’s intervention. If a rash or skin irritation persists for more than a few days and becomes increasingly painful, professional treatment is important.
Diagnosis
Physicians typically recommend a skin patch test to identify the cause of a skin reaction. Following a detailed discussion to pinpoint when the reaction began, the patch test is conducted. This test involves three clinic visits where small amounts of allergens/irritants are applied to the skin and removed after 48 hours for examination of any reactions. On the third day, the skin is checked for delayed reactions. Once the exact allergen/irritant is identified, complete avoidance is necessary.
Treatment
Once a rash or skin irritation is detected, it’s crucial to maintain cleanliness and avoid contact with fingernails (to prevent itching) and unclean surfaces at all costs. The affected area should solely be cleansed with clean, cool water.
Various approaches exist for managing contact dermatitis:
1. Emollients: These substances aid in moisturizing and softening the skin. Given that contact dermatitis can cause skin dryness and cracking, emollients serve a dual purpose. They form a protective moisture barrier on the skin’s surface, keeping it soft and shielding it from direct contact with irritants. The choice of emollient depends on the nature of the skin eruption. For instance, for oozing wounds, a less oily emollient such as a low-grease lotion may be recommended. Occasionally, your doctor may prescribe a combination of different types of emollients based on the severity and location of the contact dermatitis.
2. Topical Corticosteroids (for severe symptoms): If the affected area exhibits redness and inflammation, your physician may prescribe corticosteroids. These medications swiftly reduce inflammation and offer much-needed relief. Topical corticosteroids should be applied to the affected area for optimal results.
3. Oral Corticosteroids (for widespread severe symptoms): In cases where the affected area is extensive and/or severe, corticosteroid tablets may be prescribed. However, prolonged use of these tablets can have adverse effects, so it’s essential to adhere to the prescribed dosage carefully.
Contact dermatitis affects a significant number of individuals because it’s often unavoidable unless the triggering substance is known from the outset. However, by recognizing common irritants, one can be more vigilant in case of accidental exposure and seek treatment promptly.