Medical Services

Contact Dermatitis

You’ve noticed a red, itchy area on your skin, and you wonder if you should be concerned. Chances are, you have contact dermatitis, which is usually easily treated and healed. Learn the symptoms of contact dermatitis and some of the more common remedies.

What is Contact Dermatitis?

Simply put, contact dermatitis happens when something that touches your skin causes a rash. Technically, dermatitis is a type of eczema, although most dermatologists will use the terms interchangeably. There are two main types of contact dermatitis: irritant contact dermatitis and allergic contact dermatitis. The most prevalent contact dermatitis is irritant contact dermatitis, which occurs when your skin’s outer layer is damaged. It can occur with a single exposure to an irritant or after a prolonged exposure. Some common triggers of irritant contact dermatitis are plants, bleach, solvents, shampoos, rubbing alcohol, and airborne substances like sawdust. Prolonged exposure to moisture or water can also irritate your skin, causing commonplace dermatitis reactions like diaper rashes or dry and cracked skin. Allergic contact dermatitis arises when a substance that your skin is sensitive to provokes an immune reaction on your skin. The American Academy of Dermatology describes allergic contact dermatitis as one of the most common reasons people visit a dermatologist. Frequently, the dermatologist will discover that the allergic reaction was caused by one of these substances: nickel (found in jewelry), poison ivy, cosmetics, medications, personal care products, and products that create a reaction from sun exposure (photoallergic contact dermatitis). Contact dermatitis is often caused by substances you come into contact with at work, a type of dermatitis often called occupational contact dermatitis. Occupations that have a greater risk of causing contact dermatitis are cosmetologists, auto mechanics, cleaners, cooks, construction workers, healthcare workers, gardeners, and agricultural workers.

Contact Dermatitis symptoms

Irritant contact dermatitis can start with dry, cracked hands. In time, the skin on the hands will start to sting and become much more sensitive. Eventually, the skin can start to itch and bleed. The American Academy of Dermatology distinguishes the symptoms of a mild irritant from a more serious irritant. Over time, a mild irritant will gradually create these symptoms, moving from milder symptoms to more intense ones as exposure to the irritant continues: dry chapped skin; itchy, red and swollen skin; cracked and scaly skin; sores and blisters that can ooze and then crust over. Allergic contact dermatitis’ symptoms will usually develop a while after the skin has had contact with the irritant; anywhere from a few hours to a few weeks (longer if it is the first time your skin has been exposed to the substance that you are allergic to). The symptoms include a rash that may be hot to the touch, itchy skin, burning or stinging, fluid-filled blisters that might ooze or crust, hives, and skin that eventually might turn scaly or leathery.

When to seek medical attention

Frequently, contact dermatitis will go away on its own in a short amount of time. However, there are some situations when you should seek the care of a board-certified dermatologist. Seek medical attention if your rash comes on suddenly, covers a lot of your body or is painful. Even if it’s not painful, an uncomfortable rash that distracts you from your daily activities or your sleep is cause to make an appointment with a dermatologist. You should also see a dermatologist if your rash doesn’t go away in 3 weeks, is on your face or genitals, or causes you embarrassment. The Mayo Clinic advises to get immediate medical help in these situations: your skin is infected, which is characterized by pus and/or a fever; your lungs, eyes or nasal tract are inflamed; or you suspect that the mucous lining of your mouth or digestive tract is damaged.

Investigate the cause

The first step in treating your dermatitis is to figure out what is triggering it. This might take some detective work. If you seek medical attention, your dermatologist will examine the rash, talk to you about other symptoms and investigate your daily activities to see what substance might have triggered the dermatitis. Your dermatologist might also perform a patch test to determine if you are having an allergic reaction. In a patch test, small amounts of a variety of common triggering substances (allergens) are put on adhesive patches. You will wear the patches for a few days and then return to the doctor, who will examine the skin under the patches to see if your skin has reacted.

At-home treatments

The best and first thing to do to treat contact dermatitis is to avoid the substance that is irritating your skin. When you’ve done that, you might still have a rash that needs some attention. If your rash is not severe enough to warrant a visit to a dermatologist, you can do some things to help ease the irritated skin. You can apply an anti-itch cream, such as one that has at least 1% hydrocortisone, a steroid cream, or calamine lotion. Rubbing moisturizer on the irritated skin might also provide some relief, especially if your symptoms include dry, flaking, or cracked skin. Another step you can take is to use an oral corticosteroid or antihistamine. Cool, wet compresses and baths with oatmeal or baking soda can help to relieve itching and burning.

Medical treatment

A dermatologist will be able to provide contact dermatitis treatment for more severe rashes and/or ones that don’t go away or recur. Your dermatologist may prescribe prednisone, a steroid that will help with swelling or a rash that covers a large part of your body. A dermatologist can also prescribe steroid creams and oral or injections of corticosteroids and antihistamines. If your skin has become infected, you will probably need to take antibiotics. Some dermatologists will use light therapy (also called phototherapy) to help calm the immune system.

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