Contact Dermatitis 101

February 20, 2019

Contact dermatitis covered hands

Have you experienced numerous unexplained rashes, hives, itching, or inflammation within the last year? Are you confused to find recurrent itching despite over-the-counter creams and antihistamines? Have you visited multiple doctors, been prescribed all kinds of topical ointments, and you’re still itching? You may have a common skin condition called contact dermatitis that is best treated by a dermatologist, like Dr. Rhea Phillips and the team at U.S. Dermatology Partners Dallas Presbyterian. Dr. Phillips says she often sees patients who are exposed to, “a constant number of new products, like detergents and lotions, that leave them with unexplained rashes, and it can often be difficult to isolate the cause.”

If you seem to be constantly struggling with non-specific irritation and rashes, it may be time to call and schedule an appointment with a dermatologist in your area. A dermatologist can help you identify the causes of contact dermatitis and provide treatment to cure the problem rather than just masking the symptoms until the next round of dry, itchy, flaky skin starts up. Keep reading to learn more.

What is Contact Dermatitis?

Simply put, contact dermatitis is a rash or skin irritation caused by contact with a specific substance. There are three separate forms of this common condition: allergic, irritant, and photoallergic contact dermatitis.

Allergic Contact Dermatitis

This condition occurs when the skin experiences an allergic reaction after exposure to a specific substance. When the skin is exposed to an allergen, inflammatory chemicals are released by the body that can lead to itching, inflammation, and irritation. Some of the common causes of allergic contact dermatitis include:

  • Jewelry made from specific metals that the skin is sensitive to
  • Latex gloves, bandages, and other products
  • Perfumes and cosmetics
  • Poison oak, ivy, sumac, etc.

Irritant Contact Dermatitis

This is the most common form of contact dermatitis. It occurs when the skin comes into contact with a toxic substance. Repeated contact with gentler substances like soap or even water can lead to irritant contact dermatitis in some situations. Some of the most common causes of irritant contact dermatitis include:

  • Bleach and other chemical cleaners
  • Detergents
  • Kerosene
  • Battery acid
  • Pepper spray

Photoallergic Contact Dermatitis

This is the rarest form of contact dermatitis. It occurs when active ingredients in skin products are exposed to the sun. In some instances, this leads to a chemical change in the ingredient that can irritate the skin, causing a photoallergic response.

How do I Know I Have Contact Dermatitis?

Many people mistakenly think that their skin’s allergic response is the result of a seasonal or environmental allergy, and they treat it as such. If contact dermatitis isn’t caused by a substance used on a regular basis, it can remain undiagnosed or be misdiagnosed for years. If you notice symptoms that may be indicative of contact dermatitis make sure to contact a dermatologist right away.

Irritant contact dermatitis symptoms are usually apparent, occur a short time after exposure, and are typically localized to just the exposed skin. Some of the common symptoms of irritant contact dermatitis include:

  • Blisters
  • Extreme dryness
  • Cracking skin
  • Inflammation and swelling
  • Tightening of skin
  • Open sores
  • Ulcerations

Allergic and photoallergic contact dermatitis symptoms are slightly different, and while they are likely to be most apparent where the allergen has direct contact with the skin, the symptoms can also spread, making it more difficult to pinpoint the specific cause of contact dermatitis. Some of the warning signs include:

  • Dry and flaky skin
  • Hives or rashes
  • Blisters and oozing
  • Redness or darkening of the skin
  • Burning or itching sensation
  • Sensitivity to sunlight
  • Swelling in the eyes, face, or groin

How is Contact Dermatitis Diagnosed?

The first step to determining whether or not you have contact dermatitis is a thorough screening from your dermatologist. Prior to your appointment, keep track of when you notice your skin is the most irritated, and be prepared to answer questions from your dermatologist like the following:

  • When did you first notice the skin irritation?
  • Have you had similar experiences in the past?
  • Does this happen often?
  • Are symptoms constant or sporadic?
  • Do you experience more or fewer symptoms during the week, weekend, when you’re away from home?
  • What has helped your symptoms in the past, and what has made them more pronounced?
  • Have you made any changes to your skin care or hygiene routine?
  • Do you have a career or hobby that involves regular use of products that make contact with your skin?

If your dermatologist determines that you are likely suffering from contact dermatitis, they may recommend a more advanced test to determine the specific cause. There are two main forms of testing for irritant, allergic, and photoallergic contact dermatitis – IgE blood testing and patch testing.

IgE Blood Testing

IgE blood testing is used to include or exclude specific allergens, including foods, weeds, pollens, mold, and animal dander. One of the reasons this test is often suggested for those with contact dermatitis is that it can be performed without the patient needing to forego any allergy medications that are being used to control the symptoms of contact dermatitis.

Allergy Patch Testing

Allergy patch testing is also an option. These tests have been used for decades to accurately diagnose allergens impacting those with contact dermatitis. Specifically, those with irritant contact dermatitis will likely need to receive a patch test as they are better suited to the diagnosis of sensitivities or allergies to irritants like chemicals and metals. Patch tests do require patients to forego the use of allergy medications prior to testing.

How is Contact Dermatitis Treated?

The first step after your contact dermatitis is diagnosed is to remove the allergens or irritants from your home and forego the use of products that contain these ingredients. Your dermatologist may also prescribe topical steroid creams and/or oral medications to relieve symptoms. Use these products as directed until instructed to discontinue use.

There are also many over the counter anti-itch ointments and oral allergy medications that can help relieve symptoms. If you’re experiencing severe itching, inflammation, or burning localized in one area, you may want to use ice packs or cold compresses to relieve this discomfort. Soaking in a cool bath with an oatmeal-based bath product or baking soda can also help to relieve itching and inflammation. While it can be a real struggle, it’s important to avoid scratching the irritated skin. This can spread hives and rashes and can cause open sores that put you at risk for infection.

When Should I Contact a Dermatologist?

You should contact a dermatologist if you experience frequent bouts of skin irritation and hives, or you feel like no medications or at-home remedies you’ve tried are working. In many cases, your general physician will refer you to a dermatologist if you have chronic contact dermatitis, so make you sure you take these referrals seriously. If you live in the DFW Metro Area, Dr. Phillips and the U.S. Dermatology Partners Dallas Presbyterian team would love to help you with all of your skin care needs. You can also complete our simple online request form to find a U.S. Dermatology Partners location near you.

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