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Contact dermatitis Causes and Risks:
Contact dermatitis is a skin inflammation that results when the skin comes in direct contact with substances that can cause an allergic or inflammatory reaction. Over-treatment dermatitis is a form of contact dermatitis that occurs when inflammation results from measures used to treat another skin disorder.
The sensitivity of the skin varies from individual to individual, and may vary in the same individual from time to time. A history of any type of allergies increases the risk of contact dermatitis.
The most common type of contact dermatitis involves inflammation that results from contact with substances that may be irritants. These include acids, alkaline materials such as soaps and detergents , solvents, and other chemicals. The reaction usually resembles a thermal (heat-caused) burn .
The second type involves exposure to a material to which the person has become hypersensitive or allergic. The skin inflammation varies from mild irritation and redness, to rash , to open sores, depending on the type of allergen , the body part affected, and the sensitivity of the individual.
Common allergens associated with contact dermatitis include: - poison ivy, poison oak, poison sumac
- other plants
- nickel or other metals
- antibiotics, especially those applied to the surface of the skin (topical antibiotics)
- rubber and latex
- cosmetics
- topical anesthetics or other medications that are applied to the surface of the skin
- detergents
- solvents
- adhesives
- fragrance, perfumes
- other chemicals and substances
Contact dermatitis may involve reaction to a substance that the person is exposed to or uses repeatedly. Although there may be no initial reaction, repeated use (for example, of nail polish remover, preservatives in contact lens solutions, or repeated contact with metals in earring posts and the metal backs of watches) can cause eventual sensitization and reaction to the product.
Some products cause reaction only when they contact the skin and are exposed to sunlight (photosensitivity). These include shaving lotions, sunscreens, sulfa ointments, some perfumes, coal tar products, oil from the skin of a lime, and others. A few airborne allergens, such as ragweed or insecticide spray, can cause contact dermatitis.
Contact dermatitis may result from occupational (work related) or recreational exposure to substances. With widespread precautions against HIV virus and other blood-borne pathogens, contact dermatitis caused by exposure to latex (found in surgical gloves, condoms , and similar products) is becoming more common.
Prevention:
Avoid contact with known allergens. Use protective gloves or other barriers if contact with substances is likely or unavoidable. Wash skin surfaces thoroughly after contact with substances. Avoid overtreating skin disorders.
Symptoms:
Signs and Tests:
The diagnosis is primarily based on the skin appearance and a history of exposure to an irritant or allergen .
Allergy testing with skin patches may isolate which of suspected allergens is causing the reaction.
Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion (see skin or mucosal biopsy culture ).
Treatment:
Initial treatment includes thorough washing with lots of water to remove any trace of the irritant that may remain on the skin. Further exposure to known irritants or allergens should be avoided. In some cases, the best treatment is to do nothing to the area.
Topical corticosteroid medications (see corticosteroids-topical-low potency; corticosteroids--topical--medium to very high potency) may reduce inflammation. Instructions should be carefully adhered to when using topical steroids as overuse of these medications, even low strength OTC topical steroids, may cause a skin condition also. In severe cases, systemic corticosteroids may be needed to reduce inflammation.
Wet dressings and soothing, antipruritic (anti-itch), or drying lotions may be recommended to reduce other symptoms.
Prognosis:
Contact dermatitis usually resolves without complications within 2 or 3 weeks, but may recur if the antigen cannot be identified or avoided. Change of occupation or occupational habits may be necessary if the disorder is caused by occupational exposure.
Complications:
- secondary bacterial skin infections
Call Your Healthcare Provider:
Call your health care provider if symptoms indicate contact dermatitis and symptoms persist longer that 2 or 3 days.
This is a typical appearance of a poison ivy rash. The early lesion consists of multiple small blisters (vesicles), often in a line where the skin has brushed against the poison ivy plant. The person then spreads the toxins to other areas of the body by scratching. (Courtesy of the Centers for Disease Control.)
Contact dermatitis is a skin condition caused by sensitivity to materials which are in contact with it. Many common materials are capable of producing contact dermatitis in sensitive individuals; this is contact dermatitis on the scalp. (Courtesy of the Centers for Disease Control.)
Poison oak rash on the arm. Several plants produce toxins that cause skin reaction. This is the appearance of poison oak dermatitis. Note the typical linear streaks produced either by scratching or brushing against the plant. (Courtesy of the Centers for Disease Control.)
Poison ivy rash on the arm: Poison ivy (Rhus toxicodendron) causes severe dermatitis in sensitive (allergic) individuals. Exposure is followed by the appearance of blisters (vesicles), often in lines or streaks where the individual has brushed the plant. Toxin on the skin can be spread to other areas by the fingers. It is not uncommon to find children with a swollen nose, eyes, and genitalia where they have spread the toxin to these areas while scratching, eating, rubbing their eyes, or using the bathroom.
Dermatitis, perioral - extensive: Dermatitis around the mouth (perioral) may be associated with irritation from specific foods or materials carried to the face on the hands. It is seen most commonly in young to middle age women and frequently no stimulus (cause) is found.
Dermatitis, contact on the chin: A skin condition caused by sensitivity to materials which are in contact with the skin. This particular rash was caused by sensitivity to Vitamin E. Many common materials are capable of producing contact dermatitis in sensitive individuals.
The metal, nickel, can cause inflammation (erythema), rash, and itching. Nickel dermatitis is relatively common, and can be seen on the wrist from the stainless backs of watches, on the earlobes from nickel plated earrings, or elsewhere on the body from snaps. This person was in contact with something made of nickel or containing nickel salts.
Poison ivy is a type of contact dermatitis. Oils in the leaves and vines of the poison ivy plant produce blistering, redness, and intense itching. The first contact with poison ivy may produce little or no symptoms, but the individual becomes sensitized. The next contact may produce a marked rash. Toxin can be spread around on the skin by scratching. Subsequently, individuals often develop rash at remote sites such as around the eyes or genitalia.
The poison ivy rash, shown here on the forearm, may begin as an area of blister formation accompanied by stinging or itching. The blisters often appear in thin lines where the person has brushed against the plant. The blisters then break and the skin drains a clear yellow fluid ("weeps") for a period of time (determined by how sensitized the individual is). Crusting occurs as the fluid dries. Healing takes place generally within 2 to 3 weeks.
Poison oak (Rhus diversiloba or R. toxicodendron) produces a contact dermatitis similar to poison ivy, but milder. Notice the facial rash where the child has rubbed his eyes. Linear streaks on the chest are where the toxin has been spread across the skin by scratching.
This is a close-up view of poison oak dermatitis. Crusting has occurred over some of the damaged areas.
This picture shows a skin inflammation (dermatitis) caused by contact with a material that causes an allergic reaction in this person. Contact dermatitis is a relatively common condition, and can be caused by many substances.
This is an example of an allergic skin reaction (allergic dermatitis) caused by hair dye. The skin on the neck is red (erythematous), thickened (lichenified), scaly, and crusted.
This picture shows a person with a skin inflammation (dermatitis) on the cheek caused by contact with a substance that produced an allergic reaction (allergen). Contact dermatitis causes redness, itching, and small blisters (vesicles).
The allergic skin reaction (contact dermatitis) on this person's ear was caused by hair dye. Contact dermatitis causes redness, crusting, and small blisters (vesicles).
This is a close-up of a dermatitis reaction. It consists of a large, red (erythematous) lesion (plaque) with numerous small pus-filled areas (pustules).
This is a typical early appearance of a poison ivy rash, located on the knee. These early lesions consist of multiple small blisters (vesicles), often in a line where the skin has brushed against the poison ivy plant. The person may then spread the toxin to other areas of the body by scratching.
This is a typical early appearance of a poison ivy rash, located on the leg. These early lesions consist of multiple small blisters (vesicles), often in a line where the skin has brushed against the poison ivy plant. The person may then spread the toxin to other areas of the body by scratching.
This person is sensitive to chemicals used in perfumes, and now develops a rash when the area is exposed to light (Phytophotodermatitis). These perfumes include Oil of Bergamot, an oil also found in some citrus fruits and wild plants. It results in streaky redness (erythema) and pigmentary changes.
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