Contact Dermatitis

by Jennifer Hellwig, MS, RD

Definition

Contact dermatitis is inflammation of the outer layers of the skin. It happens after contact with something that the body is irritated by. It will cause a rash in the place the substance touched.

Contact Dermatitis

Causes

Contact dermatitis is most often caused by something that irritates the skin or causes an allergic reaction. It may be something that was often around but never caused problems before. Some common causes of contact dermatitis are:

Acids
Alkalis—such as bleach or oven cleaner
Solvents—can be found in dry cleaning, nail polish remover
Acetone—can be found in electronics, makeup, medicine, textiles
Soaps
Detergents
Metals, such as nickel—common in jewelry allergy
Rubber
Latex
Make up, creams, lotions, aftershave
Deodorants
Sunlight or artificial light
Preservatives
Plants, such as poison ivy
Medicine

Risk Factors

Things that may increase the risk of contact dermatitis are:

Jobs that have regular contact with problem substances
Outdoor activities such as hiking and gardening
Allergies to some things, such as plants, chemicals, or medicine

Symptoms

Symptoms may differ from person to person. The rash may have:

Itching
Redness
Swelling
Blisters
Crusting, leaking, and scaling
Skin feels thicker

Rash is often only in the place where the contact happened. Sometimes it may spread.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Contact dermatitis may be diagnosed based on the rash itself. The doctor may ask questions to see what may have caused the problem. The cause may not always be clear.

A patch test may be done to find out what is causing the problem. A small amount of a substance is applied to the skin and covered with tape. The patch is removed after a period of time. If your skin is red and swollen under the patch, the substance applied to the skin is probably causing the problem.

Treatment

It will take a few days to a couple weeks for the skin to clear. It is important to stay away from the substance that caused the problem. Steps to help the area while it heals include:

Skin Care

Damage to skin can lead to an infection. To keep the skin as healthy as possible:

Wash the area with water and mild soap. Pat dry gently, do not scrub.
Use petrolatum or petroleum jelly over the area. It can help seal the skin until it heals.
Do not poke at or cut open blisters.
Cover blisters with dry bandages.

Medications

Over-the-counter medicine may help to ease symptoms. Options include:

Creams and ointments with cortisone
Antihistamines—may relieve itching for some. Not always useful for contact dermatitis.

Prescription medicine may be recommended such as:

Creams or pills with corticosteroids
Immunosuppressants—for severe reactions, those that do not respond to other treatment, or that happen often

Phototherapy may also be used for severe reactions or those that keep coming back. It uses light to ease some inflammation.

Prevention

To prevent contact dermatitis:

Find out what substances are causing the problem. Try to avoid them.
Use gloves or protective clothing if you have to come into contact with the problem substance.
Use protective skin cream.
Take care of your skin. Use gentle cleansers and moisturizers.

RESOURCES:

American Academy of Allergy, Asthma & Immunology
http://www.aaaai.org

American Academy of Dermatology
https://www.aad.org

CANADIAN RESOURCES:

Canadian Dermatology Association
https://www.dermatology.ca

Health Canada
https://www.canada.ca

References:

Mowad CM, Anderson B, et al. Allergic contact dermatitis: Patient diagnosis and evaluation. J Am Acad Dermatol. 2016 Jun;74(6):1029-40

Contact dermatitis. EBSCO DynaMed website. Available at:
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Accessed January 29, 2021.

Contact dermatitis overview. American Academy of Allergy Asthma and Immunology (AAAAI) website. Available at: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/contact-dermatitis. Accessed January 29, 2021.

Last reviewed September 2020 by EBSCO Medical Review Board Shawna Grubb, RN
Last Updated: 1/29/2021

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