Submitted by Doug Leone, MD and Adrienne Schupbach, MD, Dermatology and Mohs Surgery Institute
Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. Anyone can get contact dermatitis, but children tend to get it more than adults. Contact dermatitis can be tricky to diagnose because it doesn’t always look the same, the symptoms vary, it can appear right away or several days after initial exposure, and it can be long-lasting or very brief. There are two main types of contact dermatitis: irritant and allergic.
The most common type is irritant dermatitis in which chemicals or substances become toxic after they’ve regularly come into contact with your skin. These chemicals and substances most commonly include harsh soaps, cleaning products, cosmetics, deodorant, and latex. Other irritants include hair dyes, shampoos, pesticides, and cement. The severity of the reaction will depend on how long your skin has been exposed and how potent the irritant is. Irritant dermatitis is usually described as dry, red patches resembling a burn. There may also be bumps, tenderness, or itching.
Allergic contact dermatitis is caused by a substance that you’ve become extra sensitive or allergic to. Although you may not have a reaction to a substance when you are first exposed to it, using the substance regularly increases sensitivity. Common allergens include nickel (which is found in most metals and jewelry), perfume, and cosmetics. Some allergens are plants like poison ivy. Some products such as sunscreen or lotions cause a reaction only when the skin is also exposed to sunlight. Unlike irritant dermatitis, allergic dermatitis symptoms are delayed 24 to 48 hours after exposure. While symptoms may vary, there is usually an itchy rash that looks red and streaky. Bumps and blisters may form that ooze, drain, or crust.
If the inflammation isn’t severe or is in its early stages, you can care for this condition at home. First, identify what caused the inflammation, wash with soap and cool water to remove the substance, and, of course, take steps to avoid it. Over-the-counter products such as Benadryl, calamine lotion, hydrocortisone cream, and oatmeal baths can relieve itching. Emollients or moisturizers help keep the skin moist and also help skin repair itself. Avoid using any soap or lotion that has perfumes or dyes, and, of course, try to avoid itching!
If there is no improvement in two to three days, or if the symptoms are severe, then it is important to see a dermatologist. Contact dermatitis can turn into neurodermatitis or a bacterial infection. Neurodermatitis is a condition characterized by chronic itching and scaling, causing your affected skin to become discolored, thick, and leathery. The more you scratch, the more your skin oozes and creates an environment for bacteria or fungi to grow. A dermatologist can prescribe medication or administer a corticosteroid shot to help clear up the rash and relieve the itching.
Knowing which type of contact dermatitis you have is important because once you become allergic to a substance, you’ll always be allergic to it. A dermatologist may need to perform allergy testing (also known as patch tests) to see what you’re allergic to. Contact dermatitis usually clears up without complications in two to three weeks. However, it may return if the substance or material that caused it cannot be found or avoided.
Prevention obviously involves avoiding substances that you know irritate your skin. Wear gloves when you’re handling household cleaning products and long pants and socks if you will be tramping through the woods. It also helps to moisturize often. A dermatologist can advise you on steps to take to avoid letting contact dermatitis get out of hand.
For more information, you may contact the Dermatology and Mohs Surgery Institute at 309- 451-DERM (3376) or
www.dermatologistbloomington.com. Dr. Leone and Dr. Schupbach, both residents of Bloomington, are board-certified dermatologists, specializing in medical and cosmetic dermatology, including the treatment of skin cancer, moles, acne, rashes, warts, and all skin disorders. Dr. Leone is one of the few Mohs-trained surgeons in the area. Their practice is located at 3024 E. Empire St. 2nd floor, in the Advocate BroMenn outpatient center.