Contact dermatitis is a condition in which the skin becomes red and painful after direct contact with a substance. There are two types of contact dermatitis: irritant and allergic.
Causes
The most common type of contact dermatitis, irritant dermatitis, is caused by contact with acids, alkaline materials like soaps and detergents, fabric softeners, solvents, or other chemicals. The reaction is usually similar to a burn.
Other irritants can include:
- Prolonged exposure to wet diapers.
- Rubber gloves.
- Hair dyes.
- Pesticides or herbicides.
- Cement.
- Shampoos.
Symptoms
The symptoms vary depending on the cause and type of dermatitis. The same person may experience different symptoms over time. Allergic reactions can occur suddenly or only after months of exposure to a substance. Hands are a common area for contact dermatitis. Perfumes, cosmetics, and hair products often cause skin reactions on the face, head, and neck. Jewelry can also cause skin problems in the area below. Itching in the skin in exposed areas is a common symptom. With allergic dermatitis, itching can be severe. Dermatitis caused by an irritant can also cause pain or a burning sensation. Allergic dermatitis frequently causes a red, streaky, or patchy rash where the substance came into contact with the skin. The allergic reaction is often delayed, and the rash appears 24 to 48 hours after exposure.
The rash may:
- Feel hot and tender.
- Have red bumps that may form wet, oozing blisters.
- Oze, drain, or form scabs.
- Become scaly, raw, or thick.
Tests and Examinations
The diagnosis is mainly based on the appearance of the skin and the history of exposure to an irritant or allergen. Patch allergy tests (called patch testing) can determine which allergen is causing the reaction. Patch testing is used in certain patients with recurrent and chronic contact dermatitis. Itching in the skin in exposed areas is a common symptom. With allergic dermatitis, itching can be severe. Dermatitis caused by an irritant can also cause pain or a burning sensation.
Treatment
Treatment involves washing thoroughly with water to remove any trace of irritants on the skin. Future exposure to known irritants or allergens should be avoided. In some cases, the best treatment is to do nothing to the area. Plasticizers or moisturizers keep the skin hydrated and repair it, preventing the skin from becoming inflamed again, and are an essential part of preventing and treating contact dermatitis. Steroid creams or ointments can reduce inflammation. Follow the instructions carefully when using these creams, as overuse, including over-the-counter products with low concentrations, can cause skin conditions.
Prognosis
Contact dermatitis usually resolves after two or three weeks without complications, but it may reappear if the substance or material that caused it is not identified and avoided. A change in work or work habits may be required if the disorder is caused by occupational exposure.
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