Do you experience intense itching, pain or a burning sensation on your skin after using a certain product, wearing jewellery or spritzing perfume? Have these symptoms increased over time, too? This may indicate contact dermatitis, also known as eczema, contact urticaria or atopic dermatitis. Get to know the symptoms, causes and types of contact dermatitis, as well as how to treat and manage this condition.
What is Contact Dermatitis?
Contact dermatitis is a skin condition that occurs when the skin comes into contact with an irritating substance or allergen. It is characterised by an itchy rash on the skin that can result in blisters or sores that ooze or crust over.
Contact dermatitis can appear anywhere on the surface of the body and may affect only a small part, like your finger, or it can cover large areas. The parts most commonly affected are the hands (including the fingers), neck, face (especially around the eyes) and feet.
People with contact dermatitis can suffer mild reactions or severe inflammation, which makes it difficult for them to carry out day-to-day activities.
What are the Symptoms of Contact Dermatitis?
In contact dermatitis, symptoms usually develop within 48 hours of exposure to a foreign substance. The skin condition may be accompanied by a number of symptoms, including:
- Scaly skin
- Oozing blisters that crust
- Pain that vary from case to case
The symptoms may become more intense after further contact with the allergen. This is a feature of contact dermatitis known as 'reactivity'. Even brief exposure to an allergen may lead to a flare-up of symptoms. Once contact with the allergen is stopped there will be a period of time before symptoms subside. This period is known as 'de-sensitization' and it may take several weeks or months for the skin to recover.
What Causes Contact Dermatitis?
Contact dermatitis can be caused by contact with any one of thousands of substances, including detergents, metals, plants, cosmetics, jewellery, dishwashing liquids and rubber products. Other common allergens include fragrances, personal care products, household cleaners, latex gloves, preservatives and rubber accelerators.
About 20% of contact dermatitis cases in adults involve contact with nickel. Nickel is found in the following:
- Mobile phones
- Metal clothing zippers and rivets
In some cases, contact dermatitis can result from contact with both a primary irritant and a secondary allergen. For example, contact with bleach may initially damage the skin but around 10% will develop contact dermatitis when they later contact nickel. It is also possible for contact dermatitis to be caused by a contact allergy.
What are Different Types of Contact Dermatitis?
There are several forms of dermatitis, each triggered by a different causative substance or group of potential allergens. Among the most common are:
Irritant contact dermatitis
This is the most common type of contact dermatitis that occurs when the skin comes into contact with irritating chemicals such as harsh soaps, metals, cosmetics products, jewellery, dishwashing liquids and rubber products.
Irritant contact dermatitis does not cause symptoms until the skin is exposed to water. This means symptoms, such as oozing itchy skin, usually appear or worsen when you wash or bathe, or in humid conditions like a shower. Although frequent handwashing is recommended to keep pathogens at bay, it is unfortunately the reason for irritant contact dermatitis.
Allergic contact dermatitis
Also known as contact eczema and allergic contact urticaria, this inflammatory reaction is triggered when the skin is exposed to a foreign substance. It does not matter whether the offending substance penetrated the skin or was simply worn over it. So long as it comes into contact with the skin, it will cause a skin reaction.
Sensitization contact dermatitis
This type of skin problem occurs when you first contact a substance and there is no reaction. But after repeated contact (even several days or months later), your skin becomes sensitised. You then react to further contact with the allergen. The symptoms of sensitisation contact dermatitis are usually confined to areas where there has been contact with the allergen such as on the hands and face.
It is common for people who suffer from this type of contact dermatitis to have persistent rashes around their eyes after using perfumed cosmetic products. This type of contact dermatitis usually stops once you have stopped contact with the allergen.
The least common form of contact dermatitis that occurs when plants, especially poisonous ones, such as poison ivy and poison sumac, release chemicals onto the skin and then it is exposed to sunlight. It may result in severe reactions such as large blisters; however they won't itch and will eventually go away.
How is Contact Dermatitis Diagnosed?
Due to the complexity of contact dermatitis symptoms, doctors may have difficulty determining whether your skin rash is an irritant contact dermatitis, an allergic dermatitis, or another type of condition. Diagnostic procedures usually include taking the patient's history of contact with certain substances or performing a skin biopsy. Patients with contact dermatitis are often referred to a skin specialist to determine the cause.
An allergy specialist or a dermatologist usually performs patch testing, where they expose a small area of the skin to an allergen. Your skin's reaction to it will tell you if you have food allergies, nickel allergies, cosmetic allergies or whatnot, and also determine the treatment you need.
Treatment, Prevention and Management of Contact Dermatitis
There is no single treatment that works for all contact dermatitis. Depending on the severity of the condition, your doctor may recommend using mild soap, topical corticosteroids or antibiotic cream. Symptoms usually disappear after a few days or weeks.
To prevent contact dermatitis, it is important to avoid coming into contact with agents known to cause it. However, a TCM practitioner may also advise you to strengthen your immune system, as this is your best defense against any type of contact allergy.