Unpleasant rashes and burning sensations? Contact dermatitis might be the culprit. Discover common triggers, effective remedies, and expert tips to soothe your skin and prevent future flare-ups
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Contact Dermatitis: Symptoms, Factors & Treatments
Reading time : 7 min
How to understand and treat contact dermatitis?
Contact dermatitis is an inflammation of the skin caused by direct contact with a particular substance. Discover common triggers, effective remedies, and expert tips to soothe your skin.
What is contact dermatitis?
Contact dermatitis is a rash on your skin which happens in contact with a substance that triggers an allergic reaction.
There are two main types of contact dermatitis:
Irritant contact dermatitis is the more common type. It is caused by direct contact with various substances that irritate the skin and cause inflammation. Redness, edema, small pimples or red patches may appear after the skin has been into contact with the substance within 24 hours to 72 hours.
In some cases, the reaction may take longer to appear and only manifests itself after several weeks or months of repeated contact with the substance responsible for the dermatitis.
Other symptoms may also appear, such as skin thickening, cracking, dryness and scaling.
The skin rash is limited to the area of contact with the substance. Irritant contact dermatitis generally diminishes in intensity within 1- or 2-days post-reaction.
Allergic contact dermatitis is caused by direct contact with allergens. Specific immune cells are involved and sensitized to a substance. These cells become activated each time the skin meets the substance, causing a cutaneous reaction.
Allergic contact dermatitis includes two phases:
Sensitization to an antigen: asymptomatic phase which can be brief (6 to 10 days) or prolonged (several years), depending on the sensitizers involved. Many allergens can cause contact dermatitis. Symptoms range from erythema, desquamation and edema to vesiculation or severe swelling with bullae. Lesions often appear as linear striations on a leg or arm, or as circumferential erythema under a watch or belt. Allergic contact dermatitis usually takes more than a day after exposure to become visible and worsens over time.
Allergic reaction after re-exposure
Contact dermatitis shows up on skin that has been directly exposed to the substance causing the reaction. The skin can be red to purple, swollen with small clusters or oozing fluid or pus.
It can take several weeks for contact dermatitis to go away when it is treated. The symptoms will decrease day after day though you still have a visible rash
Contact dermatitis is common as irritants and potential allergens are numerous. People with sensitive skin are more likely to develop contact dermatitis.
Contact dermatitis is related to eczema as it affects people with allergies. The difference between both is that eczema occurs in people with allergies but not related to touching a specific substance whereas contact dermatitis occurs in people when they touch something that their skin reacts to.
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What causes contact dermatitis?
Contact dermatitis is always caused by physical contact with an allergen or irritant. A wide variety of chemicals are responsible for contact dermatitis. Particularly common in certain professions, contact dermatitis is largely under-detected, but it is estimated that 2-10% of the population1 is affected by this inflammation of the skin.
It is assumed that people suffering from contact dermatitis have an unfavorable allergic background.
Irritant contact dermatitis is created by a substance that causes irritation on the skin, breaking down its protective barrier.
Irritant contact dermatitis is mainly caused by:
Soaps
Detergents
Chemical products
Creams
Diapers
Contact dermatitis is not contagious, the body reaction is triggered by the substance and not everyone reacts the same way.
Animals can trigger allergic reactions from the flakes of dander that come from their skin. Allergic reactions often appear when in contact with animals like cats and dogs.
Contact dermatitis can spread to other parts of the body depending on what is responsible for the skin reaction.
It is often the case for allergic contact dermatitis when you touch an allergen and then touch other parts of your body. If the rash spreads to other parts of your body, you need to contact a healthcare provider to get proper treatment. Indeed, contact dermatitis can lead to an infection if not treated properly.
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What are the risk factors of contact dermatitis?
Contact dermatitis is common in people whose professions involve daily use of chemicals like mechanics, healthcare workers, hairdressers...
Other factors like contact with some plants, metals or medications can cause contact dermatitis.
Other factors like frequent handwashing, dry climate or stress can be risk factors for contact dermatitis
How to diagnose contact dermatitis?
Contact dermatitis is most often diagnosed based on skin lesions and exposure history but may also require skin testing.
Physical exam: the appearance of the lesions, their location, and their evolution according to season or period of activity, can guide the diagnosis towards the type of product responsible for dermatitis. The patient's profession, hobbies, domestic occupations, recent travels, topical medications and cosmetics must be considered in the clinical assessment.
Patch test: when history fails to identify the cause of the reaction, patch tests can be used. Patch tests are indicated when allergic contact dermatitis is suspected but is not responsive to treatment, suggesting the trigger has not been identified.
Patch tests are easy to use and can detect 36 of the most common allergens.
The test involves applying standard contact allergens to the upper back using adhesive strips. After 48 hours, the skin's reaction can be assessed, and the allergens responsible for allergic skin reactions identified. This test may require up to 3 consecutive visits to an allergist or dermatologist.
However, patch testing only detects half of the clinically significant contact allergens.
How to get rid of contact dermatitis?
The key to relieving the symptoms of contact dermatitis is identifying and avoiding the substance responsible for the rash. If the person is exposed to the substance, the dermatitis does not go away. Redness and itching usually disappear from the skin 1 to 3 weeks after the last exposure.
Supportive care and topical or oral treatments are available to relieve the effects of contact dermatitis, such as itching. Preventive measures can also be taken to limit contact dermatitis.
What to use for contact dermatitis?
There is no cure for contact dermatitis but to relieve the symptoms and heal the skin you can use different types of medication.
Topical treatments consist of cortisone-based creams and are often prescribed to treat dermatitis and relieve itching.
Supportive care includes:
Cool compresses cold water to help reduce itching and burning
Moist dry bandages to soak oozing bubbles, dry the skin and promote healing
Antihistamines for pruritus
In the most severe cases of contact dermatitis, oral treatment with cortisone may be necessary.
If itching does not improve, if there is swelling of the skin with or without blistering, and if there are signs of infection, you should consult your healthcare professional as soon as possible
How to prevent contact dermatitis?
You can prevent contact dermatitis by:
Avoiding known allergens
Choose fragrance-free moisturizers and cleansers
Adopt a good skin care routine to prevent flare-ups
Washing your hands, skin and clothes immediately after coming into contact with a known allergen
Atopic disorders increase the risk of irritant contact dermatitis, as the skin's barrier function is impaired.
Healing of contact dermatitis can take up to 3 weeks after stopping exposure to the substance responsible for the rash. It is essential to identify triggering factors and to avoid them for life.
If you experience the symptoms described for contact dermatitis, it's important to consult your healthcare professional. Only he can make a diagnosis and identify the agents responsible for your skin reactions.
Without a diagnosis, it's impossible to determine the factors triggering your skin reactions, and to provide an effective solution and treatment.
In the case of irritant contact dermatitis linked to your profession and caused by one or more skin irritants, you may need to consider changing jobs if preventing measures like wearing gloves or protective clothes are not sufficient.
Difficult to live with, contact dermatitis is a skin condition that can have a major impact on your daily life. Intense itching can have a serious impact on sleep and quality of life. Visible plaques and lesions can affect social relationships and the way others look at you.
