St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Contact dermatitis

    Dermatitis - contact; Allergic dermatitis; Dermatitis - allergic

    Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after directcontact with a substance. There are two kinds of contact dermatitis: irritant or allergic.

    See also: Poison ivy - oak - sumac

    Causes

    Irritant dermatitis is the most common type. It's caused by contact with acids, alkaline materials such as soaps and detergents, fabric softeners, solvents, or other chemicals. The reaction usuallylooks likea burn.

    Other irritants may include:

    • Cement
    • Hair dyes
    • Long-term exposure to wet diapers
    • Pesticides or weed killers
    • Rubber gloves
    • Shampoos

    Allergic contact dermatitis is caused by exposure to a substance or material to which you have become extra sensitive or allergic.

    Common allergens include:

    • Adhesives, including those used for false eyelashes or toupees
    • Antibiotics such as neomycin rubbed on the surface of the skin
    • Balsam of Peru (used in many personal products and cosmetics, as well as in many foods and drinks)
    • Fabrics and clothing
    • Fragrances in perfumes, cosmetics, soaps, and moisturizers
    • Nail polish, hair dyes, and permanent wave solutions
    • Nickel or other metals (found in jewelry, watch straps, metal zips, bra hooks, buttons, pocketknives, lipstick holders, and powder compacts)
    • Poison ivy, poison oak, poison sumac, and other plants
    • Rubber or latex gloves or shoes

    Although you may not have a reaction to a substance when you are first exposed to it, regular use can eventually cause sensitivity and a reaction to the product.

    Some products cause a reaction only when the skin is also exposed to sunlight (photosensitivity). These include shaving lotions, sunscreens, sulfa ointments, some perfumes, coal tar products, and oil from the skin of a lime. A few airborne allergens, such as ragweed or insecticide spray, can cause contact dermatitis.

    Symptoms

    Symptoms vary depending on the cause and whether the dermatitis is due to an allergic reaction or an irritant. The same person may also have different symptoms over time.

    Allergic reactions may occur suddenly, oronly after months of being exposed to a substance.

    The hands are a common site for contact dermatitis. Hair products, cosmetics, and perfumes often lead to skin reactions on the face, head, and neck. Jewelry can also cause skin problems in the area under it.

    Itching of the skin in exposed areas is a common symptom. In the case of an allergic dermatitis,itching can be severe.Dermatitis caused by an irritant may also cause burning or pain.

    Allergic dermatitis often causes a red, streaky, or patchy rash where the substance touched the skin.The allergic reaction is often delayed, with the rash appearing 24 - 48 hours after exposure. The rash may:

    • Have red bumps that may form moist, weeping blisters
    • Feel warm and tender
    • Ooze, drain, or crust
    • Become scaly, raw, or thickened

    Irritant dermatitis often shows as dry, red, and rough skin. Cuts (fissures) may form on the hands. Skin may become inflamed with long-term exposure.

    Exams and Tests

    The diagnosis ismostly based on the skin appearance and a history of exposure to an irritant or an allergen.

    Allergy testing with skin patches (called patch testing)maydetermine which allergen is causing the reaction. Patch testing is used for certain patients who have long-term, repeated contact dermatitis. It requires three office visits and must be done by ahealth care providerwiththe experience and skill to interpret the results correctly.

    • On the first visit, small patches ofpossible allergens are applied to the skin. These patches are removed 48 hours later to see if a reaction has occurred.
    • A third visitabout 2 days later is done to look for any delayed reaction.
    • If youhave already testeda material on a small area of your skin and noticed a reaction, you should bring the material with you.

    Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion (see skin or mucosal biopsy culture).

    Treatment

    Treatment includes washing with lots of water to remove any traces of the irritant that may remain on the skin. You should avoid further exposure to known irritants or allergens.

    In some cases, the best treatment is to do nothing to the area.

    Emollients or moisturizers help keep the skin moist, and also help skin repair itself. They protect the skin from becoming inflamed again. They are a key part of preventing and treating contact dermatitis.

    Corticosteroid skin creams or ointments may reduce inflammation. Carefully follow the instructions when using these creams. Overuse, even of low-strength over-the-counter products, may cause a skin condition.

    Along with, or instead of corticosteroids, your health care provider may prescribe drugs called tacrolimus ointment or pimecrolimus cream to use on the skin.

    In severe cases, corticosteroid pills may be needed. You will start them on a high dose, which istapered gradually over about 12 days. You may also receive a corticosteroid shot.

    Wet dressings and soothing anti-itch (antipruritic) or drying lotions may be recommended to reduce other symptoms.

    Outlook (Prognosis)

    Contact dermatitis usually clears up without complications in 2 or 3 weeks. However, it may return if the substance or material that caused it cannot befound or avoided.

    You may need to change your job or job habits if the disorder is caused by occupational exposure.

    Possible Complications

    Bacterial skin infections may occur.

    When to Contact a Medical Professional

    Call your health care provider if:

    • You havesymptomsof contact dermatitis
    • It is severe
    • There is no improvement after treatment

    References

    Usatine RP, Riojas M. Diagnosis and management of contact dermatitis. Am Fam Physician. 2010; 82:249-255.

    Gober MD, DeCapite TJ, Gaspari AA. Contact dermatitis. In: Adkinson NF Jr, ed. Middleton’s Allergy: Principles and Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 63.

    Habif TP. Contact dermatitis and patch testing. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 4.

    BACK TO TOP

    • Poison oak rash on the a...

      illustration

    • Latex allergy

      illustration

    • Poison plants

      illustration

    • Dermatitis, nickel on th...

      illustration

    • Dermatitis, contact

      illustration

    • Dermatitis, close-up of ...

      illustration

    • Dermatitis, contact on t...

      illustration

    • Dermatitis, pustular con...

      illustration

    • Poison ivy on the knee

      illustration

    • Poison ivy on the leg

      illustration

    • Phytophotodermatitis on ...

      illustration

      • Poison oak rash on the a...

        illustration

      • Latex allergy

        illustration

      • Poison plants

        illustration

      • Dermatitis, nickel on th...

        illustration

      • Dermatitis, contact

        illustration

      • Dermatitis, close-up of ...

        illustration

      • Dermatitis, contact on t...

        illustration

      • Dermatitis, pustular con...

        illustration

      • Poison ivy on the knee

        illustration

      • Poison ivy on the leg

        illustration

      • Phytophotodermatitis on ...

        illustration

      A Closer Look

        Talking to your MD

          Self Care

          Tests for Contact dermatitis

            Review Date: 11/21/2011

            Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
            adam.com

            A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


            Back  |  Top
            About Us
            Contact Us
            History
            Mission
            Locations & Directions
            Quality Reports
            Annual Reports
            Honors & Awards
            Community Health Needs
            Assessment

            Newsroom
            Services
            Brain & Spine
            Cancer
            Heart
            Maternity
            Orthopedics
            Pulmonary
            Sleep Medicine
            Urgent Care
            Women's Services
            All Services
            Patients & Visitors
            Locations & Directions
            Find a Physician
            Tour St. Luke's
            Patient & Visitor Information
            Contact Us
            Payment Options
            Financial Assistance
            Send a Card
            Mammogram Appointments
            Health Tools
            My Personal Health
            mystlukes
            Spirit of Women
            Health Information & Tools
            Clinical Trials
            Health Risk Assessments
            Employer Programs -
            Passport to Wellness

            Classes & Events
            Classes & Events
            Spirit of Women
            Donate & Volunteer
            Giving Opportunities
            Volunteer
            Physicians & Employees
            For Physicians
            Remote Access
            Medical Residency Information
            Pharmacy Residency Information
            Physician CPOE Training
            Careers
            Careers
            St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
            Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile