Contact Dermatitis

Click Here for Downloadable PDF File

Your doctor has determined that you have contact dermatitis, a skin irritation caused by direct contact with a particular substance. Symptoms vary and may include redness or a rash, itching, heat, swelling or pain. Sometimes the skin may blister, crack or peel after the initial irritation.

About the Condition

The skin is the largest organ of the body. Its top layer is the epidermis, which provides protection against the environment. The second layer of the skin is the dermis, which supplies blood, oxygen, strength and support. Underneath the dermis is the hypodermis, or subcutaneous fat layer, which provides an ongoing blood supply to the dermis.

Contact dermatitis occurs when the skin reacts to direct contact with a triggering substance. There are two main types of contact dermatitis: allergic and irritant. Allergic contact dermatitis indicates an overreaction of the body's immune system to a normally harmless substance. Common causes of allergic contact dermatitis include:

•  Plants such as poison ivy, poison oak, ragweed and primrose
•  Metals such as nickel, which is used in many items including jewelry, belt buckles and kitchen utensils
•  Fragrances and preservatives found in cosmetics, soap, lotions, perfumes, deodorants, scented tissues and hair dyes, straighteners and removers
•  Nail polish, nail polish remover and other nail care products
•  Latex rubber, which is used in many items including waistbands, bras, sneakers and shoe soles, rubber gloves, bandages, balloons and hot water bottles 
•  Tanning agents used for leather products
•  Certain medications such as antihistamine and antibiotic skin creams

Irritant contact dermatitis, which occurs when the skin comes in contact with an irritating, harsh or dangerous substance, accounts for about 80% of contact dermatitis cases. The longer the substance stays on the skin, the more severe the reaction becomes. Common causes of irritant contact dermatitis include industrial cleaning products, solvents, drain cleaners, turpentine, dishwashing and other detergents, soaps and household cleaners.

Sometimes contact dermatitis happens after a person touches a substance then exposes that area of skin to sunlight, which is called photoallergic contact dermatitis. Contact with the substance by itself and sun exposure without the presence of the substance do not cause a reaction. It only occurs as a combination of the two factors. Common causes of photoallergic contact dermatitis include sunscreens, cosmetics, aftershaves and perfumes, antibiotics, coal tar and oils.

Treatment Options

Contact dermatitis can be treated in a variety of ways, but treatment is generally not effective until there is no further contact with the triggering substance. Then it may take up to four weeks for the irritated area to return to normal. The following treatment possibilities are available:

Soothing Therapies Cool cloth or gauze compresses soaked in water or aluminum acetate (Burow's solution) can be applied for up to an hour several times a day to help ease the symptoms of contact dermatitis. Other soothing therapy choices include calamine lotion (not containing diphenhydramine) and cool tub baths with added bath oil or colloidal oatmeal.

Oral Antihistamines Over-the-counter (OTC) or prescription oral antihistamines may be recommended to help relieve itching. Antihistamine creams, however, are not recommended for treating contact dermatitis.

Corticosteroids An OTC hydrocortisone or prescription-strength corticosteroid cream may be used to treat contact dermatitis. For severe cases, an oral corticosteroid pill or corticosteroid injection may be prescribed.

Antibiotics When an infection develops at the site of contact dermatitis, antibiotics may be prescribed to treat the infection.

In addition, the liberal use of emollient moisturizers is recommended to protect the skin as it recovers from a bout of contact dermatitis.

What You Can Do

Steps you can take to further reduce symptoms and prevent future occurrences of contact dermatitis include:

•  Avoiding scratching if you have a skin reaction
•  Finishing your recommended treatment program and all prescription medications
•  Avoiding all substances that trigger your contact dermatitis
•  Washing the skin immediately with soap and cool water if exposed to a triggering substance
•  Using sunscreens that do not contain PABA
•  Wearing gloves and long sleeves and pants if you are working outdoors
•  Using fragrance-free products when possible
•  Covering objects containing nickel with clear nail polish or a special spray and wearing earrings that have surgical steel posts
•  Using a barrier cream to block the action of certain substances, such as poison ivy

Additional Resources

American Academy of Dermatology, 888.462.3376, http://www.aad.org/
Asthma and Allergy Foundation of America, 202.466.7643, http://www.aafa.org/

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 9.07