Causes and Treatments of Contact Dermatitis
Skin Allergies or Contact dermatitis is caused by direct contact with an irritating substance. This causes an inflammation of the skin. There are different factors in the environment that can produce allergic reactions on the skin. Some allergic reactions are brief, self-limiting and non threatening, others can create complications that may need immediate medical attention.
Skin Allergy or Skin Rash are generic terms that are commonly used to referred to Allergic Dermatitis or Contact Dermatitis. Common references also include Skin Rash; Itchy skin; Poison ivy; Poison oak; Poison sumac. A skin rash may be caused by factors that are external or internal. To determine the underlying cause of the rash on your skin, you’ll need to see a dermatologist. Other “rashes” my include hives, shingles, eczema, contact dermatitis, ringworm, psoriasis and impetigo.
What are the most common causes of Skin Allergies and Dermatitis
When the skin gets in contact with an irritant or allergy-causing substance, it gets inflamed. This inflammation of the skin is called contact dermatitis. Reactions vary from patient to patient over time. In some OC patients, a history of any type of allergies increases the risk for Contact dermatitis.
Irritant dermatitis which is the most common type of contact dermatitis causes inflammation of the skin that is the result of direct contact with acids, alkaline materials such as soaps and detergents, solvents, or other chemicals. The inflammation and skin reaction often times resembles a burn.
Allergic contact dermatitis, the second most common type of contact dermatitis,is caused when the skin is exposed to a material or substance to which you have become extra sensitive or allergic. The allergic reaction often does not appear right after exposure with the rash appearing 24-48 hours contact. The skin inflammation varies depending on the type of irritant, the affected body part and how sensitive your skin. Skin reaction may vary from mild irritation to open sores.
Over-treatment dermatitis is another form of contact dermatitis that occurs the skin irritation is caused by treatment for another skin disorder.
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Common contact allergy-causing substances include:
- Poison ivy, poison oak, poison sumac
- Other plants
- Nickel or other metals ( These are often found in fashion earrings, snaps, metal buttons and zippers)
- Antibiotics, especially those applied to the surface of the skin (topical)
- Topical anesthetics
- Other medications
- Fabrics and clothing
- Fragrances, perfumes
- Other chemicals and substances
Contact dermatitis may occur when your body reacts to a substance that you use often or that you were exposed to. Although in many cases there may be no instant reaction, the regular use of the substance (for example, preservatives in contact lens solutions, nail polish remover, or repeated contact with metals in earring posts and the metal backs of watches) can eventually cause an allergic reaction.
Some products can cause allergic reactions only when exposed to sunlight (photosensitivity) or when they are in contact with the skin. These products include sunscreens, perfumes, shaving lotions, the oil from the skin of a lime or coal tar products. Contact Dermatitis can also be caused by a few airborne allergens including insecticide spray or ragweed.
- Itching of the skin in exposed areas
- Skin redness or inflammation in the exposed area
- Tenderness of the skin in the exposed area
- Localized swelling of the skin
- Warmth of the exposed area (may occur)
- Skin lesion or rash at the site of exposure
- Lesions of any type: redness, rash, papules (pimple-like), blisters
- May involve oozing, draining, or crusting
- May become scaly, raw, or thickened
How is the cause of my skin rash determined?
The diagnosis is primarily based on the skin appearance and a history of exposure to an irritant or an allergen.
According to the American Academy of Allergy, Asthma, and Immunology, “Patch testing is the gold standard for contact allergen identification. ” Allergy testing with skin patches may isolate the suspected allergen that is causing the reaction.
Skin Patch testing is used for Orange County patients who have chronic, recurring contact dermatitis. It requires three office visits and must be done by a clinician with detailed experience in the procedures and interpretation of results. A dermatologist is a skin specialist and qualified to diagnose and treat contact allergies.
On the first visit, small patches of potential allergens are applied to the skin. These patches are removed 48 hours later to see if a reaction has occurred. A third visit approximately 2 days later is to evaluate for any delayed reaction. You should bring suspected materials with you, especially if you have already tested those materials on a small area of your skin and noticed a reaction.
Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion
What treatments can be used for a skin rash?
Initial treatment includes thorough washing with lots of water to remove any trace of the irritant that may remain on the skin. Orange County patients are advised to avoid further exposure to known irritants or allergens. In some cases, the ideal treatment is to do nothing to the area.
Corticosteroid skin creams or ointments may reduce inflammation. Carefully follow the instructions when using these creams, because overuse, even of low-strength over-the-counter products, may cause a troublesome skin condition. In severe cases, systemic corticosteroids may be needed to reduce inflammation. These are usually tapered gradually over about 12 days to prevent recurrence of the rash. In addition to or instead of corticosteroid skin treatment, your doctor may prescribe other RX creams.
Wet dressings and soothing anti-itch or drying lotions such as calamine or products containing Benadryl-type ingredients may be recommended to reduce other symptoms
How long do most cases last?
Contact dermatitis usually clears up without complications within 2 or 3 weeks, but may return if the substance or material that caused it cannot be identified or avoided. A change of occupation or occupational habits may be necessary if the disorder is caused by occupational exposure.
What are the possible complications?
Secondary bacterial skin infections may occur. Scarring from persistent scratching may occur. Small children cannot be told, “don’t scratch” so they should be treated to stop the symptoms. Some itching associated with childhood – and adult- dermatitis that the Orange County patient will scratch until the skin bleeds, opening up the higher likelihood of a bacterial infection.
When should I call my dermatologist?
Call your dermatologist if symptoms indicate contact dermatitis and it is severe or there is no improvement of mild cases after home treatment. In most cases Dr. Sikorski can immediately identify the cause and prescribe a treatment for your skin rash.
How do I prevent the occurrence of skin allergies?
Avoid contact with known allergens. Use protective gloves or other barriers if contact with substances is likely or unavoidable. Wash skin surfaces thoroughly after contact with substances. Avoid overtreating skin disorders.
Things to avoid if you or family members have skin allergy issues:
- Laundry detergents with color or fragrance.
- Fabric softeners and dryer sheets with fragrance
- Commercial cleaning products – Try instead “green” products
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We look forward to meeting with you and helping you find the simplest solution to achieve the goals you desire. If you believe you are experiencing contact dermatitis symptoms, contact Dr. Sikorski to schedule a consultation at her office in the Orange County area. Call (949) 448-0487.
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