What Are The Symptoms And Signs Of Contact Dermatitis
Distinguishing allergic contact dermatitis from irritant contact dermatitis and other forms of dermatitis can be challenging. A full history and physical examination are frequently necessary.
- A red rash is the usual reaction. It appears immediately in irritant contact dermatitis, but in allergic contact dermatitis, the rash does not appear for one to two days after the exposure.
- Your skin may develop small fluid filled structures that can cause weeping, a characteristic of these sorts of eruptions. This condition is distinguished from hives that produce short-lived itchy welts .
- Hives are most often induced by allergic reactions to orally ingested foods and drugs, but topical contact hives occurs and is mediated by antibodies.
- Your skin will itch and perhaps burn. Irritant contact dermatitis can be more painful than itchy.
- Irritant contact dermatitis often affects the hands, which have been exposed by resting in or dipping into a container containing the irritant.
- Once a reaction starts, it may take as long as four weeks to resolve completely.
In most cases, contact dermatitis does not require professional medical treatment.
Natural And Alternative Treatments
If youre experiencing contact dermatitis but dont want to use prescription or OTC medications, there are some alternative treatments that may be effective. These include:
- Coconut oil, which has been shown to limit the growth of harmful skin bacteria, also has strong moisturizing properties when applied topically. Use cautiously though, as there have been cases of allergic reactions caused by coconut
- Vitamin E applied topically, which can provide relief from both itching and inflammation.
- Honey, applied topically, has antibacterial and antiseptic properties.
You should stop any alternative treatment immediately if you have a negative reaction.
What Is Perioral Dermatitis
Perioral dermatitis is an inflammatory rash involving the skin around your mouth. The rash may spread up to your nose or even your eyes. In that case, its referred to as periorificial dermatitis.
Perioral dermatitis usually appears as a scaly or red bumpy rash. In darker skin, the lesions may be hyperpigmented or brown.
The bumps may contain fluid, so there may be a clear fluid discharge from the bumps. Slight itching and burning can also occur.
The condition is most common in women between 20 and 45 years old , but it can be seen in all ages, races, and ethnicities. It can occur in children of any age.
Episodes of perioral dermatitis can last weeks and even months. Perioral dermatitis is often chronic and relapsing, but it may resolve after the offending agents are removed.
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How Is Contact Dermatitis Managed Or Treated
Treatment for both types of contact dermatitis is the same. Even with treatment, it can take several weeks for the rash to go away. Treatments include:
- Avoidance: If you can figure out whats causing the rash, take steps to avoid it or minimize exposure.
- Anti-itch creams:Corticosteroid creams can ease inflammation and itching.
- Oral steroids: Prednisone, a type of steroid, can relieve rash symptoms that dont respond to antihistamines or other treatments.
- Immunosuppressive medications: In severe cases, where repeated bouts of oral steroids are needed.
Are There Home Remedies For Contact Dermatitis
- Avoid touching the trigger.
- Washing with soap and cool water can remove or inactivate most of the offending substance, if it is done immediately after exposure.
- If blistering develops, cold moist compresses applied for one to five minutes many times a day are helpful followed by air drying, perhaps supplemented with a fan.
- Oral antihistamines such as diphenhydramine can also relieve itching.
- Do not apply antihistamine lotions to the skin, because you may have an allergic contact dermatitis from the lotion itself.
- For mild cases that cover a relatively small area, over-the-counter 1% hydrocortisone cream may be sufficient.
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Use Cosmetics With Caution
Avoid using heavy cosmetics or skin creams. Ask the doctor or dermatologist which moisturizers are acceptable to use. Try switching brands if you decide to continue using cosmetics.
Switch to gentle cleansers and moisturizers. Ask your doctor or dermatologist for recommendations that would best suit your skin.
Can A Tolerance For A Certain Allergen Change Over Time
A persons ability to develop an allergic response is thought to be determined by genetic factors and the frequency and intensity of exposure to the allergen. The potency of the allergen is another critical factor. Generally, once a person develops an allergy, the sensitivity to that chemical is lifelong.
The integrity of the skin barrier is considered to be an important element in the sensitization process. Allergens, which are small molecules that can pass through most gloves, are more likely absorbed through damaged skin. In this way, people who have irritant contact dermatitis may be more likely to develop an allergy to substances that theyre exposed to .
Under those circumstances, it makes sense that people who develop allergic contact dermatitis based on a new allergy might mistake it for another kind of skin condition such as chronically dry skin, says Dr. Choate.
Symptoms Of Contact Dermatitis
In nearly all cases of contact dermatitis, a rash will develop after exposure to an allergen or irritant. This rash may appear red on lighter skin tones, while on darker skin tones, it may appear dark brown, purple, or gray.
In most cases of contact dermatitis, the rash will be discolored and itchy, and it may sting. If exposure to an irritant or allergen continues, the skin may harden.
Additionally, contact dermatitis may lead to:
will disappear after exposure to the substance has ended.
However, the rashes that contact dermatitis causes may take time to heal after the initial exposure ends. This will naturally take longer if irritants damage the skin.
As a result, people can treat and manage most cases of contact dermatitis by avoiding contact with known irritants.
Should the symptoms of contact dermatitis cause discomfort, a person may be able to treat them with home remedies or over-the-counter treatments, including:
- anti-itch ointments for the infected skin
- oatmeal baths, or similar
- antihistamine drugs
In severe cases, a person may need to see a dermatologist, an allergist, or another healthcare professional. They can prescribe ointment, creams, or prescription drugs to treat contact dermatitis.
Key Points About Contact Dermatitis
- Contact dermatitis is a physiological reaction that happens after skin comes in contact with certain substances.
- Skin irritants cause most contact dermatitis reactions.
- Allergens can cause an allergic reaction that results in contact dermatitis.
- It is important to identify the cause of your contact dermatitis so you can avoid contact with that substance.
- Topical and oral medicines may be recommended by your healthcare provider to relieve itching.
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Choice Of Topical Corticosteroid
Different strengths of topical corticosteroids can be prescribed, depending on the severity of your contact dermatitis and where the affected skin is.
You may be prescribed:
- a stronger cream for short-term use for severe contact dermatitis
- a weaker cream if the eczema is mild
- a weaker cream for use on your face, genitals or in the creases of your joints , as your skin is thinner in these areas
- a stronger cream to use on your palms and the soles of your feet, as the skin is thicker here
What Are Contact Dermatitis Risk Factors
Exposure to normal or damaged skin to irritating chemical or known allergens is a significant risk. Anyone who compulsively washes their hands many times a day can develop dermatitis induced by simple soap and water.
Common solvents used in the workplace can damage the skin, producing an irritant dermatitis and permitting allergens access to the deeper tissues. The practice of ear piercing is known to predispose to nickel allergy. The use of topical antibiotics like neomycin is associated with an allergy to this antibiotic.
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How Is Allergic Contact Dermatitis Treated
Allergic contact dermatitis is best treated by identifying and avoiding the allergen that you are sensitized to.
For symptom relief, applying a hydrocortisone cream and taking an antihistamine can help stop itching. Your doctor may prescribe topical steroids, and if the condition is widespread and more severe, it can be treated with systemic steroids such as Prednisone, which doctors will sometimes prescribe to ensure that the condition is fully treated. It can take a week to 10 days for the rash to resolve, but patients should experience relief from itchiness shortly after treatment begins.
Fully evaluating allergic contact dermatitis through patch testing, especially when its recurrent, can provide a patient with substantial quality of life improvements. According to Dr. Choate, The minute that you figure out what’s causing reactions, you can have patients modify their lifestyles and everything goes away. It’s really remarkable.
Who Gets Perioral Dermatitis
There are a number of risk factors for perioral dermatitis. For instance, almost all cases occur in young women, most commonly between the ages of 15 and 45 years. It is thought to affect up to 1 in 100 women at some point in their lives. Perioral dermatitis is uncommon in men and children. However, as the number of men using facial skin products increases, the number of men with perioral dermatitis is increasing.
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What Are The Triggers For Contact Dermatitis
There are many different triggers for contact dermatitis.
ICD may develop from everyday substances such as water, mechanical factors such as pressure or friction, and environmental changes such as extremes of temperature and humidity.
There are a large number of potential allergy-producing chemicals. Here we present the common ones that are problems for patients with atopic dermatitis:
What Medications Treat Contact Dermatitis
- Corticosteroids, either oral or topical depending on the severity of the reaction.
- A topical corticosteroid cream or ointment stronger than hydrocortisone may be prescribed to combat inflammation in a localized area. If the reaction covers a relatively large portion of the skin or is severe, a corticosteroid that is taken as pills or as an injection may be prescribed.
- If the reaction covers a relatively large portion of the skin or is severe, a corticosteroid that is taken as pills or as an injection may be prescribed.
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What Are The Complications Of Periorificial Dermatitis
- Granulomatous periorificial dermatitis a variant of periorificial dermatitis that presents with persistent yellowish papules.
- Occurs mainly in young children and nearly always follows the use of a corticosteroid.
- Granulomatous perifollicularinfiltrate on histopathology.
Childhood Granulomatous Perioral Dermatitis
CGPD is a rare variant often seen in children with dark-coloured skin. It was previously termed FACE . However, it has since been renamed as it has been observed in children with light-colour skin and those not of Afro-Caribbean heritage.
Patients present with skin-coloured, red or yellow-brown monomorphic, dome-shaped papules. There is typically a lack of pustules and vesicles in CGPD, and erythema and scaling are less prominent than in classic POD. Additionally, the histological features between CGPD and POD are different.
Extra-orificial skin can also be affected with an eruption on the neck, chest, and extremities, in addition to conjunctivitis and blepharitis.
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When To Contact Your Doctor About Contact Dermatitis
Spreads over a large part of your body
On your face or genitals
Not better after a couple of days
Oozing or infected
Affecting your eyes, nose, or lungs
Your doctor will take a look and ask you questions to help figure out what’s going on.
Depending on how severe it is, they may prescribe:
Steroid pills, creams, or ointment
Immunosuppressive medications for severe cases
Your doctor can do skin tests to determine what you are allergic to.
If you can’t avoid what’s bothering your skin, talk to your doctor about wearing gloves or using creams to keep it safe.
Who To See About Contact Dermatitis
If youre experiencing contact dermatitis for the first time and are struggling to make an appointment with a specialist, you can contact your primary care physician. They can usually start treatment.
A dermatologist can be helpful for recurring dermatitis. They can diagnose eczema and other types of dermatitis that could be affecting you. They can also run tests and prescribe the necessary medications.
If dermatitis is possibly caused by allergic reactions, you may be referred to an allergy specialist for allergy testing. This testing can help determine what youre allergic to so you can avoid the allergen in the future.
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How Is Contact Dermatitis Diagnosed
Clinical examination can reveal clues to the underlying diagnosis of irritant or allergic contact dermatitis. A careful history can uncover clues as to the offending agent.
With either type of contact dermatitis, you can avoid the substance for a while to see if the rash goes away. If avoidance is not possible or not sustainable, further diagnostic testing may be indicated.
For suspected cases of allergic contact dermatitis, a series of tests called patch testing can identify the underlying cause of allergic contact dermatitis.
With a patch test, you wear adhesive patches on your skin. The patches contain chemicals known to commonly trigger allergic reactions. After 48 hours, your healthcare provider checks your skin for reactions. Youll see your provider again in another 48-96 hours for one last skin check.
There isnt a test for irritant contact dermatitis. Your healthcare provider may be able to determine whats causing the rash based on the types of irritants or chemicals youre exposed to regularly.
What Are The Symptoms Of Contact Dermatitis
The following are the most common symptoms of contact dermatitis. However, each person may experience symptoms differently. Symptoms may include:
- Mild redness and swelling of the skin
- Blistering of the skin
- Scaly, thickened skin
The most severe reaction is at the contact site. The symptoms of contact dermatitis may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.
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Rapid Itch Improvements Achieved In Patients Taking Systemic Oral Medication In Phase 3 Trials
An oral medication called upadacitinib yielded rapid and significant improvements in patients with moderate to severe atopic dermatitis , also known as eczema, in phase 3 clinical trials, Mount Sinai researchers reported today in The Lancet online.
Patients who received upadacitinib, a Janus kinase inhibitor 1 , showed impressive reductions in all clinical disease measures, as well as in all itch-related outcomes. The results of these trials were so incredible that by week 16, most patients with moderate to severe atopic dermatitis either had a 90 percent disease clearance, or even 100 percent disease clearance, said Emma Guttman-Yassky, MD, PhD, Waldman Professor and System Chair of the Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, and first author of the paper.
We achieved extremely high clearance rates that are bringing us closer to the amazing clearance rates that we see in psoriasis, said Dr. Guttman-Yassky. Also, the itch improvements already started to be significant within days from the beginning of the trials, and the maximum clinical efficacy was obtained early, at week 4, and maintained to week 16. She also noted that upadacitinib was well tolerated by patients in the doses of the drug15 mg and 30mgand no important safety risks were observed.
To watch a video about the study and Dr. Guttman-Yasskys research
How Do You Get Rid Of Contact Dermatitis
Avoid scratching, which worsens the inflammation. Continue self-care until all symptoms are gone.
If you have been treated by your health care provider, complete the recommended treatment.
If you are taking oral steroid medication, finish the entire prescription, or the rash may come back. You may be taking medicine for only three to five days, or for as long as four weeks, depending on the severity of your reaction.
If you have frequent dermatitis, you may want to see a dermatologist to identify the cause.
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Is There A Way To Prevent Contact Dermatitis
If you know what causes the dermatitis, avoid that trigger. If you cannot avoid the trigger altogether, take steps to protect your skin from the trigger.
Wearing protective clothing such as long sleeves, long pants, and gloves helps protect the skin from allergens and irritants.
Protection is especially important at an industrial site, but it is also important when working outdoors where you could come in contact with plants from the poison ivy family as well as with lawn and garden chemicals, cleaning solvents, and other toxic substances.
Take care to avoid poison ivy, poison oak, and poison sumac when enjoying the outdoors.
If you do become exposed, wash the area immediately with soap and cool water to prevent a rash from developing.
If you have dermatitis often and you do not know what is causing it, you may want to see a skin allergy specialist.
- You will be asked questions to try to determine what may be causing the reactions.
- If the questions do not reveal the cause, skin patch tests may be applied to identify the trigger.
- You can then take steps to avoid the trigger. There is no treatment to “cure” the allergy so the allergen must be avoided in order to prevent symptoms.
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Are There Different Kinds Of Allergic Contact Dermatitis
There arent different kinds of allergic contact dermatitis, but there are many different allergens that can cause the condition. These allergens can be obvious, like poison ivy, or more subtle, like preservatives in personal care products, leather dyes or spandex.
Allergic contact dermatitis needs to be distinguished from irritant contact dermatitis, rashes that are usually caused by repeated exposure to soaps, detergents or industrial chemicals. People can have both irritant and allergic contact dermatitis. If you have atopic dermatitis , your skin is more sensitive and susceptible to irritant reactions from a variety of exposures.
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