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Contact Dermatitis

What is contact dermatitis?

If you have a patch of red, itchy, swollen or bumpy skin, you may have contact dermatitis. “Dermatitis” is the medical term for a rash or inflammation of the skin. “Contact” means the rash was caused by touching something that irritates your skin. 

Contact dermatitis is common and can affect people of any age. Your risk of getting contact dermatitis is higher if you have certain skin conditions or sensitive skin. It can develop after one or multiple exposures and affect any part of your skin at any time. 

What are the symptoms of contact dermatitis?

If you have contact dermatitis, you may notice skin problems such as red, itchy skin, a rash or dry, cracked skin. It can be itchy and uncomfortable, disturb your sleep and make it difficult to focus at work or school. The rash might clear up in a few days if you avoid the irritant that caused it, or it may last longer if you keep in contact with whatever is bothering your skin. 

Contact dermatitis can look like other skin problems (such as some types of eczema that are caused by food or environmental allergies), but it is different because whatever is irritating you is actually touching your skin.

If you get contact dermatitis, it’s important to figure out what caused it so you can avoid touching whatever is causing your rash in the future. 

Types of contact dermatitis

There are three types of contact dermatitis: irritant contact dermatitis, allergic contact dermatitis and photo contact dermatitis.

Irritant contact dermatitis

This is the most common type of contact dermatitis. This condition occurs when a chemical touches the skin and causes irritation. It can also be caused by soap or hand sanitizer, especially if you wash your hands or use hand sanitizer often. That’s because frequent hand washing or hand sanitizer use can break down your skin’s natural barrier.

Health care providers, restaurant employees, bartenders, machinists, food handlers, hair stylists, florists, custodians, plumbers, mechanics, teachers and parents of young children often experience this type of dermatitis. It’s likely to appear on the hands and face, and it usually happens soon after exposure.

Irritant contact dermatitis can also be caused by chemicals such as:

  • Detergents and cleaning products
  • Paint, varnish, resin or epoxy
  • Hair dyes and nail products
  • Pepper spray
  • Bleach
  • Drain cleaner
  • Certain plants

With this type, you may notice:

  • Blisters
  • Skin cracking
  • Crusty sores
  • Skin that feels tight or swollen

Allergic contact dermatitis

In this type of contact dermatitis, your skin has an allergic reaction to something you touch. Poison ivy and poison oak are examples. When you touch poison ivy or oak, you can develop an itchy rash 24 to 48 hours (about two days) later.

Allergic contact dermatitis can happen anywhere your body comes into contact with something you’re allergic to, such as when the elastic on your socks causes a rash on your ankles or a necklace causes a rash on your neck.

Jewelry containing nickel or cobalt, latex gloves or other latex products, certain preservatives found in cosmetics and cleaning products (such as methylisothiazolinone or methylchloroisothiazolinone), antibiotics, perfumes and other everyday chemicals are common causes of allergic contact dermatitis.

With this type, you might experience: 

  • Hives
  • Blisters
  • Swelling
  • Sun sensitivity
  • Darkened or leathery skin

Some people that have skin sensitivity to nickel or cobalt may also need to be careful about eating certain foods that naturally contain higher amounts of these metals (such as some types of nuts, beans and chocolate). 

Photocontact dermatitis

Photocontact dermatitis is less common than irritant or allergic contact dermatitis. This skin reaction happens when the ingredients in a product applied to your skin causes irritation when it is exposed to the sun. For example, a splatter of lime juice on your hand that is not rinsed off, followed by sunlight on your hand, can create a photocontact dermatitis reaction. Photocontact dermatitis can also happen after using certain skincare products, such as retinols or exfoliating acids like alpha-hydroxy acids (AHAs).   

Is contact dermatitis contagious?

Contact dermatitis is not contagious, though you can sometimes pass the irritating substance along to someone else. For example, if you touch poison ivy and touch someone else without washing your hands, you could pass the poison ivy on to them. You could also spread it to other places on your own body by touching your skin. 

Treatment for contact dermatitis

In most cases, you can treat contact dermatitis at home. To ease the symptoms of your itchy skin and rash, try these tips:

  • Avoid scratching your skin, since that can worsen the irritation and may cause an infection
  • Stop using any products you think might be causing the rash 
  • Wash the affected area with water and a gentle soap, such as Cetaphil
  • Take a cool shower to ease burning and itching
  • Relax in an oatmeal bath (oatmeal contains anti-inflammatory and moisture-retaining properties)
  • Put a clean, cool, moist cloth on the affected area
  • Apply a topical steroid (such as an over-the-counter (OTC) 1% hydrocortisone cream) or calamine lotion
  • Taking an OTC antihistamine (allergy pill) may help calm your itchy, irritated skin
  • Avoid direct sunlight
  • Use simple moisturizers, such as Vaseline, on top of any medicated creams you may be using to help protect your skin as it heals

When to see a doctor

Determining if your rash is contact dermatitis or something else may be difficult. If you’ve tried these tips and your rash isn’t healing within couple of weeks, schedule an appointment with your health care provider or a dermatologist. You may need prescription medication such as a steroid to help heal your rash. 

You should also see a doctor if your rash:

  • Is close to your eyes or mouth
  • Spreads, swells or gets worse
  • Covers a large part of your body
  • Goes away and comes back
  • Seems infected
  • Begins to smell
  • Has blisters that open and develop a crust
  • Is accompanied by a fever

How is contact dermatitis diagnosed?

To diagnose contact dermatitis, your provider will take your medical history, check your skin and ask questions about when your symptoms started. They will also ask what home treatments you’ve tried, if you’ve spent time outdoors recently and what products or chemicals you have used.

If the cause of your rash isn’t clear, your provider may want you to see a dermatologist or allergist for patch testing to help uncover the cause. With this test, your skin is exposed to a small amount of common allergens to see if you have a reaction.

Rarely, your provider might recommend a skin culture (a test to see if you have an infection) or a biopsy (a small skin sample sent to a lab if your provider suspects other health problems).

How to prevent contact dermatitis

It’s hard to avoid everything that could cause contact dermatitis. But if you have sensitive skin, here are a few things you can try:

  • Choose fragrance-free (unscented) or hypoallergenic products, especially detergents, cleaning products, skincare products and cosmetics
  • Avoid latex gloves and other products
  • Stop using a new product if you think it might be the cause 
  • Immediately wash your hands and any skin that comes in contact with an irritant 
  • Keep your arms and legs covered when you’re in areas that could have poison ivy or oak
  • Try patch testing: Before using a new product, test it on your skin by putting a little bit on your forearm, covering it with gauze or a bandage and checking the spot for redness or irritation after 48 hours (about two days)
  • Consider taking photos of product ingredient lists that irritate your skin. If you get a similar reaction to another product in the future, you can then compare the ingredient lists to figure out which ingredient may be wrong for you.   

Complications of contact dermatitis

With simple care, it’s unusual to develop complications from contact dermatitis. In most cases, the rash will clear up with home treatments in a few days to a few weeks. That said, it’s possible to develop hives with allergic contact dermatitis, so contact your doctor if you develop itchy raised bumps.

In rare cases, allergic reactions could trigger anaphylaxis (a dangerous reaction where your airways can swell and close). If you’re having trouble breathing or your lips or mouth are swelling, call 911. If you know you have allergies and you have an epinephrine injector like an EpiPen, you can use it to help reverse the reaction.