What is it?
Contact dermatitis is a rash that occurs at the site of exposure to a substance that inflames the skin. It is inflammation of the skin, which results from contact of an external substance with the skin. This can occur through one of two mechanisms: irritant or allergic.
Irritant dermatitis is the most common type. Its caused by contact with acids, alkaline materials such as soaps and detergents, fabric softeners, solvents, or other chemicals. The reaction usually looks like a burn.
Other irritants may include:
Long-term exposure to wet diapers
Pesticides or weed killers
Allergic dermatitis is caused by exposure to a substance or material to which you have become extra sensitive or allergic to.
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 moisturisers
Nail polish, hair dyes, and permanent wave solutions
Nickel or other metals (found in jewellery, watch straps, metal zips, bra hooks, buttons, pocket knives, 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 exposed to sunlight (photosensitivity) too. These include shaving lotions, sunscreens, sulphur ointments, some perfumes, coal tar products, and oil from the skin of a lime. A few airborne allergens, such as insecticide spray, can cause contact dermatitis.
Signs and symptoms
Dry, reddish, itchy skin indicates some kind of dermatitis, or skin inflammation, of which there are many types:
A red rash that is limited to the area of skin exposed to an irritant is probably contact dermatitis.
Red, itchy, circular patches of weeping, scaly, or encrusted skin suggest nummular dermatitis, common in older people, who have dry skin or live in dry environments.
Greasy, yellowish scales on the scalp and eyebrows, behind the ears, and around the nose indicate seborrhoeic dermatitis; in infants it is called cradle cap.
Scaling, sometimes ulcerated skin appearing inside the lower legs and around the ankles, may indicate stasis dermatitis.
Extreme, persistent itchiness may signal atopic dermatitis (eczema). Very often, however, itchiness results simply from dry skin.
How is contact dermatitis diagnosed?
Irritant contact dermatitis is diagnosed by its clinical appearance associated with appropriate historical clues furnished by the patient during the medical interview. The incubation period between exposure and the onset of symptoms is minutes to hours, so that the patient usually is aware of the identity of the causal substance. Allergic contact dermatitis is much more difficult to diagnose.
What is the prognosis for contact dermatitis?
If it is possible to avoid contact with the inciting substance, then the prognosis is extremely good. If the cause of contact dermatitis is not discovered and avoided, then it is likely that it will recur upon the next exposure. In the case of allergic contact dermatitis, there is as yet no reliable technique to desensitise the immune system of allergic patients, so avoidance is the only alternative.
Washing with lots of water to remove any traces of the irritant that may remain on the skin.
Avoidance of further exposure to known irritants or allergens.
In some cases, the best treatment is to do nothing to the area.
Emollients or moisturisers help keep the skin moist, and also help the skin to repair itself. They protect the skin from becoming inflamed again. As well, 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 ointments or creams to use on the skin.
In severe cases, corticosteroid pills may be needed. You will be started on a high dose, which is tapered 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.
Can contact dermatitis be prevented?
Avoidance is prevention for both allergic and irritant contact dermatitis. On the other hand, there are certain precautions that can be taken to prevent exposure to either irritants or potent allergens. Protective clothing can be quite helpful. There are certain so-called barrier creams that may be more or less useful in limiting contact to irritants, and possibly allergens as well.
In the final analysis, being aware of your body and what works for you, is very critical in dealing with sensitivity, given the wide variety of things that can affect you.
Your feet mirror your general health . . . cherish them!
Leana Huntley is an
English trained foot health practitioner attached to ALMAWI Limited The Holistic Clinic. Contact the clinic at email@example.com
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