Contact Dermatitis & Treatment

What is contact dermatitis?

Contact dermatitis is a type of eczema that occurs when your skin comes into contact with a substance that irritates it or triggers an allergic reaction. It causes red, itchy, and inflamed skin and is a common condition in the UK.

Contact dermatitis is a skin condition caused by exposure to irritants or allergens. It is not contagious but can cause discomfort. There are two main types: irritant contact dermatitis, which is caused by direct damage to the skin from substances like soaps or chemicals, and allergic contact dermatitis, which occurs when the immune system reacts to an allergen such as nickel or certain plants. It is common in workplaces involving frequent contact with water, chemicals, or allergens.

Symptoms of contact dermatitis

The symptoms of contact dermatitis include:

Redness and inflammation of the skin.
Itchy, dry, or scaly patches.
Blisters that may ooze and crust over.
Burning or stinging sensations.
Cracked, sore, or swollen skin in severe cases.

Symptoms usually appear within hours or days after exposure to an irritant or allergen and can affect any area of the skin but are most common on the hands, face, or areas in contact with the substance.

Types of contact dermatitis

Irritant contact dermatitis:
- Irritant contact dermatitis occurs when the skin is damaged by repeated exposure to irritants, such as:
  - Soaps, detergents, or cleaning products.
  - Acids, alkalis, or solvents.
  - Frequent handwashing or wet work.
  It is the most common type of contact dermatitis and typically affects areas exposed to irritants, like the hands. Symptoms can include redness, dryness, cracking, and soreness of the skin, which may worsen with continued exposure.
- Most common type and often linked to frequent hand washing or exposure to harsh substances.

Allergic contact dermatitis:
- Allergic contact dermatitis occurs when the immune system reacts to a specific substance (allergen) that comes into contact with the skin. Common allergens include:
  - Metals like nickel or cobalt.
  - Fragrances and preservatives in cosmetics or skincare products.
  - Rubber or latex.
  - Plants like poison ivy or certain flowers.
  Symptoms, such as redness, itching, swelling, and sometimes blistering, may develop hours or even days after exposure. The reaction can spread beyond the area of contact.
- Caused by an allergic reaction when the immune system responds to a specific allergen such as nickel, fragrances, latex, or certain plants.
- Symptoms may take longer to appear compared to irritant contact dermatitis and can spread beyond the contact area.

Contact dermatitis treatment

Avoid the trigger: Identify and avoid irritants or allergens causing the reaction.
Self-care measures:
- Wash the affected area with mild soap and lukewarm water.
- Use emollients (moisturisers) to soothe and protect the skin.
Topical corticosteroids: Apply prescribed creams or ointments to reduce inflammation and itching.
Antihistamines: These may help relieve itching, especially for allergic reactions.
Barrier protection: Wear gloves or protective clothing to prevent exposure.

If symptoms are severe, persist despite treatment, or involve a large area, seek medical advice.

Emollients

Emollients are moisturisers that help to hydrate and protect the skin by forming a barrier to prevent water loss. They are essential for managing contact dermatitis as they:

Soothe dry, itchy, and irritated skin.
Restore the skin’s natural barrier.
Prevent flare-ups by reducing skin sensitivity to irritants.

Emollients are available as creams, ointments, or lotions. Ointments are best for very dry skin, while creams and lotions may suit milder cases. Apply regularly, especially after washing, and avoid products with fragrances or additives that could irritate the skin further.

Topical corticosteroids

Topical corticosteroids are anti-inflammatory creams or ointments used to reduce redness, itching, and swelling caused by contact dermatitis. They are prescribed in different strengths, depending on the severity of the condition.

Mild steroids: E.g., hydrocortisone, for sensitive areas like the face or mild cases.
Moderate to strong steroids: E.g., clobetasone or betamethasone, for severe or persistent symptoms.

Apply a thin layer to the affected area as directed by a healthcare professional. Overuse or long-term use can cause side effects, such as skin thinning, so follow your doctor’s advice carefully.

When to see a doctor

You should see a doctor if:

Symptoms are severe, painful, or widespread.
The condition does not improve with self-care and over-the-counter treatments.
Blisters develop and ooze, or there are signs of infection, such as increased redness, swelling, warmth, or pus.
You are unsure what is causing the reaction or how to avoid it.
The condition recurs frequently or interferes with daily life.

A doctor can provide a diagnosis, recommend appropriate treatments, and may refer you for allergy testing if needed.

How to prevent contact dermatitis

Avoid triggers: Identify and avoid substances that irritate your skin or cause allergic reactions, such as certain soaps, detergents, or metals.
Wear protective clothing: Use gloves, long sleeves, or barrier creams when handling irritants like chemicals, cleaning products, or plants.
Moisturise regularly: Keep your skin hydrated with emollients to maintain its natural barrier and reduce the risk of dryness and irritation.
Use mild products: Choose gentle, fragrance-free soaps, shampoos, and skin-care products.
Take care when washing hands: If frequently washing your hands, use a mild soap and apply a moisturiser immediately afterward.

By taking these precautions, you can reduce the likelihood of developing contact dermatitis.

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