Contact dermatitis on the wrist
Contact dermatitis can appear as an itchy, red rash. In this photo, the irritation is likely due to a watchband or to soap residue trapped beneath the band.
Contact dermatitis is a red, itchy rash caused by direct contact with a substance or an allergic reaction to it. The rash isn't contagious or life-threatening, but it can be very uncomfortable.
Many substances can cause such reactions, including soaps, cosmetics, fragrances, jewelry and plants.
To treat contact dermatitis successfully, you need to identify and avoid the cause of your reaction. If you can avoid the offending substance, the rash usually clears up in two to four weeks. You can try soothing your skin with cool, wet compresses, anti-itch creams and other self-care steps.
Contact dermatitis on the face
Contact dermatitis usually affects areas of skin directly exposed to an offending substance. Here, the dry, red rash is likely caused by cosmetics or soap.
Poison ivy blisters
Blisters such as these are common in a skin reaction to urushiol, the highly allergenic oily substance in poison ivy.
Contact dermatitis usually occurs on areas of your body that have been directly exposed to the reaction-causing substance — for example, along a calf that brushed against poison ivy or under a watchband. The rash usually develops within minutes to hours of exposure and can last two to four weeks.
Signs and symptoms of contact dermatitis include:
- A red rash
- Itching, which may be severe
- Dry, cracked, scaly skin
- Bumps and blisters, sometimes with oozing and crusting
- Swelling, burning or tenderness
When to see a doctor
See your doctor if:
- The rash is so uncomfortable that you are losing sleep or are distracted from your daily activities
- The rash is sudden, painful, severe or widespread
- You're embarrassed by the way your skin looks
- The rash doesn't get better within three weeks
- The rash affects your face or genitals
Seek immediate medical care in the following situations:
- You think your skin is infected. Clues include fever and pus oozing from blisters.
- Your lungs, eyes or nasal passages are painful and inflamed, perhaps from inhaling an allergen.
- You think the rash has damaged the mucous lining of your mouth and digestive tract.
Contact dermatitis is caused by a substance you're exposed to that irritates your skin or triggers an allergic reaction. The substance could be one of thousands of known allergens and irritants. Some of these substances may cause both irritant contact dermatitis and allergic contact dermatitis.
Irritant contact dermatitis is the most common type. This nonallergic skin reaction occurs when a substance damages your skin's outer protective layer.
Some people react to strong irritants after a single exposure. Others may develop signs and symptoms after repeated exposures to even mild irritants. And some people develop a tolerance to the substance over time.
Common irritants include:
- Rubbing alcohol
- Bleach and detergents
- Shampoos, permanent wave solutions
- Airborne substances, such as sawdust or wool dust
- Fertilizers and pesticides
Allergic contact dermatitis occurs when a substance to which you're sensitive (allergen) triggers an immune reaction in your skin. It usually affects only the area that came into contact with the allergen. But it may be triggered by something that enters your body through foods, flavorings, medicine, or medical or dental procedures (systemic contact dermatitis).
You may become sensitized to a strong allergen such as poison ivy after a single exposure. Weaker allergens may require multiple exposures over several years to trigger an allergy. Once you develop an allergy to a substance, even a small amount of it can cause a reaction.
Common allergens include:
- Nickel, which is used in jewelry, buckles and many other items
- Medications, such as antibiotic creams and oral antihistamines
- Balsam of Peru, which is used in many products, such as perfumes, cosmetics, mouth rinses and flavorings
- Formaldehyde, which is in preservatives, disinfectants and clothing
- Personal care products, such as deodorants, body washes, hair dyes, cosmetics and nail polish
- Plants such as poison ivy and mango, which contain a highly allergenic substance called urushiol
- Airborne substances, such as ragweed pollen and spray insecticides
- Products that cause a reaction when you're in the sun (photoallergic contact dermatitis), such as some sunscreens and oral medications
Children develop the condition from the usual offenders and also from exposure to diapers, baby wipes, sunscreens, clothing with snaps or dyes, and so on.
Some jobs and hobbies put you at higher risk of contact dermatitis. Examples include:
- Health care and dental employees
- Construction workers
- Hairdressers and cosmetologists
- Auto mechanics
- Scuba divers or swimmers, due to the rubber in face masks or goggles
- Gardeners and agricultural workers
- Cooks and others who work with food
Contact dermatitis can lead to an infection if you repeatedly scratch the affected area, causing it to become wet and oozing. This creates a good place for bacteria or fungi to grow and may cause an infection.
General prevention steps include the following:
- Avoid irritants and allergens. Try to identify and avoid substances that irritate your skin or cause an allergic reaction.
- Wash your skin. You might be able to remove most of the rash-causing substance if you wash your skin right away after coming into contact with it. Use a mild, fragrance-free soap and warm water. Rinse completely. Also wash any clothing or other items that may have come into contact with a plant allergen, such as poison ivy.
- Wear protective clothing or gloves. Face masks, goggles, gloves and other protective items can shield you from irritating substances, including household cleansers.
- Apply an iron-on patch to cover metal fasteners next to your skin. This can help you avoid a reaction to jean snaps, for example.
- Apply a barrier cream or gel. These products can provide a protective layer for your skin. For example, an over-the-counter skin cream containing bentoquatam (IvyBlock) may prevent or lessen your skin's reaction to poison ivy.
- Use moisturizer. Regularly applying moisturizing lotions can help restore your skin's outermost layer and keep your skin supple.
- Take care around pets. Allergens from plants, such as poison ivy, can cling to pets and then be spread to people.
Video: Allergy or irritant: The truth about your rash
Hand-washing is essential for preventing the spread of germs. But, sometimes, all this scrubbing can cause a rash. Does this mean you're allergic to the soap?
"One important thing to differentiate from allergic contact dermatitis is irritant contact dermatitis," says Mayo Clinic dermatologist Dawn Davis, M.D.
Dr. Davis says allergic dermatitis means a substance is causing an allergic reaction on your skin. But irritant contact dermatitis means your skin is inflamed from repeated exposure to something.
"For example, if I used lye soap on my skin, and I used it over and over again, I would develop an irritant contact dermatitis simply from eroding away the natural barrier of my skin with repetitive washing," says Dr. Davis.
Dr. Davis says it's not always easy to tell the difference between an allergy or irritant.
"So it's very helpful to go to a health provider, especially a dermatologist or allergist, to help differentiate between irritant contact dermatitis and an allergy," says Dr. Davis.
That way you can properly treat the rash and prevent it from happening again.