Understanding and Treating Contact Dermatitis

By Sondra Forsyth

Contact dermatitis is an inflammatory reaction to something that has come into contact with the skin. The effects are generally mild and treatable, but avoiding irritants and getting treatment quickly are both important for a quick recovery. Christopher Byrne, PA-C, with Advanced Dermatology PC has experience treating contact dermatitis and is here to share the important pieces of information about this topic that everyone should know.

“The first thing to understand about contact dermatitis is that it comes in two main forms: irritant contact dermatitis, and allergic contact dermatitis. They’ve very similar, but not identical, and knowing which one you’re dealing with can not only help improve treatment but also help avoid future episodes,” said Byrne.

Irritant contact dermatitis is caused by direct expose to an irritant that directly damages skin cells. According to the National Eczema Association, irritants are responsible for as much as 80% of cases of contact dermatitis. The severity of an outbreak will be determined by how concentrated the irritant was and how long the exposure lasted. Environmental factors like humidity or temperature can also affect how serious the reaction is.

Common irritants include:

• Detergents
• Solvents
• Cleaners
• Bleach
• Industrial chemicals

“It should be noted that irritants don’t have to be harsh if the exposure if frequent enough. It’s not uncommon for some professionals such as workers in the healthcare or food service industries to experience contact dermatitis on their hands due to repeated washing,” said Byrne.

Allergic contact dermatitis is caused not by direct damage to the skin, but instead is an inflammatory overreaction by the immune system to some outside substance. The most common allergen causing contact dermatitis is poison ivy, and similar allergens include poison oak and poison sumac. Other common allergens that can cause this reaction include:

• Metals such as nickel, cobalt, and chromium
• Fragrances
• Dyes
• Latex

There is a third variant called photocontact dermatitis which involves exposure to an irritant that is activated by sunlight, but this variant is far less common than the others.

“Anyone can have contact dermatitis, but some people are more at risk than others. Infants and older adults tend to have a higher likelihood of getting contact dermatitis, as well as people with a history of atopic conditions like asthma, hay fever, atopic eczema, or allergic conjunctivitis,” Byrne said.

Other risk factors include exposure to relevant occupational hazards, wearing jewelry or fragrances, or having red hair and fair skin.

Symptoms can appear immediately or might take several days, depending on which type of contact dermatitis someone is experiencing. Irritant contact dermatitis is usually at its worst within a few minutes to a few hours of exposure, and then healing begins. For allergic contact dermatitis, the symptoms progress more slowly, taking up to three or four days to reach their peak intensity.

Someone with contact dermatitis will generally experience some level of discomfort that can include itchiness, burning, stinging, soreness, or pain. The skin at the contact site can become red and might turn dry or flaky. Hives might appear, and some people will get blisters and potentially some oozing. Because contact dermatitis is an inflammatory disease, some swelling is also to be expected.

“Our hands are responsible for a lot of the touching we do in our day-to-day lives, so they’re frequently affected by contact dermatitis. It’s important to remember that if you think you’re having a reaction on your hands, don’t touch your skin elsewhere on your body. If there are irritants left on your hands, you don’t want to spread them to somewhere like your eyes,” said Byrne.

Quick treatment can help to minimize the severity of the reaction. First and most crucially, avoid additional contact with a suspected irritant or allergen as soon as a reaction is noticed. Immediately and carefully wash the affected area with cool water and a mild, gentle soap. After washing, apply a cool compress to help reduce swelling.

To help with discomfort, applying moisturizer can be helpful so long as it’s hypoallergenic and doesn’t include any fragrances that might cause more irritation. Applying aloe or vitamin E might also make the skin feel better.

Over-the-counter medications such as anti-itch creams or antihistamines (Benadryl, Zyrtec, Allegra) can help relieve symptoms that persist more than a couple hours.

“For stronger reactions, a dermatologist can prescribe a corticosteroid cream, or in the most severe cases corticosteroid injections or oral applications. But most important of all: don’t scratch. Scratching doesn’t just irritate the skin, but it can lead to infections which might then require antibiotics,” said Byrne.

Most of the time, people are able to pinpoint what it was that caused an outbreak of contact dermatitis. But in the cases where someone isn’t sure, a visit to a dermatologist’s office can help provide answers.

“Contact dermatitis is definitely an example of an ounce of prevention being worth a pound of cure. Once you know what substances to avoid, you’ve got a lot more agency over your health outcomes,” said Byrne.

Christopher Byrne, PA-C, is a physician assistant who specializes in dermatology at Advanced Dermatology P.C.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery has over 50 offices in NY, NJ, CT and PA and is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology, as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com