Contact Dermatitis

What is contact dermatitis?

Contact dermatitis is an itchy, inflammatory skin disease. Contact dermatitis develops when the skin comes into direct contact with a substance that causes irritation or an allergic reaction.

There are two main types of contact dermatitis: allergic contact dermatitis and irritant contact dermatitis. Allergic contact dermatitis arises from an allergic immune reaction, meaning your immune system has a reaction. It can be a delayed reaction that appears as a rash a day or two after skin is exposed to an allergen, such as poison ivy. Irritant contact dermatitis is a non-immune mediate reaction that happens when skin cells are damaged by exposure to irritating substances, like soaps or hair dye, and occurs within minutes to hours.

Symptoms of contact dermatitis include redness, swelling, itching and sometimes blisters. The reaction is usually limited to the area of skin that comes in contact with the irritant or allergen, but it can be severe if exposure continues.

You can develop contact dermatitis anywhere on the body that comes in contact with allergens, including hands, feet, scalp, face, arms, legs, chest, abdomen and genitals.

What does contact dermatitis look like?

Contact dermatitis often appears as an itchy rash or dry, scaly patches on the skin that may appear red, purple, brown or grayish hue depending on skin tone. Symptoms can appear anywhere on the body depending on where skin came in contact with an irritant or allergen.

Who gets contact dermatitis?

Anyone can get contact dermatitis, regardless of age or skin tone. Contact dermatitis can be occupational, meaning it occurs in people exposed to chemicals or irritants at work. This includes mechanics, custodians, healthcare workers, hair stylists, etc. People with atopic dermatitis are more likely to have contact dermatitis due to an impaired skin barrier.

Once the trigger is identified, avoiding the substance is critical to prevent further reactions. It is also possible to have contact dermatitis at the same time as other eczemas, such as atopic dermatitis.

Learn more about the seven types of eczema

Is contact dermatitis contagious?

No, contact dermatitis is not contagious. You cannot catch it or spread it to others.

View images of contact dermatitis

What is the difference between eczema and contact dermatitis?

Contact dermatitis happens when the skin becomes irritated or inflamed after coming in contact with a substance that triggers an allergic or irritant reaction. Contact dermatitis is one of the seven different types of eczema, and it bears many of the same symptoms as the six other types of eczema, like itchy, dry skin. However, unlike atopic dermatitis — the most common and difficult-to-treat form of eczema — contact dermatitis does not run in families and isn’t linked to other allergic conditions, such as hay fever or asthma.

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What causes contact dermatitis?

Contact dermatitis occurs when the skin is exposed to an irritant or allergen. It is caused by an inflammatory response to contact between the skin and an ingredient or object that a person is either allergic to or that is irritating to the skin.¹

What are common contact dermatitis triggers and how do I prevent flares?

Healthcare providers and people with eczema often refer to something that causes or aggravates their contact dermatitis a “trigger.” By knowing what bothers your skin, you can help prevent symptom flares. But identifying triggers can be difficult. A flare can appear some time after exposure to an irritant or allergen. This lag time can make it challenging to nail down a particular trigger.

Some common contact dermatitis triggers include:

• Metals, such as nickel, gold and cobalt¹
• Topical medicines like neomycin and glucocorticoids^1,2
• Fragrances²
• Rubber products, such as gloves¹
• Preservatives like formaldehyde, methylisothiazolinone and parabens^1,3
• Borax, which can be used to make a “slime” toy for children³
• Latex, like in balloons³
• Lanolin from sheep, which can be found in moisturizers²
• Plants like poison ivy⁴
• Hair dyes⁴

Can animals trigger allergic contact dermatitis?

Traditionally, animal allergies tend to cause a different set of allergic symptoms such as watery eyes, nose itching, hives, difficulty breathing, etc. However, in some cases pet hairs and dander can also cause a rash when directly in contact with the skin. For some people with allergies to animals, consider coordinating preventative care with an allergist to avoid hives, itchy skin, a skin rash or other symptoms that might occur after coming in contact with an animal known to cause your skin to flare.

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What are the symptoms of contact dermatitis?

Common symptoms of contact dermatitis include:

• Significant itch in affected areas — itch may result in intense scratching that causes skin to bleed
• Inflamed skin (which can look pink, red, purple, brown or gray depending on skin tone) that can also be painful to touch
• Dry, scaly skin or skin that oozes clear fluid

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How is contact dermatitis diagnosed?

Many people may find that their contact dermatitis goes away on its own if they’re able to identify what is triggering it and how to avoid it. With irritant contact dermatitis, the trigger is usually easy to identify, as stinging, pain or discomfort usually happens within minutes of contact with the trigger. For allergic contact dermatitis, knowing what to avoid often takes longer to identify and might require special testing, called patch testing, usually performed by a dermatologist.

If symptoms persist, contact dermatitis is typically diagnosed during a doctor visit. This may include a visit with a primary care physician, a dermatologist and/or an allergist.

Contact dermatitis is often diagnosed with a physical examination of the symptoms based on appearance and duration. This may include patch testing. This is when the doctor applies patches with small amounts of various allergens to the patient’s back and then evaluates skin after about 48 hours and 96 hours. Sometimes, a provider may opt for a skin biopsy, where a sample of the skin is taken for lab testing to rule out other skin conditions that may appear like contact dermatitis including psoriasis, seborrheic dermatitis, etc.

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How do you manage contact dermatitis?

The best way to manage contact dermatitis is to identify the trigger that is causing the reaction and avoid it.

Basic contact dermatitis care includes:

• Avoiding contact with known triggers (this may involve wearing protective clothing, like gloves, if contact is unavoidable)
• Bathing with a gentle cleanser
• Frequent moisturizing to lock moisture into the skin to help repair the skin barrier, combat dryness and keep out irritants and allergens

What treatments and medications are available for contact dermatitis?

When it’s not possible to avoid the trigger, some of the same treatments used to treat atopic dermatitis can also be used to treat contact dermatitis.⁵ However, this can sometimes be problematic as the immune reaction that causes the symptoms is ongoing every time a person comes in contact with the trigger, so the treatment may have to be very long-term, which can lead to unwanted side effects.⁵

There are many treatment options available, including:

• Over-the-counter medicines like hydrocortisone
• Topical prescription medications that are applied to the skin
• Biologic prescription medicines, which are given by injection
• Oral prescription medications, which are taken by mouth in the form of a pill

It’s important to discuss your treatment options with your doctor to assess what works best for you.

Learn more about available treatments for eczema

Does contact dermatitis go away?

To avoid recurring contact dermatitis symptoms, it’s critical to identify and avoid contact with the allergen(s) or irritant(s) that triggered your flare as much as possible.

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If you have contact dermatitis, do you have an increased risk of developing other health conditions?

People with contact dermatitis can get itchy rashes on the body that can ooze fluid and bleed when scratched, making skin vulnerable to infection. It’s important to treat any open wounds, keeping them clean and moisturized, to avoid infection.

Is contact dermatitis an autoimmune disease?

No, contact dermatitis is not an autoimmune disease.

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