What is Contact Dermatitis?

Contact dermatitis is the name of inflammations in skin caused by substances which came into contact with the skin. It is also called contact eczema.

Why does contact dermatitis occur?

Contact dermatitis is classified into two groups depending on the underlying cause:
• Irritant contact dermatitis It is caused by agents which irritate he skin such as detergents or solvents. Those substances impair the natural fat tissue of the skin and lead to dryness and peeling followed by itchy eczema plaques and severe dryness, cracks and thickened skin. Amount of the contacted substance and duration of the contact are important in the development of the eczema. The most common type is the hand eczema which is seen in housewives, but individuals with high-risk occupations such as nurses, hair dressers, bartenders and those who work in cleaning and food industries are also under risk. Irritant contact dermatitis may occur in everybody who continuously contact with water and detergent.
• Allergic contact dermatitis: Here, a certain chemical substance that contact with the skin leads to an allergic reaction. These substances can be rubber, hair dye, perfume, cosmetic agents, protective compounds and metals. This type of dermatitis does not develop in everybody or it does not occur at the first contact. Individuals are required to have a past history of contact with the substance.

Signs of Contact Dermatitis

Contact dermatitis is initially manifested by sensation of burn, itching and redness, especially in the locations of contact with the suspected agent. Blisters, tissue swelling, scurf formation and skin thickening may occur in the area of contact over the time. While irritant contact dermatitis is limited to the area of contact, allergic contact dermatitis may spread to whole body. The most common form is the hand eczema. Formation of skin clefts, thick scurf and dry skin in hands, finger tips and palmar surface are the major symptoms. Allergic hand eczema may lead to small blisters on medial surfaces of fingers. Allergies secondary to cosmetic products tend to occur in eyelids and face, while hair dye allergy develops in forehead, the neck and behind the ears and glove allergy in hands and wrists, textile allergy in skin folds such as arm pits and inguinal region.

How Is Contact Dermatitis Diagnosed?

History of contact with irritants and appearance of eczema in the areas of contact are sufficient for diagnosis of irritant contact dermatitis. An allergy test, called skin patch test, is used to identify the causative allergen in allergic contact dermatitis. Small boxes that contain the allergen are attached to the back and they stay there for 2 days to perform this test. The tapes are removed 2 days later; test results are assessed on days 3-4 and patients are recommended to avoid the substance if an allergen is identified.


How Is Contact Dermatitis Treated?

The actual treatment of contact dermatitis is the avoidance from the identified agent. However, it is not always possible to avoid those chemicals and recurrent eczema may occur. It is important to strengthen the barrier by moisturizing the skin, use protective gloves and avoid use of irritant cleaning materials such as soap and detergent. If the identified substance is present in the work place, protective precautions or assignment to another department are recommended. Treatment of contact dermatitis may last for months. Topical steroids (cortisone creams) and humidifiers form the principal base of the treatment. Humidifiers should be used after every handwash.  Topical steroids should be used strictly as instructed by the physician, they should not be administered instead of moisturizers and their use should be limited. Side effects include thinning of the skin in case of long-term use. Cortisone therapy in the oral or injection form may be necessary in cases of severe contact dermatitis.

What should the patients take care of?

Individuals with contact dermatitis should exercise great care for the protection of skin. Among them are moisturizing the skin frequently, use of protective gloves and decreasing the contact with soap and detergent. Chemical substances with irritant or allergic effects should be avoided.