what is contact dermatitis?
I have contact dermatitis. Help!
Contact dermatitis is a type of eczema that usually presents as red, uncomfortable, itchy, usually raised rashes (which dermatologists call papules and plaques). In severe cases, one may develop vesicles or blisters, and wounds. It can occur in any age group. Direct contact of your skin with a suspected substance causes this type of rash.
The two variants of contact dermatitis are ALLERGIC and IRRITANT contact dermatitis.
ALLERGIC CONTACT DERMATITIS is an immunologic reaction. Your skin mounts a delayed hypersensitivity reaction to the foreign substance your skin has been in contact with.
IRRITANT CONTACT DERMATITIS is non-immunologic; rather it is a cytotoxic skin reaction to a substance your skin has been exposed to.
AlLERGIC CONTACT DERMATITIS
This is a type of rash that you will experience every instance you are exposed to an allergen that you are sensitive to.
Do you have a recurring itchy rash on your earlobes every time you wear your favorite fancy earrings? You might be allergic to the material of your earrings. It may be due to nickel, even silver and gold can also cause contact dermatitis.
Some people have stubborn itchy rash on their belly near the belly button. This area usually corresponds to the buckle of your belt or the button of your jeans pants, skirt or shorts. This is also a common sign of nickel allergy. Patients usually have a long-standing history and patients come in with thickened plaques. These can be erythematous (red) or hyperpigmented (brownish).
Some patients suffer from contact dermatitis caused by chemicals or substances that they are exposed to at work. You might have noticed an improvement in your rash when you are on holiday or vacation? For example, a teacher who has frequent exposure to chalk or chemicals in whiteboard markers might have active rashes during the school year but experience relief on school breaks. Hair colorists may experience improvement of their rashes on their hands when they rest from work, similar to people who does laundry or dishwashing as an occupation. Most patients notice improvement of their rash when they take a break from work (when the suspected allergen is from their workplace).
IRRITANT contact dermatitis
Constant exposure to substances will eventually irritate our skin and cause irritant contact dermatitis. This type of rash is more common and most substances can cause this.
What are the common irritants?
Water, alcohol rubs, sweat, saliva!
Common presentations of irritant contact dermatitis are: diaper rash (so don’t let your baby soak his precious skin in wet nappies), lip dermatitis (stop licking your lips!), dry, cracked hands due to chronic exposure to water.
You may also develop irritant contact dermatitis when a toxic substance such as bleach comes in contact with your skin. Hence dermatologists recommend you wear protective gloves when you use bleach and other strong chemicals.
Some also develop irritant contact dermatitis from handling food and soap!
People who always get their hands wet at work (dishwashers, bartenders, healthcare workers, etc.) are more prone to developing dry, cracked hands. These can be itchy, stinging and tender. With the pandemic, we are all doing frequent and adequate hand hygiene, and in our clinic we see a growing number of cases with irritant contact dermatitis. So don’t forget to moisturize your hands with a bland moisturizer after every hand wash or hand rub with alcohol or sanitizing gel.
Consult with your dermatologist if your rash persists. You and your dermatologist will work together to find out your triggers and identify whether your rash is allergic or irritant. Seek medical advice on how best to treat your eczema and avoid flare-ups.
Stay tuned to learn more about contact dermatitis! Blog entries are coming up in the next few days.
Cheers to healthy skin!
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