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Contact dermatitis is a type of eczema triggered by contact with a particular substance.
Eczema is the name for a group of conditions that cause skin to become irritated and dry.
With treatment, most people with contact dermatitis can expect their symptoms to improve. Some cases will clear up completely.
This topic covers:
Contact dermatitis causes the skin to become red, blistered, dry and cracked.
This reaction usually occurs within a few hours or days of exposure to an irritant or allergen.
Symptoms can affect any part of the body, but most commonly affect the hands and face.
Read about symptoms of contact dermatitis.
See your GP if you have persistent, recurrent or severe symptoms of contact dermatitis. They can try to identify the cause and suggest appropriate treatments.
Your GP may refer you to a dermatologist (a doctor who specialises in treating skin conditions) for further tests if:
Read about diagnosing contact dermatitis.
Contact dermatitis can be caused by:
Contact dermatitis is most commonly caused by irritants such as soaps and detergents, solvents or regular contact with water.
Read about causes of contact dermatitis.
If you can successfully avoid the irritants or allergens that trigger your symptoms, your skin will eventually clear up.
However, as this isn't always possible, you may also be advised to use:
Read about treating contact dermatitis.
The best way to prevent contact dermatitis is to avoid contact with the allergens or irritants that cause your symptoms.
If you can't avoid contact, you can take steps to reduce the risk of the allergens or irritants causing symptoms, including:
Other types of eczema include:
Contact dermatitis can cause skin to become red, inflamed (irritated), blistered, dry, thickened and cracked.
These symptoms can develop on any area of the body, although the hands and face are most often affected.
Symptoms caused by an irritant usually appear within 48 hours, or even immediately. Milder irritants (such as soap and detergents) may not cause problems immediately – you may need frequent exposure to these before they cause problems.
Symptoms caused by an allergen, such as make-up or metal jewellery, often take several days to develop.
If you can avoid being re-exposed to the substance responsible for the reaction, your skin will usually clear up within a few days or weeks.
However, some people experience severe and long-lasting symptoms, which may affect their quality of life.
Depending on the substance that caused the reaction, you may also experience some additional symptoms.
For example, allergens may cause affected areas of the skin to itch and irritants may cause a burning or stinging sensation.
Occasionally, areas of skin affected by contact dermatitis can become infected. Signs of an infection can include:
Seek immediate medical advice if you think your skin may have become infected, as you may need to take antibiotics.
Contact dermatitis occurs when your skin reacts to a particular substance.
This can be either:
Irritant contact dermatitis may be caused by frequent exposure to a weak irritant, such as soap or detergent. It may also develop if you've been in contact with a stronger irritant for a short while.
You're at an increased risk of irritant contact dermatitis if you also have atopic eczema, which is the most common form of eczema.
Common irritants include:
If you already have irritant contact dermatitis symptoms, they can be made worse by heat, cold, friction (rubbing against the irritant) and low humidity (dry air).
You may be more at risk of irritant contact dermatitis if you work with irritants as part of your job, or if your job involves a lot of wet work.
If you develop the condition because of a substance you work with, it may be referred to as occupational irritant dermatitis.
This type of dermatitis is more common in certain occupations, including:
The first time you come into contact with an allergen, your body becomes sensitised to it, but doesn't react to it. It's only when you're exposed to the substance again that your immune system reacts and causes the skin to become red and itchy.
Allergens that commonly cause allergic contact dermatitis include:
Your GP can usually diagnose contact dermatitis from the appearance of your skin and by asking about your symptoms.
They'll want to know when your symptoms first appeared and what substances you've been in contact with.
If your GP has diagnosed contact dermatitis, they'll try to identify what has triggered your symptoms. If the allergens or irritants can be identified, you can take steps to avoid those substances and reduce the risk of your symptoms flaring up.
Your GP will look at your medical history and ask questions about your lifestyle and occupation. They may also ask whether there's a history of dermatitis or eczema in your family.
If the allergens or irritants causing your contact dermatitis can't be identified, you may be referred to a dermatologist (a doctor who specialises in treating skin conditions).
You may also be referred to a dermatologist if the trigger has been identified, but your symptoms are not responding to treatment.
The best way to test for a reaction to allergens is by patch testing. During a patch test, tiny amounts of known allergens are applied to your skin.
The substances are attached to your back using a special kind of non-allergic tape. They may sometimes be attached to the upper arms.
After two days, the patches are removed and your skin assessed to check if there has been any reaction.
Your skin will usually be examined again after a further two days, as most allergic contact dermatitis reactions take this long to develop.
It's very difficult to test whether specific products irritate your skin, because testing for these is very unreliable.
In some cases, a repeated open application test (ROAT) is useful, particularly to assess cosmetics. A ROAT involves reapplying the substance onto the same area of skin twice a day for 5 to 10 days, to see how your skin reacts.
This is a particularly useful way for you to check your own cosmetics at home for reactions.
Treatment for contact dermatitis can help most people manage their symptoms. Some people may find their symptoms clear up entirely.
There are several ways to treat contact dermatitis, including:
These are explained below.
One of the most important steps in treating contact dermatitis is identifying and avoiding the allergens or irritants that affect you. If you can successfully avoid or reduce your exposure to the cause, you shouldn't experience any symptoms.
It's not always easy to avoid irritants or allergens that affect you, but your GP or dermatologist (specialist in treating skin conditions) can find ways to minimise your contact with them.
If you're exposed to irritants as part of your job, wear protective clothing to minimise any contact. Tell your employer about your condition, so they can help you avoid the causes as much as possible.
Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. They're often used to help manage dry or scaly skin conditions such as eczema.
Several different emollients are available. You may need to try a few to find one that works for you. You may also be advised to use a mix of emollients, such as:
The difference between lotions, creams and ointments is the amount of oil they contain. Ointments contain the most oil, so they can be quite greasy, but are the most effective at keeping moisture in the skin. Lotions contain the least amount of oil, so aren't greasy, but can be less effective. Creams are somewhere in between.
Creams and lotions tend to be more suitable for red, inflamed (swollen) areas of skin. Ointments are more suitable for areas of dry skin that aren't inflamed.
If you've been using a particular emollient for some time, it may eventually become less effective or may start to irritate your skin. If this is the case, your GP can prescribe another product.
Use your emollient frequently and in large amounts. Many people find it helpful to keep separate supplies of emollients at work or school.
To apply the emollient:
If you're exposed to irritants at work that cause your contact dermatitis, make sure you apply emollients regularly during and after work.
Don't share emollients with other people.
Occasionally, some emollients can irritate the skin. If you have contact dermatitis, your skin will be sensitive and can sometimes react to certain ingredients, such as perfume in over-the-counter emollients.
If your skin reacts to the emollient, stop using it and speak to your GP, who can recommend an alternative product.
Be aware that some emollients contain paraffin and can be a fire hazard, so shouldn't be used near a naked flame. Emollients added to bath water can make your bath very slippery, so take care getting in and out of the bath.
If your skin is very red, sore and inflamed, your GP may prescribe a topical corticosteroid (a cream or ointment applied directly to your skin), which can quickly reduce the inflammation.
When used as instructed by your pharmacist or doctor, corticosteroids are a safe and effective treatment for contact dermatitis.
Different strengths of topical corticosteroids can be prescribed, depending on the severity of your contact dermatitis and where the affected skin is.
You may be prescribed:
When using corticosteroids, apply the treatment in a thin layer to all the affected areas. Unless instructed otherwise by your doctor, follow the directions on the patient information leaflet that comes with your medication. This will give details of how much to apply.
During an episode of severe contact dermatitis, don't apply the corticosteroid more than twice a day. Most people only have to apply it once a day.
You should apply your emollient first and wait around 30 minutes before applying the topical corticosteroid.
The medication will usually start to have an effect within a few days. Speak to your GP if you've been using a topical corticosteroid and your symptoms haven't improved.
Topical corticosteroids may cause a mild and short-lived burning or stinging sensation as you apply them. In some cases, they may also cause:
Most of these side effects will improve once treatment stops.
Generally, using a stronger topical corticosteroid or using a large amount of topical corticosteroid increases your risk of getting side effects. You should use the weakest and smallest amount possible to control your symptoms.
If you have a severe episode of contact dermatitis and it covers a large area of your skin, your doctor may prescribe corticosteroid tablets.
You may be prescribed steroid tablets to take for five to seven days. Depending on how effective this is, your dose may then be may gradually reduced over two to three weeks.
If steroid tablets are taken often or for a long time, they can cause a number of side effects, such as:
For this reason, your doctor is unlikely to prescribe repeat courses of corticosteroid tablets without referring you to a specialist.
If the treatments prescribed by your GP aren't successfully controlling your symptoms, they may refer you for assessment and treatment by a dermatologist.
Further treatments that may be available from your dermatologist include:
Some people may choose to use complementary therapies for contact dermatitis, such as food supplements or herbal remedies, but there is often a lack of evidence to show they are effective in treating the condition.
If you are thinking about using a complementary therapy, speak to your GP first to make sure the therapy is safe for you to use. You should continue to use any other treatments prescribed by your GP.