Contact dermatitis is inflammation of the skin that results from direct contact of a substance with the surface of the skin, which may or may not be related to an allergy. Some substances are always irritating to the skin.
A person develops contact dermatitis when something that touches the skin does one of the following:
There are two types of contact dermatitis:
Anyone can develop contact dermatitis. Your risk factor may be increased if you are in regular contact with an irritant or allergen, or if you already have allergies to certain substances, such as plants, chemicals, or medications. People working in certain professions have a higher risk. Sometimes this is referred to as occupational dermatitis. It is important to know that the more you come in contact with a substance, the more likely you are to develop an allergy to it and for it to be the cause of allergic contact dermatitis.
People who are more likely to get occupational dermatitis include:
Signs and symptoms of contact dermatitis rarely appear with immediate contact. Most symptoms of contact dermatitis appear within 24-72 hours. An allergic reaction requires more than 1 exposure to the substance, but after this, a reaction can occur quickly. Rarely, people can develop a severe allergic reaction known as anaphylaxis (an-uh-fuh-lax-sis). Symptoms occur within seconds or minutes. A person may have:
The entire body reacts during these events. If anyone has any of these symptoms, seek immediate medical care.
During normal contact dermatitis reactions, when signs and symptoms do appear, you may have:
If exposure to the allergen continues, your skin may:
To diagnose this common skin condition, dermatologists:
If your dermatologist suspects that you have an allergy, patch testing may be recommended. A patch test involves applying panels to your skin that contain small amounts of possible allergens for a period of time. After this time, the patches are removed to inspect the skin for reactions. Relevance must be kept in mind when considering the results of a patch test. For instance, if the substance a patient reacts to is not something they come in contact with regularly, it is not likely to be the source of the contact dermatitis.
Treatment is the same for both types of contact dermatitis.
The steps involved during treatment are:
By avoiding what caused the rash, most people can avoid flare-ups.
If you work with substances that caused the rash, you can still avoid a rash. Your dermatologist can recommend ways to work and products to use. More than 80% of people diagnosed with occupational dermatitis successfully manage the condition and recover without any problems.
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Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. There are two types of contact dermatitis: irritant and allergic.
Patch testing is a diagnostic test that may determine which allergen is causing the skin to become irritated in the case of allergic contact dermatitis.
Occupational dermatitis is a skin disorder caused by coming into contact with certain substances in the workplace. It can have long term consequences for workers' health and in extreme cases it can hinder a person's ability to continue working. Research has indicated that 10 years after the condition first occurs, up to 50% of affected workers will still have some skin problems.
In irritant contact dermatitis, the substance that damages the skin is known as the irritant. A highly irritating substance is known as a corrosive. Irritant dermatitis makes up about 80% of contact dermatitis cases. The other 20% are allergic.
There are several causes of skin damage that can lead to irritant contact dermatitis:
Irritation is analogous to a chemical burn. It acts by eroding or burning the outer protective layers of the skin. Irritant contact dermatitis usually occurs only on the parts of the body that come in direct contact with the irritant substance e.g. hands, forearms, or face.
In this case, a substance causes a person to become sensitized or to develop an allergic reaction some time after initial contact. The type of allergic mechanism is known as Type IV or delayed hypersensitivity. People do not become allergic to a substance immediately at first contact. The sensitization period (the time between contact and the development of an allergy) can vary from a number of days to months or even years. The risk of becoming allergic depends on several factors:
Once the individual becomes sensitized, each time he/she comes into contact with the sensitizing substance, even in very small amounts, dermatitis will develop. This is different from irritant dermatitis which is dose related.
Sensitization is specific to one substance or to a group of substances that are chemically similar. Once sensitized, a person is likely to remain so for life. In allergic dermatitis, the rash can occur in areas of the skin not in direct contact with the substance.
Common sensitizers are chromates (found in cement), nickel (jewelry), epoxy resins, formaldehyde, wood dust, flour, printing plates, chemicals and adhesives.