Contact dermatitis

This is a form of eczema which occurs as a result of contact with a surface or object. It develops as an allergic reaction to something or from touching a substance which irritates the skin. It is less common than atopic eczema but presents with a similar set of symptoms such as dry, cracked, flaky skin.

Who is most likely to be affected, men or women?

Contact dermatitis affects women more than men. But this may be due to women having greater contact with substances which cause eczema. One example of this is household products such as cleaners.

Skin conditions such as contact dermatitis and other forms of eczema often run in families. This is also the case in families with a high incidence of hay fever and asthma.

Causes of contact dermatitis

There are two categories of triggers for this condition:

Irritants

These are substances which cause an adverse reaction in the skin resulting in rashes such as contact dermatitis. They remove protective oils from the skin which dries it out, leaving it prone to skin complaints.

Examples of irritants include solvents, chemicals, perfumes, dust, detergents and machine oils. Some people develop dermatitis after contact with certain kinds of plants or even water.

And then there are people who get dermatitis from contact with irritants that they use at work. These occupational irritants occur in areas such as hairdressing, manufacturing, healthcare, printing and catering. If you work in any of these areas and are prone to skin conditions then take extra care.

Allergens

An allergen is something which triggers an abnormal reaction, e.g. rash due to hypersensitivity. Your body’s immune system perceives a substance to be a threat and responds accordingly. It releases a burst of antibodies which attack healthy tissues and cells, causing an allergic reaction. This reaction takes the form of localised swelling, pain and soreness.

Your immune system reacts the same way each time you are in contact with the allergen.

Examples of popular allergens include rubber, metal, e.g. nickel, cosmetics, glues, fabrics and even topical steroids.

Symptoms of contact dermatitis

This is characterised by patches of red, dry, flaking skin which is intensely itchy and scaly. It can become sore and cracked especially on the hands which causes a great deal of pain. In some cases small blisters form which ooze fluid when rubbed or scratched.

Affected areas of skin become thicker, rough in texture and prone to blisters.

Contact dermatitis mainly affects the hands but also develops on the face, arms and legs.

But the symptoms depend upon whether you have irritant contact dermatitis or allergenic contact dermatitis.

Diagnosing contact dermatitis

If you experience any of these symptoms then see your GP. He or she will be able to confirm a diagnosis of contact dermatitis by examining the affected areas of skin.

Your GP will ask you questions about your family/medical history and the type of job you do. The reason for the latter is that there are some jobs which cause an outbreak of contact dermatitis from direct contact with a particular substance. He or she may refer you to a dermatologist for further testing, for example the patch test.

Irritant contact dermatitis is diagnosed once your GP knows about what substances you handle and how often. This is often a process of elimination.

Allergenic contact dermatitis involves the patch test. The patch test is where small patches containing potential allergenic substances are placed on your skin, i.e. your back. These are left for one to two days. They are removed after then and your skin examined to see if there has been an adverse reaction to any of them, e.g. a skin rash.

Treatment for contact dermatitis

Once you have identified the trigger for your contact dermatitis, for example a known allergen then the next step is to avoid contact with this whenever possible. We appreciate this is easier than it sounds especially if the allergen is something you use or are in frequent contact with at work.

If your condition is caused by a work related allergen then speak to your employer as they need to be made aware of this. They can arrange for you to have protective clothing, e.g. gloves or may switch you to a different role or department.

Another option is to use creams which keep your skin soft, smooth and lubricated. The aim is to stop your skin from becoming dry which only exacerbates this condition. Apply a cream which keeps the skin moisturised and protects it against potential irritants and allergens. These creams are known as emollients and are prescribed by your GP.

Other forms of treatment include:

  • Topical steroids (creams which are applied to the skin)
  • Corticosteroids
  • Antibiotics
  • Retinoids such as Alitretinoin
  • Phototherapy

Your GP or dermatologist will discuss these with you, explaining about the benefits and any possible side effects.

Find out more about these therapies in our dermatology treatments section.

Contact dermatitis can be a managed effectively although this depends upon the severity of your symptoms. Some people find this easy to do but others experience a severe form which dramatically affects their quality of life. Your GP will be able to advise you about living with this condition.