Types of contact dermatitis
In simple contact dermatitis, the substance directly damages the skin's protective barrier, and the reaction depends on the concentration and duration of exposure. The hands most often affected are those of doctors, hairdressers, cooks, cleaners and construction workers. Allergic dermatitis is a delayed reaction: after the first encounter with an allergen, the immune system “remembers” it, and with repeated contacts, after 1–3 days, inflammation appears, sometimes extending beyond the contact area. Separately, photocontact dermatitis is isolated, when a substance causes a reaction only under the influence of the sun.
- Simple (irritant) contact dermatitis
- Allergic contact dermatitis
- Phototoxic and photoallergic dermatitis
- Contact urticaria - rapid reaction to latex and products
- Acute, subacute and chronic course
Common reasons
The list of substances that can cause dermatitis is very wide, but in practice the culprits are often the same groups. Allergies to nickel in earrings, belt buckles and fasteners are common. Cosmetics and hair dyes contain fragrances, preservatives and paraphenylenediamine. The reaction is caused by rubber gloves, adhesives, medicinal ointments and some plants. Irritant hand dermatitis develops from frequent washing, antiseptics, detergents, cement and solvents.
- Nickel and cobalt in jewelry and accessories
- Cosmetics flavorings and preservatives
- Henna hair dyes and tattoos with additives
- Rubber and latex
- Detergents, solvents, cement
- Local medications, including antibiotic ointments
Symptoms
Inflammation usually coincides with the site of contact: the earlobes when reacting to earrings, the wrist under a watch, the hands after working with chemicals, the eyelids when reacting to fingernail polish carried by the hands. In the acute phase, the skin turns red, swells, small blisters and weeping appear. Chronic dermatitis appears as dry, thickened patches with peeling and painful cracks. Simple dermatitis is often accompanied by burning and pain, allergic dermatitis is often accompanied by severe itching.
- Redness and swelling
- Itching, burning
- Bubbles and weeping
- Dryness, peeling, cracks
- Thickening of the skin over a long period of time
- Borders that follow the shape of the object
Diagnostics
The doctor finds out what the skin comes into contact with at home, at work and during hobbies, and what products were used for treatment. The main method for confirming allergic dermatitis is patch testing: plates with standard allergens are glued to the skin of the back and the reaction is assessed after 48 and 72 hours. A blood test for IgE and skin prick tests for contact dermatitis are not very informative, since the reaction is associated with cellular immunity. If a fungal infection is suspected, a scraping is taken.
- Detailed survey about contacts and profession
- Assessment of rash location
- Application patch tests
- Microscopy of scraping to exclude fungus
- Trial exclusion of a suspected drug
Treatment and prevention
The basis of treatment is to stop contact with the irritant or allergen. To relieve inflammation, the doctor prescribes local glucocorticosteroids of suitable strength in a short course; in case of a widespread process, sometimes systemic therapy. Emollient creams restore the skin barrier and are needed constantly. Antihistamine tablets have little effect on the dermatitis itself, but can make it easier to sleep if the itching is severe. Self-medication with hormonal ointments without control is dangerous due to thinning of the skin, especially on the face and eyelids.
- Eliminate the identified allergen, including in other products
- Wear cotton gloves under rubber ones
- Wash your hands with warm, not hot water and mild detergents
- Apply emollient cream regularly
- Choose nickel-free jewelry
- Check the composition of cosmetics and hair dyes