Solving the mystery of contact dermatitis
Dry, itchy skin can make anyone uncomfortable. To get effective relief, you’ll first have to identify the trigger behind it.
Allergic skin reactions are frustrating and irritating, but even more so when you can’t seem to figure out the reason behind them. Whats prompting that itchy, red, scaly skin and more importantly, how can you make it go away?
In many cases, the cause of your problems is a common condition called contact dermatitis. As the name implies, it occurs when your skin touches something to which you’re allergic; one of the first questions to ask is, What have you changed recently within your workplace or home? Identifying the causes of contact dermatitis usually requires a little digging and the help of a licensed dermatologist.
Not surprisingly for anyone who has ever had a case of it, poison ivy is the hallmark example of contact dermatitis. Skin reactions range from red bumps and mild itching to blisters and severely itchy skin, and can depend on two factors: amount of exposure to poison ivy and the sensitivity of the person it’s affecting. Next in line is nickel allergy, which can show up after contact with nearly any form of metal, from jewelry to cellphones. Since the source isn’t as easy to identify as a case of poison ivy, it’s also the most commonly tested.
Hand eczema is particularly common in people with jobs in which they work with skin irritants and allergens, such as a hairdresser who is allergic to hair dyes or perms. Outward signs on the hands include itchy, rough, thick and scaly skin that can actually become bad enough to limit job performance. Another common allergen is neomycin, which is found in numerous triple antibiotic ointments and can bring about a rash after being applied to a cut or abrasion. In addition, skin reactions can flare up from preservatives and fragrances found in a number of lotions, cosmetics, shampoos and soaps.
Switching to different laundry detergents or soaps will commonly initiate symptoms and are often difficult for an individual to identify without medical help.
The first treatment step a dermatologist will recommend is to avoid potential allergens with the use of hypoallergenic products. If symptoms continue, the only definitive way to identify what is causing your contact dermatitis is by conducting a patch test. After discussing your personal history and lifestyle, the doctor will select a number of allergens for which you should be tested, place a small amount on an 8mm patch with a petroleum jelly base and stick them to your back for 48 hours. In contrast to other allergy tests, this is only performed to identify skin allergies, and no needle pricks or scratches are necessary. The patches are then removed, and if a small red mark appears within a couple of days, then you’re allergic to that substance. Typical treatments at that point include finding alternatives for the allergen, along with cortisone ointments and even cortisone pills or injections, to eliminate the symptoms.
Research is ongoing to help identify genetic causes for some people’s sensitivity to this condition and approve new medications and treatments that can actually prevent symptoms from flaring up. In the meantime, consulting your dermatologist when problems persist is the wisest approach to find relief.
Dr. Joseph F. Fowler, M.D., is a nationally known dermatologist recognized for his work in the field of rosacea, skin allergies and contact dermatitis. President of the North American Contact Dermatitis Group, he has maintained a private practice for almost 30 years in Louisville and is a Clinical Professor of Dermatology at the University of Louisville, Ky. Dr. Fowler is the author of over 160 scholarly publications and medical chapters and the co-author of Fishers Contact Dermatitis, one of the most widely used dermatology textbooks.