Contact dermatitis is a condition in which a localized rash or irritation affects the skin after direct contact with a substance that is foreign to the body. Symptoms may include inflammation of the skin, a red rash, and in some cases small fluid filled blister-like structures that may weep. Most irritations are accompanied by burning and itching, while others may be painful rather than itch. Substances that commonly cause both kinds of contact dermatitis include plant sap, metals, cleaning solutions, cosmetic additives, perfumes, industrial chemicals, and latex rubber additives. Some products only evoke a reaction with exposure to sunlight. You more be prone to develop contact dermatitis if you also have other skin conditions. At Johns Creek Dermatology we treat two kinds of contact dermatitis which typically have similar symptoms but different triggers.
Irritant Dermatitis usually resembles a burn and is initiated by contact with acids; alkaline materials such as soaps and household cleaning products; shampoo and detergents; fabric softeners; solvents; hair dye; latex or rubber gloves; cement; lawn and garden products; or other chemicals. The skin reaction usually appears immediately upon contact, and evolves into dry, rough, red skin, sometimes splitting. However, in some cases you may not have an immediate reaction to a substance, and regular use over time can eventually cause sensitivity and a reaction to the product. The hands, face, head and neck are most commonly affected.
Allergic Contact Dermatitis often results from an immune response to a small, structurally simple, nonprotein molecule, caused by exposure to a substance or material to which you have become extra sensitive or allergic. Allergic type reactions may occur suddenly, a few days after exposure, or months after exposure to a substance. Where contact occurred with the substance, a red, streaky or patchy rash may occur, often with bumps that form moist, weepy blisters that ooze, drain and crust. Or, skin may be scaly, raw or thickened and feel warm. Common allergens may include: adhesives; fragrances in perfumes and personal care products; antibiotics; clothing materials, such as wool or spandex; nail polish; hair products and dyes; nickel or other metals; poison ivy, oak sumac and other plants; and rubber or latex.
Symptoms vary depending on the cause and the type of dermatitis. Distinguishing allergic contact dermatitis from irritant contact dermatitis and other forms of eczematous dermatitis can be challenging. Johns Creek Dermatology will document the history of exposure to the irritant or allergen, and conduct an evaluation of the skin’s appearance. When necessary for diagnosis, we may conduct tests, including skin lesion biopsy or culture of the skin lesion. Patch testing (the application of chemicals to the skin for 48-72 hours) may be required in association with allergic dermatitis, particularly for patients with repetitive dermatitis.
Upon diagnosis, Johns Creek Dermatology will develop a treatment plan, which usually consists of medications to relieve the symptoms, and avoidance of the suspected irritant. Emollients or moisturizers will be recommended to maintain skin moisture, and help skin repair itself. Corticosteroid skin creams or ointments may be prescribed to reduce inflammation, and in severe cases an oral steroid or injection may be required. An OTC or prescription antihistamine regimen may also supplement the other treatments. We will prepare a maintenance plan in allergic dermatitis cases, because it is important to remember that even though your symptoms may be cleared within weeks, your immune system will recall the substance to which you are allergic.