Contact dermatitis: Causes, symptoms and treatments
What is contact dermatitis?
Have you developed red, inflamed patches on your skin after coming into contact with a certain substance? You might be experiencing contact dermatitis.
About contact dermatitis
Contact dermatitis is a type of eczema where your skin reacts after exposure to substances in your environment. It’s a common occupational health complaint, particularly amongst people who work with harsh or hazardous chemicals and materials. It’s thought that contact dermatitis affects 9% of people in the UK*.
Contact dermatitis is common amongst chemical workers, cleaners, machine operators, agricultural workers, beauticians, hairdressers, cooks, health workers, mechanics, and people who work in construction.
The symptoms of contact dermatitis normally develop within 48 hours of exposure. If you can avoid repeat exposure to the same substance, the reaction should clear up and you shouldn’t experience any lasting symptoms or complications.
Contact dermatitis is typically caused either by an irritant (e.g. a harsh chemical) or by an allergen, any kind of substance or material that your body gradually develops an allergy to.
You’re more likely to experience contact dermatitis if you have a history of atopic eczema – this is an allergic condition that is often experienced by people with hay fever and asthma.
Symptoms of contact dermatitis
If you develop contact dermatitis you might notice that your skin is:
- Inflamed and irritated
In addition you might experience some itching (this is more common if the rash is caused by an allergen), or a sensation of burning or stinging (more common with irritant substances).
If your contact dermatitis becomes infected, your symptoms might suddenly worsen and become more painful. You may also develop a fever, generally feel unwell, and notice discharge from the skin.
If you think you have a skin infection, you should see a doctor as soon as possible. You will probably need a course of antibiotics to tackle the infection and prevent further complications.
Types of contact dermatitis
As we’ve previously highlighted, contact dermatitis symptoms tend to develop after exposure to two types of substance:
- Irritants – which damage the outer layer of the skin
- Allergens – which cause a reaction in the immune system, leading to skin symptoms
Irritant contact dermatitis
This variety of contact dermatitis might arise after long-term exposure to a weak irritant, or after one-off contact with a strong irritant. You’re more likely to develop symptoms if you have a history of atopic eczema.
Common causes of irritant contact dermatitis
- Soaps and detergents
- Toiletries and cosmetics containing perfumes and preservatives
- Acids and alkalis
- Dust, soil and powders
- Machine oil
- Chlorinated or hard water
- Certain plants
Your skin symptoms can be made worse if you rub at your skin, or if it is subsequently exposed to an environment that is very hot, cold or dry.
Allergic contact dermatitis
Allergic contact dermatitis does not arise after first exposure to a substance, as it is not caused by the substance directly irritating the skin. Instead, contact with the substance causes your body to become sensitive to it. The immune system subsequently “overreacts” to contact with that substance, triggering skin symptoms.
Common causes of allergic contact dermatitis
- Nickel, cobalt and other metals
- Preservatives, fragrances and other ingredients found in cosmetics
- Latex and other types of rubber
- Textile dyes and resins
- Epoxy resin and other glues
- Flowering plants such as daffodils and tulips
- Topical medicines
A nickel allergy is relatively common, as nickel is often found in metal jewellery. If you develop the allergy you might notice a red rash under your watchstrap or around a piece of jewellery.
Contact dermatitis treatment
Once you start experiencing the symptoms of contact dermatitis, it’s vital that you take steps to avoid repeat exposure.
If you can identify the substance causing the reaction, and avoid future contact with it, your symptoms should clear up without causing any complications. If you don’t know what caused your symptoms, it’s a good idea to speak to a doctor or occupational health specialist.
In a work scenario, consult your employer, as they may have an occupational health specialist who can recommend preventative measures. It may be that the substance can be replaced with something that doesn’t cause symptoms, or that your employer can equip you with protective clothing.
For irritant contact dermatitis, you should implement the following preventative measures:
- Wear protective gloves with cotton liners, particularly when washing with detergents
- Keep your hands clean by washing with lukewarm water and an emollient cleanser (i.e. one for dry, sensitive skin that does not contain soap)
For allergic contact dermatitis, you should wear protective gloves made of rubber or PVC with cotton liners when handling anything you have an allergy to.
If you don’t know what you’re allergic to, you might need to see a dermatologist for a patch test. This is where small amounts of different allergens are applied to this skin using a hypoallergenic tape. After a few days the skin is checked to see if the allergen has provoked a reaction.
In addition to avoiding contact with the trigger, you can also treat symptoms in the short term by applying emollients. Emollients are cleansers and moisturisers tailored towards very dry and sensitive skin. They do not contain soap, and are typically non-fragranced and hypoallergenic.
Emollients come as cleansers, bath oils, ointments, creams, and lotions. You can use them to wash your skin, and to moisturise your skin once it’s dry. Ointments are the best emollient for very dry skin as they contain a high fat content. However they can be very greasy and are not suited to areas of skin covered in hair.
While experiencing the symptoms of contact dermatitis, it’s a good idea to apply emollient moisturisers to your skin every few hours.
If your symptoms are more severe, your doctor may recommend a topical corticosteroid. This is a cream or ointment containing steroids, which can help to reduce inflammation.
You should apply topical corticosteroids in a thin layer to affected areas once or twice a day, exactly as directed by your doctor. Usually it’s recommended that you apply an emollient first, letting it soak into the skin for 30 minutes before you apply the steroid cream.
Some mild topical corticosteroids, such as HC45, are available over the counter. Before you buy them you’ll need to have a short conversation with the pharmacist, or answer some questions if you’re ordering online.
In very severe cases, your doctor might prescribe a short course of steroid tablets.
You can learn more about how to treat contact dermatitis by visiting your nearest LloydsPharmacy and speaking to one of our experienced pharmacists.
When to see a doctor
The NHS advises seeing your GP if you have “persistent, recurrent or severe symptoms of contact dermatitis”. Your GP can try to identify what is causing the reaction and suggest some treatments to bring your symptoms under control.
In some cases, a referral to a dermatologist might be needed. They will be able to do tests to work out the cause of your dermatitis, and prescribe specialist treatment.
How to prevent contact dermatitis
If you’ve had contact dermatitis in the past, the best way to protect yourself is to avoid the irritant or allergen that triggered your symptoms. If this isn’t always possible, you can take protective steps, such as the following:
- Wear gloves to protect your hands
- Clean your skin with warm water and an emollient if you come into contact with an irritant or allergen
- Switch up the cosmetics products you use to cut out irritating ingredients
- Keep your skin moisturised and protected by applying emollients frequently