Contact Dermatitis: Substance-Triggered Allergy


Do you experience red, itchy bumps around your ankles hours after hiking through the woods? Have you developed a rash after wearing a new accessory like a necklace, bracelet, or earrings? Has your face become red and itchy during an afternoon at the beach? Have you ever used a new type of skin care product or detergent, only to have your skin become red and irritated.

If you answered yes to one of the questions above, you may be experiencing a skin condition called contact dermatitis. Contact dermatitis causes localized rash or skin irritation from direct contact with a foreign substance. The rash isn’t contagious or life-threatening, but it can be very uncomfortable until it goes away. Some rashes happen immediately. Most take time to appear.

Different Causes of Contact Dermatitis

There are many different causes or triggers for contact dermatitis. Along with the physician evaluation, a person’s history of exposure to various chemicals and substances can help to determine the cause of the rash. An allergist can help you get to the bottom of what’s causing the irritation.

Causes of Occupational Contact Dermatitis

Occupational contact dermatitis is a type of eczema caused by the interaction of the skin with chemical, biological or physical agents found in the work environment. The most common jobs associated with contact dermatitis include healthcare professions (usually due to a latex allergy), food handlers and processors, beauticians and hairdressers, machinists, and construction workers.

The main occupational allergens are rubber additives, metals (chromium, nickel, cobalt), plastics (epoxy resins, acrylic), and biocides. Diagnosis is based on clinical examination, medical history and allergy testing.

Plants that Cause Contact Dermatitis

Most allergenic family members belong to the genus Toxicodendron, and they possess a toxic oleoresin called urushiol. The rash from these plants results in a linear, or streak-like group of itchy blisters or bumps. Here are the common plants that cause contact dermatitis:

  • Poison Ivy
  • Poison Oak
  • Poison Sumac
  • Wood Nettle and their stinging hairs
  • Stinging Nettle
  • Dried Baby’s Breath
  • Leadwort
  • Ragweed

Beauty Products That Can Cause Contact Dermatitis

Beauty products and perfume can help you feel on top of your game but they can also cause skin irritation or an allergic reaction. Contact dermatitis on face is the most distressing type of reaction that an individual may experience. Problems can range from simple rashes to full-blown allergic reactions. Symptoms can start right after you use something new or after years of using a product with no problems.

Be extra careful in using beauty products such as make-up, shampoo, and perfume. It might make you feel great about yourself but you might be allergic to it or it might irritate your skin. Labels such as “hypoallergenic,” “dermatologist tested,” “sensitivity tested,” or “non-irritating,” doesn’t guarantee that your skin is safe from irritants or allergens. Alpha-hydro acids levels over 10%  on beauty products can cause skin irritation like redness and itching. Sunscreen and sunblock lotions tend to cause a dermatitis reaction. Talk to your dermatologist on what sunscreen products is best for your skin. Here are common ingredients in beauty products that can irritate skin:

  • Essential Oils 
  • Sulfates (Sodium laureth sulfate and sodium laurel sulfate)
  • Emollients (lanolin, coconut butter, cocoa butter, isopropyl palmitate, isostearyl isosterate, and myristyl lactate.)
  • Metals (Nickel for Jewelries; Cobalt in antiperspirants and hair dyes)
  • Fragrances
  • Acids (salicylic acid and glycolic acid)
  • Aluminum compounds (in antiperspirants. 

Topical Medication for Contact Dermatitis

Numerous topical medications can result in contact dermatitis when applied to the skin. These include lanolin, found in some moisturizers such as Eucerin, topical antibiotics such as neomycin (Neosporin) and bacitracin, para-aminobenzoic acid (PABA), found in some sunscreens, anti-itch creams containing local anesthetics, topical corticosteroids, such as hydrocortisone cream, and topical NSAIDs, such as Aspercreme.

Oral and Dental Products

Oral contact dermatitis is relatively rare. Our oral mucosa is more resistant to primary irritants, and is not as readily sensitized as the skin. Nevertheless, contact reactions can occur on the oral mucous membrane. The most common causes of contact dermatitis involving the mouth include flavorings (Balsam of Peru, cinnamic aldehyde) and other chemicals found in toothpaste and mouthwashes. Metals used in dentistry are known to cause contact dermatitis in the mouth and include mercury, chromium, nickel, gold, cobalt, beryllium, and palladium.

Contact Dermatitis Symptoms

Contact dermatitis symptoms can range from mild to severe, and they can appear anywhere from a few hours to 10 days after coming into contact with the irritant or allergen. A contact dermatitis rash cannot be spread to anyone else. Symptoms include:

  • Red, irritated skin
  • Itching
  • Swelling
  • Bumps or blisters, sometimes filled with clear fluid
  • Hot or tender skin

Contact Dermatitis Treatment

Identifying the trigger is essential for contact dermatitis treatment. Avoidance is key to treating the rash. If avoidance is not possible, the rash may become chronic, disabling and lead to a major impairment in quality of life. Advice might include:

  • Cold compress to help with the itch.
  • Burrow’s solution (aluminum triacetate), calamine, and/or oatmeal baths can also be utilized for oozing lesions.
  • Avoid excessive hand washing and use non-irritating moisturizers. Choose mild soaps, moisturizers, and detergents without dyes or perfumes.
  • Use barrier sock for foot contact dermatitis.
  • Wash skin immediately after contact with an allergen to limit the spread and severity of the reaction
  • Apply covers over metal fasteners in clothing to avoid contact with nickel.

If home care steps don’t ease your signs and symptoms, your doctor may prescribe medications. Examples include:

  • Steroid creams or ointments. These topically applied creams or ointments help soothe the rash of contact dermatitis. A topical steroid may be applied one or two times a day for two to four weeks.
  • Oral medications. In severe cases, your doctor may prescribe oral corticosteroids to reduce inflammation, antihistamines to relieve itching or antibiotics to fight a bacterial infection.

It may seem like a difficult task to avoid the triggers causing your symptoms, especially if the cause is occupational or you are not exactly sure of the cause entirely. If your symptoms have a significant impact on your quality of life, speak to Dr. Amy Schiffman now, an allergist in Boca Raton, Florida. You can reach her at 561-409-2800.

Please call the office to discuss your allergy evaluation needs, and medications to avoid in preparation for testing.

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