What is dermatitis?

    Dermatitis is an inflammation of the skin. It causes red, itchy skin that may also blister. There are several types of dermatitis. However, dermatitis is generally grouped into two main types:

    • Dermatitis caused by a problem from ‘within’ the body. For example atopic eczema is a common condition that tends to run in families.
    • Dermatitis caused by a substance from outside the body. This typically causes patches of inflammation on areas of skin that have come into contact with the substance. This is called ‘contact dermatitis’.



    What are the different types of contact dermatitis?

    There are two types of contact dermatitis:

    (1) Irritant contact dermatitis

    This is caused by direct contact with a substance that irritates the skin. It most commonly affects the hands. Irritant substances are those that can cause inflammation in almost everyone if they are in contact for long enough, repeatedly enough, and in strong enough concentration.

    For example:

    • Detergents (washing-up liquid, soaps).
    • Solvents such as petrol.
    • Acids and alkalis, including cement.


    (2) Allergic contact dermatitis

    This occurs when your immune system reacts against a specific substance. The substance is then called an “allergen”. You only need a small amount of allergen in contact with your skin to cause the rash.

    There are many substances that can cause an allergic contact dermatitis:

    • Nickel occurs in many types of metal. For example: jewelers, studs in jeans and bra straps.
    • Cosmetics – particularly perfumes, hair dyes, preservatives, and nail varnish resins.
    • Additives to leather and rubber (in shoes, clothes, etc).
    • Preservatives in creams and ointments.


    What are the symptoms of contact dermatitis?

    Signs and symptoms of contact dermatitis include:

    • Red rash or bumps
    • Itching, which may be severe
    • Dry, red patches, which may resemble a burn
    • Blisters and draining fluid from the involved skin in severe cases
    • Skin rash limited to the exposed area
    • Pain or tenderness


    When you should see a doctor?

    See your doctor if:

    • You’re so uncomfortable that you’re losing sleep or are distracted from your daily routines
    • Your skin is painful
    • You suspect your skin is infected
    • You’ve tried self-care steps without success
    • You suspect the dermatitis is job-related


    Do I need any tests?

    Your doctor may diagnose contact dermatitis after talking to you about your signs and symptoms and examining your skin. If the cause of your rash isn’t apparent or if your rash recurs often, your doctor may recommend a patch test.

    During a patch test, small quantities of potential allergens are applied to small patches, which are then placed on your skin to check for a reaction. The patches remain on your skin for three days before being evaluated by your doctor. If you are allergic to a particular substance being tested, you develop a raised bump or a reaction limited to the skin just beneath the patch.


    What is the initial treatment for contact dermatitis?

    • If the inflamed skin is not too bad then just using an emollient (moisturizers) frequently may be all that you need until the inflammation settles and the rash clears.
    • Topical steroids are creams, ointments and lotions that contain steroid drugs. They work by reducing inflammation in the skin. Topical steroids are usually applied twice daily until the inflammation has gone. This may take up to a couple of weeks or more.
    • An antibiotic may be prescribed if the inflammation becomes infected. This is uncommon in most bouts of contact dermatitis.
    • Rarely, a course of steroid tablets is needed if you have a large and severe area of skin inflammation.


    What I can do to reduce my contact dermatitis?

    • Try to identify and avoid substances that irritate your skin or that cause an allergic reaction.
    • Apply an anti-itch cream or calamine lotion to the affected area.
    • An oral antihistamine, such as diphenhydramine, may be helpful if itching is severe.
    • Avoid scratching whenever possible.
    • Apply cool, wet compresses.
    • Take a comfortably cool bath.
    • Wear smooth-textured cotton clothing.

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