Goodskin Dermatology

Symptoms, Diagnosis, and Treatment for Contact Dermatitis

It’s back. 

That awful, itchy rash that covers your hands and/or face. Every once in a while it pops up and you slather moisturizer on yourself to get some reprieve. 

Contact dermatitis can be unsightly, uncomfortable, and undermine your confidence. It can be hard to pinpoint what triggered this episodic attack, but with diagnosis and treatment, a physician can help you identify and resolve your contact dermatitis. 

In this article, we will be discussing the symptoms, diagnosis, and treatment of contact dermatitis. 

Table of Contents

contact dermatitis treatment

What Is Contact Dermatitis?

Contact dermatitis is a type of inflammatory eczematous skin disease. This essentially means that it is a type of eczema caused by a source of irritation. Dermatitis is medical terminology for skin irritation. 

Contact dermatitis is divided into two categories: 

  1. Irritant contact dermatitis; and
  2. Allergic contact dermatitis

Contact dermatitis occurs more often in: 

  • Women 
  • Individuals with red hair and/or fair skin
  • Older adults 

What Causes Contact Dermatitis?

The difference between the two distinctions of contact dermatitis lies within their cause: 

  • Allergic contact dermatitis is caused by a histamine response triggered by allergens. 
  • Irritant contact dermatitis is the result of contact with a substance or material. Irritant contact dermatitis is more common than allergic contact dermatitis. 

Irritants

Irritant contact dermatitis can occur when an allergenic irritant comes in contact with the skin. This irritant can be a substance, plant, animal, chemical, or material. 

Irritant dermatitis can occur in anyone who comes in contact with an irritant, but individuals with atopic dermatitis are more susceptible. A list of common irritants that can cause irritant contact dermatitis include:

  • Soaps and detergents
  • Antiseptics and antibacterials
  • Perfumes
  • Cosmetics
  • Toiletries
  • Solvents
  • Machine oil 
  • Disinfectants
  • Acids and alkalis
  • Cement
  • Powders, dust, and soil
  • Water (hard, treated, chlorinated, etc.)
  • Plants

Allergens

It was once believed that allergic contact dermatitis was a rare condition in which an allergic response triggers an episode of eczema. Recent studies have cast doubt on this belief, as the data presents allergic contact dermatitis occurring in up to 20% of school-aged children. 

The three most common sources of allergic contact dermatitis are rubber gloves, nickel, and poison ivy. Other sources include:

What Are the Symptoms of Contact Dermatitis?

Symptoms for both irritant and allergic contact dermatitis present the same and can range from mild to severe. In rare cases, a symptom of contact dermatitis is anaphylaxis

Symptoms most often appear on the hands, neck, or face, but can occur in other parts of the body.

Itchy Dry or Cracked Skin

Dry, cracked, or scaly skin is a common symptom of contact dermatitis and can cause irritation, itching, and burning. This symptom can be mistaken for a form of dermatitis caused by washing/bathing too often or exposure to dry climates, which is sometimes referred to as “winter itch.”

Blisters or Ulcers

Bumps, ulcers, or weepy blisters in the form of a rash are other common symptoms of contact dermatitis. The bumps may be swollen, hive-like, or small and pimply, and usually cluster together in patches.

Changes in Skin Pigmentation

Symptoms like redness and discoloration are often associated with contact dermatitis. In patients with light skin, the skin may become red or pink. In patients with darker skin, the discoloration may look dark brown, purple, or gray. 

Contact dermatitis may also lead to post-inflammatory skin pigmentation. This occurs when the skin’s natural response to inflammation causes an excess in melanin production. 

While recovering from contact dermatitis may leave your skin feeling better, the resulting uneven pigmentation on your face, neck, or hands can affect your self-image. 

At Goodskin Dermatology, we can help your skin recover, and treat your post-inflammatory skin pigmentation, and any other skin ailments like acne or actinic keratosis. 

Swelling

In extreme cases, areas affected with contact dermatitis may swell. Generally, this is mild. Severe swelling is more often associated with allergic contact dermatitis.

How Is Contact Dermatitis Diagnosed?

Contact dermatitis can be diagnosed by a dermatologist or physician following an examination of the affected area and a patient history evaluation. Your doctor may ask about:

  • Any known allergies
  • Family medical history
  • When the symptoms first appeared
  • Your occupational and lifestyle habits
  • Any new substances you’ve come in contact with

If the physician suspects allergens to be the culprit, you may be asked to undergo a patch test to identify the allergen. 

During a patch test, tiny amounts of known allergens are applied to the skin and covered with non-allergenic tape. The patches are usually placed on your back or upper arms and are kept on for up to two days. After two days, the patches are removed and the area is assessed. Sometimes it can take longer for contact dermatitis to appear, so you may be asked to come in for further examination after another two days. 

contact dermatitis treatment

How Is Contact Dermatitis Treated?

Identification and prevention of exposure to the trigger is the best form of treatment. 

But contact dermatitis may not clear up immediately on its own. Other treatments may need to be incorporated.

Contact dermatitis treatments may vary depending on the: 

  • Condition
  • Individual patient; and
  • Care provider

Consult your healthcare specialist to seek a recommended treatment. 

Emollients

Emollients are moisturizing contact dermatitis treatments that provide the skin with a protective layer as it heals. They also help reduce water loss to keep dry, cracked skin moisturized. 

Your skincare provider may suggest you use one emollient or a combination of two or more which may include:

  • Ointments
  • Creams or lotions
  • Soap substitute
  • An emollient for sensitive skin

Ointments and creams have a higher concentration of oil, which makes them more effective at keeping moisture in the skin. 

Certain emollients may irritate the skin, especially if they contain fragrances. It is suggested that you use an emollient recommended by a physician or dermatologist. 

Goodskin Dermatology specializes in treating a variety of skin ailments and conditions. We not only help you identify and treat your contact dermatitis, but we also help you find a skincare routine that fosters healthy, beautiful skin.

Topical Corticosteroids

Topical corticosteroids are steroid ointments that help treat inflammation and soreness. Inflammation is an immune response to irritants or allergens. Topical corticosteroids reduce inflammation by constricting blood vessels. 

High-potency topical corticosteroids you may be prescribed include: 

  • Hydrocortisone topical (AlaCort, AlaScalpt, Aquanil)
  • Triamcinolone topical (Kenalog Orabase, Kenalog topical, Pediaderm TA)
  • Clobetasol (Clarelux, Clobex, Clobex Spray

Steroid Tablets

Severe episodes of contact dermatitis may prompt a need for oral steroids but this is rare. Typically, systemic steroid therapy is employed if the patient has contact dermatitis covering extensive areas of the skin (around 20%).

If your case of contact dermatitis is severe enough to need steroids, you may be prescribed an initial dose of 40-60 mg tapered over a two-week period. 

Further Treatments

For persistent cases of contact dermatitis, your general physician may refer you to a dermatologist for further assessment and treatment. These additional contact dermatitis treatments may be used to complement other prescribed treatments like emollients, topical corticosteroids, or oral steroids. 

The following treatments typically are not prescribed for cases of contact dermatitis where the trigger can be adequately controlled or eliminated. 

Immunosuppressant Therapy

As previously mentioned, contact dermatitis is a product of inflammation due to an immune system reaction. Immunosuppressants may help alleviate contact dermatitis by reducing immune response. 

Immunosuppressants that may be prescribed to treat severe cases of contact dermatitis include:

  • Methotrexate 
  • Cyclosporine 
  • Azathioprine

Immunosuppressants are only used in severe cases, because they may cause serious side effects, including: 

  • Increased risk of infections
  • Nausea and vomiting
  • Increased risk for certain types of cancers
  • Increased blood pressure 
  • Increased risk of kidney damage
  • Risk of liver damage

Alitretinoin

Alitretinoin is a medication that is a part of the retinoid family. Retinoids play an important role in cell growth and death regulation. How alitretinoin helps contact dermatitis that is resistant to steroids or other therapies is unknown. 

Alitretinoin can be prescribed by a physician as a topical gel or oral capsule.

Phototherapy

Phototherapy is an emerging treatment for contact dermatitis. It poses minimal risk and does not require the use of topical ointments or medications. 

During phototherapy, UV (ultraviolet) light is altered to help reduce inflammation. UV is altered into narrowband rays called UVB waves. UVB rays are similar to UV rays, only the light wavelengths that are more damaging to the skin have been removed. 

After one or two sessions, you may find that the burn, itch, and inflammation from your dermatitis are alleviated.

contact dermatitis treatment

How Long Does It Take For Contact Dermatitis To Heal?

The duration of contact dermatitis may vary from person to person and can depend on several factors such as:

  • Specific irritants
  • Affected area of the skin
  • Severity
  • Overall health and immune response 

Mild cases of contact dermatitis may resolve in a few weeks. More severe or persistent cases may endure for weeks or possibly months. 

Promptly identifying the allergen or irritant is an extremely important part of the healing and treatment of contact dermatitis. The sooner the irritant is recognized and remediated, the shorter the duration of the condition will be. 

At Goodskin Dermatology, our skincare and health professionals have extensive experience in identifying and treating common skin conditions. We will tirelessly work with you to find the irritant and begin treatment. 

Our skin is one of our most important organs. When you’re having issues with your skin, it can detract from your overall well-being. That’s why we provide patient-centered, quality care so you can get back to feeling like yourself again. 

Goodskin Dermatology Provides High-Quality, Patient-Based Care for Contact Dermatitis

Dealing with contact dermatitis can be frustrating, but you don’t have to do it alone. 

As skincare and health professionals, we’ve identified and treated hundreds of cases of contact dermatitis. 

We know how to promptly identify the trigger, suggest prevention methods, and begin a treatment that will quickly alleviate your symptoms. It is our priority to help you achieve healthy skin. 

Goodskin Dermatology provides a wide array of care that specializes in:

  • General dermatology, providing care for:
    • Warts
    • Acne
    • Hair loss
    • Psoriasis
    • Etc.
  • Surgical dermatology for the treatment of:
    • Skin cancer treatment
    • Cyst removal
  • Cosmetic dermatology, providing anti-aging and non-surgical cosmetic procedures, including:
    • Chemical peels
    • Facials
    • Dermaplaning
    • Ultherapy
    • And more

Schedule your first appointment today. 

The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.