What is contact dermatitis?
Contact dermatitis is a type of eczema triggered by contact with a particular substance or material. It occurs most commonly on the hands and face though it can affect any part of the body.
For most people, avoiding exposure to the substance will help the contact dermatitis clear up. But for some people, long-lasting or chronic dermatitis can affect their quality of life.
What causes contact dermatitis?
Contact dermatitis occurs when your skin reacts to irritants or allergens. Irritants are a substance that damages the outer layer of your skin such as soap or washing detergent, antiseptics, perfumes, solvents, cement or soil and even hard or heavily chlorinated water.
If you already suffer with eczema, you might be at greater risk of contact dermatitis from an irritant.
Contact dermatitis can also be caused by an allergen which causes your immune system to respond in a way that noticeably affects your skin. This usually happens when you’re exposed to an allergen again and again; your immune system reacts and causes your skin to become itchy and red.
Common allergens include:
- Cosmetics, including perfumes, hair dyes and nail varnish chemicals
- Metals, such as cobalt and nickel which are common in jewellery and pipework
- Textiles, including cloth which has been dyed
- Rubber, including latex
- Glues and resins, such as those used in woodwork and floor or carpet laying
- Other chemicals, such as turpentine, epoxy resin and hardenersand even the chemicals used in the manufacture of gloves
- Some flowers and plants
What are the symptoms of severe contact dermatitis?
If you have contact dermatitis, your skin may become itchy, blistered, dry and cracked. Symptoms which are caused by an allergen, such as metal or a cream, can take several days to develop. With milder irritants such as soap, you may need more frequent exposure before symptoms occur.
Your skin can take on different shades – you may notice patches of dark brown, purple or grey skin developing.
Who is most likely to get contact dermatitis?
You’re more at risk of irritant contact dermatitis if you work with irritants; for example, if you’re a healthcare worker, cleaner or cook or if you work in the hair and beauty sector. You’re also at risk if you work in construction, with metal, operate machinery or work as a mechanic, carpenter, gardener, floor or carpet layer.
How is contact dermatitis diagnosed?
If you think you may have contact dermatitis, you should speak to your GP. They’ll ask you questions about your symptoms as well as the substances you’ve been exposed to. They might also ask you whether there’s a history of eczema or contact dermatitis in your family.
What’s the treatment for severe contact dermatitis on my hands?
If you’re able to identify the trigger of your dermatitis, your GP will recommend that you avoid exposure to it as much as possible and your contact dermatitis should clear up. If you’re exposed to irritants as part of your job, you should wear protective clothing to minimise contact with substances that trigger your dermatitis.
Emollients are moisturisers that can be applied directly to your skin. They provide a protective film, reducing water loss and stopping your hands from turning dry or scaly. Emollients are available as an ointment, cream or lotion and some can be used instead of soap.
Your clinician might also recommend topical corticosteroids or steroid tablets which can reduce inflammation. These very in strength and are available on prescription.
If you skin becomes infected, you should contact your GP as you may need contact dermatitis medication, such as antibiotics. Signs of infection include:
- Worsening of existing symptoms
- A discharge from your skin
- Pain and discomfort
- Feeling hot or shivery and generally unwell
What can I do if treatment doesn’t work?
If the irritants or allergens can’t be identified, or the contact dermatitis isn’t responding to treatment, your GP can refer you to one of our specialist Consultant Dermatologists. They’ll carry out a ‘patch test’ where small amounts of known allergens are applied to your back or upper arms.
After a couple of days, the Consultant will remove the patches and check for any reactions to the allergens. Some allergens may take longer than others to provoke a reaction.
They might recommend phototherapy, where the affected area is exposed to UV light, immunosuppressant therapy or alitretinoin capsules which can help treat severe contact dermatitis of the hands.
How can I access treatment for severe contact dermatitis?
To find out more about treatment for severe or chronic contact dermatitis, complete our online enquiry form or contact our Private Patient team via Livechat or on 01580 363158.
Published on 04 January 2022