Irritant and contact Dermatitis

Most cases of dermatitis occur when your skin is exposed to an irritant (a substance that causes direct harm to the protective surface layer of skin, e.g. Clorox^®), an allergen (a substance that provokes a response from the immune system, e.g. nickel), or a combination of both.

Irritants strip the surface oils from your skin, while allergens cause your immune system to assume that a substance is harmful, thereby activating defense systems.

There are thousands of known irritants and allergens that can prompt your skin to break out in a rash. Common irritants include soaps, detergents, solvents, rubbing alcohol, shampoos, airborne substances like sawdust, plants, fertilizers, pesticides. battery acid, drain cleaners, pepper spray, and bleach. Common allergens may include poison ivy, poison oak, hair dyes, nickel, leather, latex, rubber accelerators, preservatives, fragrances, and topical medications.

Irritant and contact dermatitis often occur on the face and hands, but rashes can appear anywhere on the body. The condition affects parts of the body that have been most directly exposed to the offending irritant or allergen. Symptoms associated with irritant and contact dermatitis include redness and itching that may become severe. Paler skin types become red, but the rash may appear dark brown, purple, or gray in darker skin types. Blistering, hives, scaling, oozing, and crusting may additionally be present. Irritant dermatitis usually appears immediately after exposure to the offending agent. Contact dermatitis requires a prior exposure to the offending agent.

Anyone can develop irritant or contact dermatitis. Healthcare workers, hairdressers, bartenders, and new mothers often have irritant dermatitis from frequent hand washing. Mechanics, industrial workers, and hairdressers can develop contact dermatitis to the chemicals they work with daily.

The treatment of choice for irritant and contact dermatitis is to avoid the offending agent. Once the rash develops, a topical steroid is often prescribed to clear it. In more severe cases, oral steroids and antihistamines may be used. To keep the skin barrier healthy, do not repeatedly scratch the skin, and apply a bland emollient cream several times per day.

The most reliable way of preventing irritant and contact dermatitis is being aware of what causes your skin to break out and taking steps to avoid repeated exposure to those offending agents. If you don’t know what’s causing the dermatitis, choose fragrance-free and dye-free skin products, wear protective gear such as gloves or goggles when working with materials that may cause reactions, apply a barrier cream to your skin, test out new products on small patches of skin, and wash your skin after exposure to an irritant. Dermatologists perform extensive patch testing to help identify offending allergens.

The Bryn Mawr Skin & Cancer Institute dermatologists are experienced in identifying skin irritation, redness, itchiness, and more, including atopic dermatitis, hives, ringworm, and other conditions. An accurate diagnosis is most important to help guide appropriate treatment.