Contact dermatitis

Contact dermatitis is an itchy, red rash caused by direct skin contact with a substance that either irritates your skin or triggers an allergic reaction. It is a very common condition and is not contagious. There are two main types: irritant contact dermatitis and allergic contact dermatitis. 

Signs and symptoms

The symptoms of contact dermatitis can range from mild to severe, depending on what caused the rash and how sensitive your skin is. 

  • Irritant contact dermatitis: Symptoms often appear immediately or within a few hours of touching the substance. The rash is usually limited to the area of contact and can feel sore, tender, or like it's burning or stinging.

  • Allergic contact dermatitis: Symptoms can be delayed, sometimes appearing 24 to 72 hours after exposure. The rash can be much itchier and may spread beyond the initial point of contact. 

General symptoms for both types can include: 

  • Red, inflamed rash (may appear darker, purplish, or brownish on darker skin tones).

  • Dry, scaly, or cracked skin.

  • Blisters that may ooze, crust over, and become scaly.

  • Swelling.

  • A burning or stinging sensation. 

Diagnosis

To figure out what is causing your rash, your doctor will likely ask you questions about your: 

  • Recent activities.

  • Exposures to potential irritants or allergens, e.g. poison ivy or poison oak during summer months 

  • Work or hobbies.

  • History of allergies. 

A physical exam of the rash is usually enough for a diagnosis. If the cause is not obvious, your doctor may recommend further testing: 

  • Patch testing: This is the most reliable way to diagnose allergic contact dermatitis. Small amounts of common allergens are applied to patches on your back for 48 hours. The doctor then checks for a reaction.

  • Skin biopsy: In rare cases, a small skin sample may be taken to rule out other skin conditions. 

Treatment

The best treatment for contact dermatitis is to identify and avoid the substance that caused the rash. For mild to moderate cases, symptoms can often be managed with home care. For more severe cases, a doctor may prescribe medication. 

Home care and over-the-counter options: 

  • Identify and avoid the trigger: This is the most crucial step for preventing future flare-ups.

  • Cool compresses: Apply a cool, wet cloth to the affected area for 15 to 30 minutes several times a day.

  • Oatmeal baths: Soaking in a cool or lukewarm bath with a colloidal oatmeal product can soothe the skin.

  • Over-the-counter creams: A 1% hydrocortisone cream can help relieve itching and redness. Calamine lotion can also help dry out oozing blisters.

  • Oral antihistamines: These can help with severe itching, especially if it interferes with sleep. 

Prescription medications: 

  • Stronger steroid creams: For more severe or widespread rashes, a doctor may prescribe a stronger topical steroid.

  • Oral corticosteroids: In severe cases, a short course of oral steroids may be prescribed to reduce inflammation and relieve itching.

  • Antibiotics: If the rash becomes infected from scratching, your doctor may prescribe an antibiotic. 

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