Dr. Joshua Fox Offers Tips on Treating Contact Dermatitis

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Contact dermatitis is a condition in which the skin becomes irritated and inflamed after coming into contact with certain substances. The good news is that the condition is fairly easy to treat, at least once you’ve done some detective work to figure out what’s causing the reaction,” says Dr. Joshua Fox, a New York-based dermatologist and founder of Advanced Dermatology, P.C.

Have you ever had a skin reaction—red bumps, itching, swelling—that you can’t readily explain? Most people have. It may be contact dermatitis, and it can be pretty uncomfortable, lasting for days to weeks. “Luckily, the condition is fairly easy to treat, at least once you’ve done some detective work to figure out what’s causing the reaction,” says Dr. Joshua Fox, a New York-based dermatologist and founder of Advanced Dermatology, P.C. “And don’t worry: It’s neither contagious, nor life-threatening.”

What Is Contact Dermatitis?
Contact dermatitis is a condition in which the skin becomes irritated and inflamed after coming into contact with certain substances. Usually, the irritation occurs at the site of contact: For instance, you might develop red, itchy bumps on the side of your face if you’re allergic to the cover of your cellphone. But you might also have itching everywhere if you’ve used a detergent that your skin doesn’t agree with.

There are two main categories: irritant contact dermatitis and allergic contact dermatitis.
Irritant contact dermatitis is more common. It occurs when a substance damages the outer layer of the skin. Allergic contact dermatitis is triggered when you touch a substance that you’re allergic to, which leads to an immune reaction in the skin, often getting worse with repeated exposures.

Either way, typical symptoms include a red rash or bumps, itching, blisters, dry patches, and pain or tenderness in the area of exposure. “The reaction can be restricted to a small area or it can be extensive, depending on the nature of the exposure, meaning how strong the irritant is and how long you were exposed to it for,” explains Dr. Fox.

Although the causes of contact dermatitis can vary widely, some of the more common substances implicated are:

  • Nickel (often found in jewelry, clothing fasteners, and coins)
  • Poison ivy, oak, and sumac
  • Cashew nuts
  • Citrus fruit
  • Topical medicines that are applied to the skin, such as antibiotics, antihistamines, and antiseptics
  • Fragrances and flavorings
  • Strong soaps and detergents
  • Skin cleansers, cosmetics, hair dyes and straighteners, and deodorants
  • Cleaning products and other chemicals
  • Clothing and shoes
  • Latex

“Almost anything can cause a reaction,” Dr. Fox notes. “The medical literature highlights examples of people with contact dermatitis as a result of exposure to eye makeup, hair dye, kitty litter, sanitary napkins, diapers, and all sorts of other things. Even organic or natural products can be problematic, since they may contain essential oils and fragrances, or they may be made from ingredients such as chamomile, feverfew, and calendula that are common allergens.”

How Is Contact Dermatitis Treated?
The first step in dealing with contact dermatitis is determining the source of the skin irritation and then avoiding any additional exposure to it. If you do have contact with it, wash your skin as soon as possible, which may prevent the reaction if you wash it quickly enough after touching it. You might also consider wearing protective gloves while doing certain chores if you suspect household products are causing the rash. The same applies to substances you come into contact with on the job, such as chemicals: “Wear gloves if you think they may be too harsh for your skin,” Dr. Fox suggests.

When you have symptoms and a rash, you can apply a non-prescription anti-itch cream with 1% hydrocortisone, calamine lotion, or compresses to the area for relief or take an over-the-counter oral antihistamine such as Benadryl (diphenhydramine). You also might want to take a cool bath with colloidal oatmeal or baking soda, as that can help heal the bumps and soothe the dry patches, followed by an application of moisturizer. “It’s important not to scratch the area, as difficult as that sounds,” Dr. Fox advises, “because that will make the problem worse, not better, and can cause an infection and possible scarring. .”

When to See a Dermatologist
The cause of contact dermatitis can be unclear, in which case you should see a dermatologist for assessment and testing. “If I suspect allergic contact dermatitis, I can do patch testing to narrow down to a specific allergen of interest,” says Dr. Fox. This entails placing adhesive patches containing traces of possible allergens on your skin and leaving them on for 48 hours. If a reaction occurs, the allergen(s) of interest has been found and can then be avoided. Perhaps most important is to see a member of the American Contact Dermatitis Association. They can tell you which product you can safely use without the offending allergen.

Seeing a dermatologist is a good idea since he can treat both the condition and its complications. Neurodermatitis is a condition that can develop when contact dermatitis persists for a long time or is unusually severe; it’s characterized by chronic itching and scaly patches of skin. You can also develop a bacterial or fungal skin infection if you scratch too much, leading to open wounds, scarring and skin discoloration. In these cases, your dermatologist can provide necessary treatments which are not available over the counter.

About Dr. Fox: Joshua L. Fox, M.D., F.A.A.D., earned his medical degree from the Mt. Sinai School of Medicine in New York. He completed an internship at Maimonides Hospital in Brooklyn, followed by a three-year dermatology residency at the New York University School of Medicine. A Fellow of the American Academy of Dermatology, Dr. Fox is a leading authority in the field of dermatology, with an expertise in skin cancer, acne, cosmetic surgery and laser procedures and is the author of many dermatologic publications. He is the founder and director of Advanced Dermatology, P.C. of New York and New Jersey and the Center for Laser and Cosmetic Surgery and is a spokesman for both the American Academy of Dermatology and the American Society of Dermatologic Surgery. He is the director of a fellowship program in Laser & Cosmetic Surgery. http://www.advanceddermatologypc.com. Dr. Fox is also the founder and President of The New Age Research Foundation, a national, non-profit [501 (C) (3)] health organization committed to improving the quality of life of those with skin conditions through research and education.

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MELISSA CHEFEC
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