Contact dermatitis: symptoms, causes, drugs, remedies, etc.

Definition

What is contact dermatitis?

Contact dermatitis is a condition that causes red skin to become inflamed after direct contact with allergens (allergens) or irritants (irritants) from the environment.

Substances that cause skin inflammation can be in the form of chemicals in cosmetics and body care products, exposure to poisonous plants, or skin contact with allergens. The cause of irritation and inflammation can vary from person to person.

Contact dermatitis is a common type of dermatitis in the world, including Indonesia. This condition can occur in all age groups and sexes. You don't even have to have a specific history of allergies to get contact dermatitis.

Skin symptoms usually go away once you avoid the trigger. If symptoms are severe enough, your doctor may prescribe a number of medications to reduce their severity.

Treatment does not make you free from the risk of developing similar conditions in the future, but it does help to prevent complications. The most common complication of contact dermatitis is infection of the skin that is scratched repeatedly.

Type

What are the types of contact dermatitis?

Based on the mechanism of cause and trigger, contact dermatitis is divided into allergic contact dermatitis and irritant contact dermatitis. Here are the differences between the two.

1. Allergic contact dermatitis

Allergic contact dermatitis is inflammation of the skin due to direct contact between the skin and an allergen. Allergens are substances that cause allergies that are actually not harmful to health, but are considered by the immune system as a threat.

You can be exposed to thousands of foreign substances every day and most of them do not trigger a reaction in the immune system. However, some people's immune systems may overreact to these substances. This response is known as an allergic reaction.

According to a report released by the Institute for Quality and Efficiency in Health Care (IQWiG), approximately 8% of adults worldwide suffer from allergic dermatitis. Men are more susceptible to contracting this skin disease than women.

2. Irritant contact dermatitis

Irritant contact dermatitis is a type of dermatitis that results from skin contact with an irritant. In contrast to allergens, irritants are substances that trigger inflammation or other irritating symptoms in the body.

The substances that are most often irritants are chemicals in body cleansing products, perfumes, and cosmetic compositions. However, it is possible that other materials commonly found in the environment can also be the trigger.

Anyone can experience this condition, but people who have atopic dermatitis (eczema) are usually more susceptible. Inflamed skin makes it easier for irritants to enter the skin, worsening ongoing symptoms.

Symptoms

What are the signs and symptoms?

Contact dermatitis is commonly characterized by itching, dry skin, and a red rash. The following is a list of symptoms based on the type.

1. Allergic contact dermatitis

Symptoms usually appear within 24 - 48 hours after direct skin contact with the allergen. In some people, symptoms may only appear after repeated skin contact with allergies.

Below are the signs.

• Itchy rash.
• Pain, soreness, or burning in the problem area of ​​the skin.
• Bumps and sores that look moist, watery, or pus. The lumps can sometimes appear dry or crusty.
• The skin feels hot or burning.
• Dry, reddish, thickened, rough, scaly skin.
• The wound looks like an incision in the skin.

An allergic reaction that is severe enough can also make the skin feel tight and blistered. These blisters can drain fluid, then turn into ulcers and peel off.

Symptoms generally appear only on areas of the skin affected by the allergen. However, in rare cases, symptoms can spread to other skin areas such as the hands, face, neck and feet.

2. Irritant contact dermatitis

Symptoms of irritant contact dermatitis usually appear immediately after the skin is exposed to an irritant, whether intentionally or not. In certain cases, new symptoms may appear after repeated skin contact with the irritant.

Different people may experience symptoms that vary, because one irritant can trigger reactions that are different from other irritants. However, sufferers generally experience the following symptoms:

• Red rash.
• Dry skin.
• Itching and burning sensation.
• Swollen skin.
• Peeling skin.

The symptoms of this condition are sometimes very similar to the symptoms of eczema. Therefore, a medical diagnosis is needed to determine the cause of the symptoms.

When should I see a doctor?

Contact dermatitis is a non-contagious skin disease that usually goes away on its own once you avoid the trigger. However, a severe reaction may interfere with daily life or lead to infection.

Therefore, you are advised to check with a dermatologist if the symptoms do not improve and there are the following conditions.

• There are red patches that make you unable to sleep or do daily activities.
• The red patch is painful and spreads.
• The red patches on your skin make you feel insecure.
• The red patches don't get better in a few weeks.
• Red patches irritate your face or genitals.
• Stopping steroid use can make skin inflammation worse.
• Use of drugs incorrectly so that the skin actually experiences side effects or symptoms that are more severe.

Cause

What causes contact dermatitis?

The following are causes of contact dermatitis by type.

1. Allergic contact dermatitis

Allergic contact dermatitis occurs when you come into direct contact with a foreign substance that has the potential to trigger an allergy. The substance is actually harmless, but the immune system actually perceives it as a threat.

The immune system then releases antibodies, histamine, and various other chemicals to fight it. In fact, this response should only be intended to eradicate germs or substances that can actually cause damage to the body.

The release of antibodies and histamine causes inflammation, especially in the parts of the body that are in direct contact with the allergen. As a result, symptoms of a rash, itching, and redness are characteristic of an allergic reaction.

The substances or products that most often trigger include:

• metals (nickel and cobalt),
• latex rubber,
• adhesive (sticky substance to plaster),
• herbs (chamomile and arnica),
• perfume in cosmetics and hygiene products,
• certain clothing dyes,
• chemicals in hair products,
• cleaning agents (detergents) and solvents,
• essential oils, and
• some medicines that are applied to the skin.

2. Irritant contact dermatitis

The cause of irritant contact dermatitis is the contact between the skin and an irritant. One-time or continuous exposure to the irritant triggers inflammation of the outermost layer of skin. Inflammation eventually destroys the protective layer of skin.

Irritants can come from chemicals used in everyday life, such as:

• personal care products such as soap and shampoo,
• detergent,
• perfume,
• acid or base solution,
• cement, as well
• resin in plants poison ivy.

In addition, the National Eczema Association revealed that environmental conditions such as extreme weather changes may play a role in being the trigger.

Risk factors

Who is at risk for contact dermatitis?

You are at risk for allergic contact dermatitis if you come into direct contact with allergens. If you have a history of food allergies, allergic rhinitis, and asthma, your chances of developing symptoms are higher.

Meanwhile, irritant contact dermatitis is more common in people who are often exposed to irritant substances. This risk is usually faced by:

• health workers in a hospital or dental clinic,
• construction workers,
• metalworker,
• hairdresser,
• makeup artist, and
• janitor.

Some chemicals without warning of side effects can also trigger skin inflammation. This material is usually found in products that are used for a long time such as nail polish, contact lens fluid, earrings, or watches with metal wires.

Not having the risk factors above does not mean you can't get dermatitis. If you experience symptoms of dermatitis after coming into contact with substances that are not mentioned above, consult a doctor to determine the cause.

Diagnosis and treatment

How do doctors diagnose this condition?

Contact dermatitis cannot be diagnosed by observing symptoms and a history of skin disease alone. Further tests need to be done to complete the diagnosis of some symptoms similar to dermatitis.

Doctors usually advise everyone with skin problems such as inflammation, dry skin, or itching to undergo a contact dermatitis test. The reason is, contact dermatitis can be affected by exposure to various allergens or irritants.

What is usually done is a named allergy testskin patch test to find out the specific types of allergens or irritants that trigger abnormal skin reactions. This test can also be accompanied by taking skin tissue, aka a biopsy.

Here are the differences between the two.

1. Skin patch test

Skin patch test can be used to diagnose allergic contact dermatitis by determining the allergen or irritant causing the reaction. It usually takes 5 - 7 days for skin patch test.

In this test, the doctor will apply several types of allergens / small doses of irritants to the patient's back. The dripping area of ​​the back is then covered with an airtight bandage or aluminum that is affixed directly.

The back patch will be removed after 2 days, then put on and removed again after 5 - 7 days. The doctor then observes the reaction on the skin to determine which substance is the trigger. Reactions can include skin rashes, bumps, or blisters.

2. Skin biopsy

A skin biopsy is not a test to diagnose contact dermatitis, but it can be used to rule out other diseases such as fungal infections. This examination is done by taking a sample of skin tissue.

Samples are usually taken in the following manner.

• Biopsy shave. The skin sample is taken from the outer layer so no stitches are required.
• Biopsy punch. A skin sample the size of a pencil eraser was taken using a special tool. A large sample may be sewn together.
• Excisional biopsy. A large sample is surgically removed, then sutured closed.

What treatment options are available?

The best treatment for contact dermatitis is to avoid substances that trigger allergic reactions or irritants. For example, you can avoid woolen clothes, learn to recognize plants poison ivy, etc.

You can also protect yourself by wearing gloves, long sleeves, and trousers before coming into contact with allergens or irritants. It must be certain that whatever you are wearing is not triggering symptoms.

If symptoms often appear and are bothersome, you can consult a doctor to get a prescription for corticosteroid or antihistamine drugs. Take these medications with you wherever you go just in case.

Home remedies

What are the lifestyle changes to treat this condition?

Below are some of the lifestyle and home remedies that can reduce the severity of symptoms and prevent recurrences.

• Use a medicated lotion if necessary, but do not scratch the skin in the first hour after use to allow the medication to sink in.
• Eat foods with balanced nutrition.
• Immediately cleanses the skin and cools the body after sweating.
• Using mild soap to clean skin. Avoid cleaning products that contain alcohol, perfume, and other chemical additives.
• Rinse skin with soap and water immediately after being exposed to an allergen / irritant.
• Use personal protection when coming in contact with allergens or irritants.
• Use a moisturizer regularly.

Contact dermatitis is an inflammatory reaction to the skin after direct contact with an allergen or irritant. Symptoms are often similar to those of other types of dermatitis, so further tests are needed to make a diagnosis.

The best way to treat contact dermatitis is to avoid its triggers. You can also consult a doctor for treatment if the symptoms are so severe and bothersome.