What are the other Names for this Condition? (Also known as/Synonyms)

• Allergic Contact Dermatitides
• Allergic Contact Eczema
• Allergic Contact Hypersensitivity of Skin

What is Allergic Contact Dermatitis? (Definition/Background Information)

• Allergic Contact Dermatitis is a medical disorder characterized by skin inflammation that occurs when there is a direct contact with chemicals or substances that cause skin irritation or allergy
• Some common allergens and irritants that can trigger the condition include soaps, detergents, plants and plant products, medications, synthetic chemicals, jewelry, rubber, etc.
• Any part of the body may be affected, but the most frequently affected parts are the hands. Some of the common signs and symptoms include skin rashes and bumps, red skin patches that resemble burns, and fluid-filled blisters
• The treatment of Allergic Contact Dermatitis involves a complete avoidance of the causative agent and the use of medications such as corticosteroids and antihistamines. The condition typically resolves within a few weeks, usually without any complications
• Identification of substances that are skin allergens and irritants is the first and foremost preventive measure

Who gets Allergic Contact Dermatitis? (Age and Sex Distribution)

• Allergic Contact Dermatitis can affect individuals of any age who are exposed to the offending substance or material causing the condition
• No gender, racial, ethnic, or geographical predominance is observed

What are the Risk Factors for Allergic Contact Dermatitis? (Predisposing Factors)

Individuals in the following profession are at an increased risk of Allergic Contact Dermatitis:

• Cooks and chefs
• Welders
• Glass blowers
• Farmers
• Factory workers
• Hair stylist
• Constructions workers
• Healthcare workers
• Lifeguards

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Allergic Contact Dermatitis? (Etiology)

• Allergic Contact Dermatitis is a type of allergic skin reaction that occurs due to a direct physical contact with a chemical or a substance or a material
• It occurs when an allergic substance activates an immune reaction in the skin resulting in the characteristic signs and symptoms of the condition

The commonly used substances that may cause Allergic Contact Dermatitis include:

• Natural rubber (rubber gloves)
• Metals such as nickel
• Costume jewelry
• Perfumes and cosmetics
• Strong soaps and detergents
• Hair dyes
• Plants such as poison ivy
• Jewelry
• Antibiotics, antihistamines, and antiseptics, which are applied on the skin in the form of creams, ointments, and lotions

What are the Signs and Symptoms of Allergic Contact Dermatitis?

The common signs and symptoms observed with Allergic Contact Dermatitis include:

• Red rashes and bumps on the skin
• Dry and cracked red patches that resemble burns on the skin
• Blisters on the skin that drain or ooze fluid
• The skin rashes are generally confined to a particular area, usually the area of contact
• Pain and tenderness in the affected area
• The most common site of clinical manifestation is the hand (due to touching, holding the chemical or offending agent)

How is Allergic Contact Dermatitis Diagnosed?

A diagnosis of Allergic Contact Dermatitis would include:

• A complete evaluation of one’s medical history to learn about the causative agent, the source of the condition
• A thorough physical examination of the patient to check for signs and symptoms with respect to the condition
• Allergy blood test
• Patch test:
  • In this test, small quantities of substances (believed to be allergens) are applied on the skin in small patches
  • The application is left for a couple of days, after which the responses are observed
  • If the individual develops bumps or rashes in the patchy area where the substances/allergens were applied, it may be confirmed that the patient is allergic to that particular substance
• Skin biopsy: A skin biopsy is performed and sent to the laboratory for pathological examination. The pathologist examines the biopsy under a microscope for a definitive diagnosis

Note: In most cases, based on the signs and symptoms, a diagnosis can be made by the dermatologist through a physical examination and medical history study, without resorting to a biopsy.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Allergic Contact Dermatitis?

Allergic Contact Dermatitis could lead to the following complications namely:

• Bacterial and fungal infection: Continuous itching and scaling of the skin will create skin moistness, providing a suitable environment for bacteria and fungi to grow and thrive
• The skin condition may give rise to cosmetic concerns in some individuals
• Stress and anxiety issues in some individuals

How is Allergic Contact Dermatitis Treated?

Treatment strategies that may be adopted in the management of Allergic Contact Dermatitis include:

• Avoiding exposure or contact with substances that are (known) irritants and allergens
• Application of anti-itch, over-the-counter creams that contain hydrocortisone can provide relief from pain and itching sensation
• Oral medications: The physician may prescribe oral corticosteroids to reduce inflammation or antihistamines to provide relief from severe itching sensation

A few self-care tips and home remedies for the condition may include:

• Scratching the affected areas must be completely avoided
• Apply cool wet compress to the affected skin
• A comfortable, cool bath may help soothe the skin
• Wearing smooth cotton clothes
• Use of mild perfumes, soaps, and detergents

How can Allergic Contact Dermatitis be Prevented?

The following measures may be adopted to prevent or reduce the risk of acquiring Allergic Contact Dermatitis:

• Identification of substances that are skin allergens and irritants is the first and foremost preventive step. Avoiding substances identified as allergens and irritants will help protect from the condition
• In case of contact with the allergic substance, wash the affected area immediately with water
• Wearing protective gloves while doing household (or outside) work will protect the skin from coming into contact with allergic substances and irritants
• Always choose soaps with mild detergents both for bathing and washing clothes
• A protective cream may be applied over the skin for protection. The use of a moisturizer can help protect the topmost layer of the skin

What is the Prognosis of Allergic Contact Dermatitis? (Outcomes/Resolutions)

• Allergic Contact Dermatitis usually resolves within a few weeks, generally without any complications. Sometimes, on removing the offending substance, the condition may get better
• If the condition is recurrent, it may be because the exact cause is not yet identified
• If Allergic Contact Dermatitis is due to an occupational exposure, then the occupation or job-related tasks or habits may have to be suitably changed/modified

Additional and Relevant Useful Information for Allergic Contact Dermatitis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/allergy-center/