Irritant Contact Dermatitis

Irritant Contact Dermatitis

Article
Allergy
Skin Care
+2
Contributed byLester Fahrner, MD+1 moreJan 06, 2022

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

  • Irritant Contact Dermatidites
  • Irritant Contact Eczema
  • Irritant Contact Hypersensitivity of Skin

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

  • Irritant Contact Dermatitis (ICD) is a medical disorder in which the skin gets damaged and inflamed due to exposure to chemicals or substances that irritate the outer protective layer of the skin
  • The condition can be acute, where the symptoms are observed right away after exposure (within a few minutes to hours). Or, it can be chronic, when the symptoms are observed after a period of time, like after many hours or days
  • Hands are generally the most common site of irritation, because of direct physical contact with the substance causing the condition. The agents causing Irritant Contact Dermatitis include soaps and detergents, hand cleaning fluids, chemical dust and vapors, etc.
  • Some of the common signs and symptoms include red rashes and bumps on the skin; dry, cracked, red patches that resemble skin burns; and the presence of blisters that drain fluid
  • The treatment of Irritant Contact Dermatitis involves a complete avoidance of the causative agent and the use of medications that include corticosteroids and antihistamines
  • Generally, the condition resolves without any significant complications. However, identifying the offending substance is the most important step towards preventing Irritant Contact Dermatitis

By definition, Irritant Contact Dermatitis does not include dermatitis cases that involve an allergic reaction or photoallergic reaction. These are separate conditions.

There are many special forms of Irritant Contact Dermatitis, which include:

  • Hand dermatitis, which affects the hands due to physical contact (touching or holding) with the offending substance
  • Airborne ICD, which occurs due to drift onto skin of chemical vapors and fumes usually in an industrial setting

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

  • Irritant Contact Dermatitis can affect any individual, at any age
  • Both men and women are affected by this condition
  • No racial, ethnic, or geographical predominance is observed

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

The risk for Irritant Contact Dermatitis may include exposure to or contact with any of the following substances:

  • Cleaning liquids, including soaps and detergents
  • Construction materials such as cement, paints, adhesives, etc.
  • Chemical vapors, fumes, dust from an industrial setting
  • Acids, bases (such as lye or ammonia), including fertilizers

Individuals in the following trades or profession are at an increased risk:

  • Cooks and chefs
  • Welders
  • Glass blowers
  • Farmers
  • Factory workers
  • Hair stylists
  • Constructions workers
  • Healthcare workers
  • Lifeguards
  • Individuals working in the environmental services

Note: Not all individuals are affected by the same substance or to the same intensity.

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 Irritant Contact Dermatitis? (Etiology)

Irritant Contact Dermatitis is the most common type of contact dermatitis. The condition occurs when the skin gets damaged due to exposure to substances that irritate the outer protective layer of the skin. An inflammatory, irritant reaction is observed on the exposed areas.

Some of the commonly used chemicals that are irritants include:

  • Harsh soaps
  • Chemical solvents
  • Cosmetics
  • Skin products
  • Deodorants
  • Industrial chemicals and metals

What are the Signs and Symptoms of Irritant Contact Dermatitis?

Irritant Contact Dermatitis may be acute or chronic. The signs and symptoms of the condition can be mild or severe and may 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
  • Severely inflamed skin that shows diffuse serum fluid seepage through the damaged skin
  • The skin rashes are generally confined to the area of contact/exposure to the offending agent
  • Pain and tenderness in the affected area
  • Acute form of ICD: The symptoms may be observed immediately on contact with the irritant; after a few minutes or hours
  • Chronic form of ICD: The symptoms may be observed after many hours or days following exposure

How is Irritant Contact Dermatitis Diagnosed?

A diagnosis of Irritant Contact Dermatitis (ICD) would include:

  • A complete evaluation of one’s medical history to learn about the causative agent, which is the source of the condition
  • A thorough physical examination of the patient to observe the signs and symptoms with respect to the condition
  • Patch test:
    • In this test, small quantities of substances (thought to be irritants) are applied on the skin in small patches
    • The application is left for a certain duration of time, after which the response is observed
    • If the individual develops rashes in the patchy area where the substances were applied, it may be confirmed that the patient either has an irritant or allergic reaction to that particular substance. Further testing is done to distinguish between an Irritant or allergic reaction

A skin biopsy is usually not necessary for a diagnosis of ICD; however, it can be performed to eliminate other skin conditions.

  • 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

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 Irritant Contact Dermatitis?

Irritant 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
  • Chronic conditions may cause emotional stress

How is Irritant Contact Dermatitis Treated?

Irritant Contact Dermatitis may be managed through the following measures:

  • Avoiding exposure or contact with substances that are (known) irritants
  • Application of anti-itch, over-the-counter creams that contain hydrocortisone can provide relief from pain and itching sensation
  • Moisturizers and creams containing silicone products can help restore the barrier function disrupted by the dermatitis
  • Prescription strength corticosteroid creams are often required
  • 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 may include:

  • Avoid scratching the affected area
  • A cool bath may help soothe the skin
  • Wear smooth cotton clothes
  • Use mild perfumes, soaps, and detergents

How can Irritant Contact Dermatitis be Prevented?

The following measures may be adopted to avoid the risk of Irritant Contact Dermatitis:

  • Identification and avoidance of substances that cause the irritation is the first and foremost preventive step
  • In case of contact with the irritant substance, wash the affected area immediately with water
  • Wearing protective gloves while doing household work will protect the skin from coming into contact with the offending substance or irritant
  • Always choose soaps with mild detergents both for bathing and washing clothes
  • A protective cream or moisturizer may be applied over the skin for protection of the topmost layer
  • In case of an industrial exposure, use protective masks or clothing
  • If the condition is due to an occupational exposure, then the occupation or job-related tasks or habits may have to be modified

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

  • Irritant Contact Dermatitis usually resolves within a short duration of time, generally without any complications
  • If the condition is recurrent, it may be because the exact cause is not yet identified

Additional and Relevant Useful Information for Irritant Contact Dermatitis:

There are various types of Contact Dermatitis and these include:

  • Irritant Contact Dermatitis
  • Allergic Contact Dermatitis
  • Photo-Allergic Contact Dermatitis
  • Phototoxic Contact Dermatitis

The following article link will help you understand contact dermatitis:

http://www.dovemed.com/diseases-conditions/contact-dermatitis/

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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Lester Fahrner, MD picture
Reviewed by

Lester Fahrner, MD

Chief Medical Officer, DoveMed Team

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