Contact dermatitis signs and symptoms
In the case of contact dermatitis, the skin of affected persons react allergic to certain substances that come into contact with it. Affected areas can be reddened and can form itchy, wet and bubbles. Certain ointments can reduce the symptoms. Read all about the symptoms and treatment of a contact dermatitis.
The contact dermatitis is an overlapping reaction of the immune system to a certain substance with which the skin has come into contact. The affected areas of the skin react allergic. Contact dermatitis is relatively frequent. Over a quarter of the population reacts to at least one substance in the World.
In the case of an allergy, the body’s own defense system is directed against substances which are virtually harmless. These substances are called allergens. They consist of vegetable or animal proteins, but also of inorganic substances such as metals, and are normally harmless. If the immune system still fights it, it is called an allergic reaction.
Contact dermatitis is characterized by the fact that the symptoms occur only 24 hours to three days after contact with the allergen. Responsible for the reaction are certain cells of the defense system. These cells are called T cells emit messengers on contact with the allergen messengers, which lead to an inflammatory reaction. Then, inflammatory reaction is visible on skin.
Nickel is the most common contact allergen. But other metals, plants or fragrances can also cause contact dermatitis.
Contact dermatitis symptoms
Contact dermatitis manifests itself in changes to the skin, which occur about one to three days after skin contact with the allergen. The following symptoms may occur in the areas where the skin has been exposed to the allergenic substance:
- Skin redness (erythema)
- Swelling (angioedema)
- Soaking bubbles
- Crusting or dandruff formation
- Itching or burning
- If the skin contact is longer, a chronic contact is formed. The skin becomes coarser, keratinized and forms grooves
Contact dermatitis causes and risk factors
Any substance that occurs in the environment can theoretically cause contact dermatitis.
Particularly frequent allergens are:
- Metals (eg nickel in jewelery, zippers, buttons)
- Perfumes (eg perfumes, soaps, cosmetics)
- Plants (eg chamomile, artemisia, arnica)
- Essential oils (eg citric or peppermint oil)
- Cleaning agents (eg plasticizers)
- Latex (eg as latex gloves)
Some factors can increase the risk of developing an allergy. A genetic preload, environmental pollution, high-fat food, smoking and alcohol, but also excessive hygiene can promote the development of an allergy.
Contact dermatitis diagnosis
In order to diagnose the contact dermatitis, the physician first asks the patient about his disease history (anamnesis):
- When did the complaints first appear?
- Are the symptoms limited to a skin site?
- Is there something that alleviates the discomfort, for example, if you avoid certain garments or jewelry?
- Are allergies already known?
After the doctor has examined the corresponding skin areas more closely, he will carry out an epicutaneous test (patch test). A sample of the allergenic substances in question is applied to the patient’s back and covered with patches. After one or two days, the pavement is removed.
Then doctor assesses the local response to the various substances. If a reddening of the skin has occurred, or if the wheals have formed, this is an allergic reaction to this substance.
Toxic contact dermatitis
In contrast to allergic contact dermatitis, the skin changes in toxic contact dermatitis are not caused by an allergic reaction but by toxic substances such as acids or alkalis.
For example, cleansing agents can cause toxic contact dermatitis in the hands. However, skin changes resemble an allergic reaction very much.
Contact dermatitis symptoms and treatment
Contact dermatitis can not be completely cured. Sensitization to the substance is usually a lifetime. Nevertheless, it is possible to reduce the symptoms. It is particularly important to avoid contact with the allergenic substances.
The affected areas of the skin should also be well cleaned to support the healing process. Moisture and care products support the skin during reconstruction. It is recommended to use refatting creams, oils or baths.
Medications for contact dermatitis
If necessary, a cortisone-containing ointment can be applied to the skin. Cortisone inhibits the overwhelming immune response and thus reduces the inflammatory reaction in the skin.
The type of cortisone and the duration of the application must be weighed carefully by the physician against the known side effects of the treatment: cortisone can make the skin thinner and stained during prolonged use. Therefore, preparations containing cortisone should be applied only briefly and at small skin areas.
If the local application of the ointments does not lead to the desired healing of the skin areas, cortisone-containing tablets can also be taken in some cases. Again, it is important that they are used only briefly and under medical supervision, as significant side effects can occur.
The physician may prescribe the active substance alitretinoin in the case of a chronic hand eczema. It has an anti-inflammatory and regulating effect on the immune system.
UV therapy for contact dermatitis
In the case of chronic eczema (especially in the case of chronic hand eczema), UV therapy can help. Either irradiation with UV-B light (UVB therapy) or irradiation with UV-A light in combination with the active substance psoralen (PUVA therapy) is used. For example, psoralen is taken or applied locally to the skin.
Contact dermatitis disease history and prognosis
Contact dermatitis generally consists of a lifetime. Depending on which allergens, how much the immune system has been sensitized and how long the contact with the allergenic substance lasts, the discomfort can be more severe or mild.
If the triggering substances are avoided, symptoms often disappear spontaneously within two or three weeks.
If contact dermatitis is prolonged, the affected areas of the skin can be infected by fungi or bacteria. Then, the skin becomes warm and is severely reddened or swollen. Depending on the pathogen, an infection is treated with antibiotics or antimycotics.
How to prevent contact dermatitis?
Contact dermatitis usually occurs without a premonitory, there is no prophylaxis. However, one can try to reduce the risk of allergies in general. It is known, for example, that breast-feeding infants suffer less frequently from allergies. When children grow up in households with animals, this also lowers their risk of allergies.
If you are already suffering from contact dermatitis, the allergenic substance should be avoided. Special clothing and gloves protect the skin. Sometimes, for example, certain activities have to be completely abandoned.
If there are some contacs to allergen subtances due to work, one should contact the company doctor or the employer’s liability insurance association. In these cases, occupational dermatological counseling is possible. Partial contact is also recognized as occupational disease.