Contact Dermatitis: Part 2

By August 3, 2020Health Tips

Last week we talked about the symptoms and causes of contact dermatitis.  Today I want to talk about how contact dermatitis is diagnosed, how it can be prevented, and how to treat it.

How do we diagnose contact dermatitis?
Much of the diagnosis is made based on the appearance of the rash along with a good history to uncover clues about the possible causes.

Contact Dermatitis
If your doctor suspects an allergic cause, they might recommend allergy testing, such as a patch test, to confirm the diagnosis.
How is a patch test done?
Small amounts of the possible trigger allergens are put on patches that adhere to your skin like tape.  You will then go home with these patches in place, where they will stay on for 2-3 days.  You will need to keep your back dry during that time period.  After 2-3 days, you return to the doctor to have the areas evaluated for skin reactions.
What can be done to prevent contact dermatitis?
There are several things that you can do for prevention.  Here are a few:
  • Avoid triggers – For instance, make sure you know how to identify poison ivy and avoid it.  Avoid overuse of hand sanitizer or other irritants.
  • Wear protective clothing – Depending on the possible exposure, you can wear gloves, long sleeves, face mask, or goggles to protect you against irritating substances.
  • Wash your skin after exposure – If you do come in contact with an allergen or irritant, wash your skin right away after coming in contact with it.  Use warm water and a mild soap.  Rinse completely.  Also put any clothes that you were wearing into the washing machine before washing your skin, so that you don’t get exposed again from touching those clothes.
  • Use a barrier cream – This protective layer may prevent the irritant or allergen from penetrating your skin.  For example, an OTC cream such as IvyBlock may prevent or lessen a skin reaction to poison ivy IF you apply it before you come into contact with the plant.
  • Keep your skin healthy – Use moisturizers regularly, and treat cuts and scrapes appropriately, which can help keep your skin healthy enough to keep some reactions to a minimum.
  • Be careful of pets – Pets can carry some allergens or irritants on their fur after they are exposed (including poison ivy).  They can then spread these substances to people.
  • If you are sensitive to nickel, look for nickel-free jewelry.  You can also apply an iron-on patch to the inside of clothing that contains metal buttons to keep them from contacting your skin.
How is contact dermatitis treated?
  • Eliminate any exposure to triggers – If you develop an irritant reaction to hand sanitizer, you should stop using it.  If you develop an irritant or allergic reaction to cleaning chemicals, you should stop using them or always wear gloves when you need to use them.  This is an important step in treatment.
  • Steroid creams or ointments – You might initially try some OTC steroid treatments, such as hydrocortisone 1% cream or ointment (I think the ointment works a little better.)  If this does not help, your doctor might prescribe a stronger steroid cream or ointment.
  • Antihistamines – You might initially try OTC antihistamines, such as Benadryl.  If OTC antihistamines don’t help, your doctor might prescribe a different oral antihistamine.
  • Oral steroids – In severe cases, your doctor might prescribe an oral steroid such as prednisone, which can reduce inflammation in the skin, and decrease your allergic reaction.
  • Antibiotics – Antibiotics are not indicated as treatment for contact dermatitis.  However, if you have severe contact dermatitis, and scratch excessively, you can develop a secondary skin infection.  In that case, your doctor may prescribe either topical or oral antibiotics.
  • Wet compresses – Use cool, wet compresses (a towel or wash cloth wet with cool water) on the affected area for 15-20 minutes at a time, several times a day.
  • Avoid scratching – If you can’t keep yourself from scratching, apply a dressing over the area to avoid direct contact.
  • Soak in an oatmeal bath, or take a cool shower.

If you have any questions about contact dermatitis treatment or prevention, please log into your account and send
us your question. We are here to help.

Dr. Anita Bennett MD – Health Tip Content Editor

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