Dermatitis is a term that describes inflammation of the skin and encompasses various types, including contact dermatitis, seborrheic dermatitis, atopic dermatitis, and nummular dermatitis. Each variant presents unique symptoms and causes, but this article will specifically delve into contact dermatitis, exploring its causes, symptoms, precautions, and treatments.

What is Contact Dermatitis?

Contact dermatitis results from skin reactions to external substances. It is primarily categorized into two types:

1. Allergic Contact Dermatitis: This occurs when small molecules known as haptens (typically less than 500 daltons) combine with skin proteins, initiating an immune response driven by T-cells.
2. Irritant Contact Dermatitis: This type is characterized by inflammation resulting from direct toxic effects of contact substances, rather than an allergic response.

Symptoms of dermatitis

Common symptoms of contact dermatitis include red rashes localized to the site of contact, though in some cases, the rash can appear in distant areas. Other presentations may include target lesions, purpuric lesions (which resemble bleeding spots), or pigmentation changes in areas of contact.

Causes of Contact Dermatitis

Contact dermatitis can be triggered by a variety of substances, with common culprits including:

• Paraphenylene diamine (found in hair dyes)
• Neomycin (used in antiseptic creams)
• Fragrances (in personal care products)
• Nickel (in Artificial jewellery, watch straps, buttons etc.)
• Other chemicals such as benzocaine, potassium dichromate, carbamates, and mercaptobenzothiazole.

These allergens can be found in everyday items like cosmetics, jewelry, sunscreens, topical medications, textiles, rubber products, and certain industrial chemicals.

Precautions for Patients with Contact Dermatitis

For individuals diagnosed with contact dermatitis through a patch test, the following precautions are essential:

• Avoid Direct Contact: Patients must avoid direct skin contact with identified allergens, as there is currently no known method to desensitize individuals to these substances.
• Monitor Improvement: After eliminating contact with the allergen, skin improvement may take anywhere from 3 to 6 weeks, or sometimes longer.
• Localized Reactions: The areas of skin that come into the most contact with the allergen will typically exhibit the most severe rash.
• Consider Other Allergens: If avoidance does not lead to complete improvement, it may be necessary to investigate other potential allergens or irritants.

10 Tips to Prevent Flares of Dermatitis

Tip #1: Do Not Let Your Skin Get Dry
The natural moisturizing factors are often lacking in individuals with skin allergies or eczema. A compromised skin barrier can lead to allergic reactions. It’s crucial to keep your skin oily, soft, and supple throughout the year. Here are some suggestions:

• Take baths with lukewarm water, avoiding hot water that strips away natural moisturizers.
• Keep baths short.
• Use mild, fragrance-free soaps or body washes that don’t foam excessively.
• Use mild shampoos, ensuring lather does not remain on your body.
• Wear silicon gloves while handling detergents.
• Pat your skin dry with a soft towel rather than rubbing it.
• Apply moisturizer immediately on slightly wet skin to trap moisture.
• Reapply moisturizer if your skin feels tight, dry, or flaky. Ideally, moisturizers should be applied every four hours.
• Use approximately 250g of moisturizer per week for children and 500g per week for adults to reduce the need for topical steroids.

Tip #2: Use Cotton Fabrics

• Avoid rough fabrics like wool.
• Stay away from synthetic materials such as polyester and nylon.
• Opt for loose-fitting cotton clothing.
• Remove tags from clothes to prevent irritation.
• Wash clothes in fragrance-free detergents and rinse thoroughly.

Tip #3: Avoid Sudden Temperature Changes

• Don’t turn on the AC immediately after coming in from the heat.
• Switch off the AC or fan a few minutes before going outside.
• Stay indoors during extreme weather conditions.
• In summer, wear loose cotton clothing and take a bath if sweating heavily.
• In winter, keep your skin warm with soft clothing.
• Take lukewarm baths regardless of the season to maintain stable body temperature.

Tip #4: Identify and avoid allergens

Allergen can be identified based on the location rash started as discussed in this video:

Tip #5: Avoid Scratching
Scratching can worsen rashes. To prevent this:

• Apply moisturizer to itchy areas.
• Take antihistamines as prescribed by your dermatologist.
• Keep nails short.
• Use cotton gloves at night to minimize scratching.

Tip #6: Avoid Infections

• Wash your hands before applying any medications.
• Ensure jars of emollients are closed properly after use.
• Use a clean spoon to scoop creams from jars or opt for pump dispensers.

Tip #7: Avoid Pets
If possible, refrain from keeping pets. If you have pets at home, vacuum regularly and keep them off your bed and furniture.

Tip #8: Avoid Dust and Pollen

• Opt for light cotton curtains instead of heavy fabrics, and vacuum carpets often.
• Choose leather furniture over thick fabrics, as leather collects less dust.
• Use light cotton bed sheets and change them frequently.
• Regularly wet mop your home to eliminate dust.
• Avoid stuffed toys that trap dust.
• If allergic to pollen, limit outdoor activities during peak seasons and change clothes after coming indoors.

Tip #9: Stop Molds
Molds thrive in damp, dark environments. To prevent mold growth:

• Avoid sitting in basements or damp rooms.
• Ensure your room gets ample sunlight daily.
• Open windows regularly to let in fresh air.

Tip #10: Avoid Allergy-Causing Foods
Certain foods, such as milk, peanuts, eggs, soy, and seafood, can trigger allergies in some individuals. If you notice a connection between specific foods and skin allergies, avoid them. However, only eliminate foods that have been proven to exacerbate your condition.

Treatment Options for Contact Dermatitis

Treatment for contact dermatitis can be broadly categorized into acute and chronic forms:

1. Acute Contact Dermatitis: In cases of weeping or oozing dermatitis—such as from a hair dye allergy—systemic corticosteroids may be prescribed for 2 to 3 weeks, accompanied by topical treatments. Patients will also receive guidance on long-term avoidance of triggers.
2. Chronic Contact Dermatitis: For chronic dermatitis, systemic corticosteroids are generally avoided due to the prolonged nature of the condition. Instead, local corticosteroids may be applied depending on the affected area and type of lesion. In some cases, intralesional corticosteroids or antihistamines may be necessary. Rarely, systemic immunosuppressants like azathioprine may be required.

Conclusion

Curing contact dermatitis is possible, provided the causative agent is identified and removed from the environment. Rather than attributing symptoms to food, it is crucial to investigate common allergens such as artificial jewelry, hair dyes, certain plants, skin care products, and occupational exposures to chemicals.

By following these tips and seeking appropriate treatment, individuals can manage and alleviate symptoms of dermatitis effectively.