Allergic Contact Dermatitis

Common features of allergic contact dermatitis include:

Redness and Swelling:
Area of contact will often become red and inflamed.

Rash:
An itchy rash that may spread to other areas of the body.

Blisters:
If the reaction is severe enough, uncomfortable, itchy blisters may appear on the skin.

Allergic contact dermatitis is caused by direct contact with allergens, many of which are found in everyday products such as cosmetics, jewelry, fabrics, detergents, hair dyes, etc. Some common allergens include:

Balsam of Peru:
A common natural fragrance that is found in cosmetics; it is also present in cloves and cinnamon.

Formaldehyde:
Contained in cigarettes, paint, paper, plastic bottles, and textiles in small amounts; it is a common trigger for allergic reactions.

Fragrances:
Often found in cosmetics, these can trigger reactions.

Neomycin:
A topical antibiotic cream.

Nickel:
The most common allergen, nickel, is often found in jewelry and metal buttons.

Quaternium 15:
A preservative found in many cosmetics. This can be a cause of allergic dermatitis in people who have sensitive skin. People who are allergic to formaldehyde are often allergic to quaternium.

Thimerosal:
A preservative used in cosmetics.

Latex or Rubber:
Common in people who need to wear latex gloves for work, such as healthcare workers.

Because allergic contact dermatitis causes the skin to become sensitive and inflamed, skin care products should be chosen with care. Avoid soaps, especially bar soaps, as they will cause dryness and may damage the skin barrier. Instead, opt for mild soap-free cleansers, preferably in liquid form.

These cleansers will gently remove dirt, excess oil, bacteria and cosmetics with minimal disruption to the skin barrier. Be careful to limit contact with hot water, as this can actually dry out the skin further.

Moisturizers help restore and maintain the skin’s natural moisture levels. Look for a moisturizer specially designed for sensitive skin that is free of fragrance, preservative, dye or other allergens that may irritate the skin. Frequent application of moisturizer can help soothe dry and itchy patches.If you are experiencing severe itching, do not scratch the affected area, as it can lead to scarring, increased pigmentation (darkening of the skin), thickening of the skin, or infection. Instead, gently pat the skin to relieve the itch.

You can also apply a damp compress for relief. Cooling with short-contact ice may help.

There is no fool-proof way of preventing allergic contact dermatitis. Keeping the skin healthy and well hydrated is the best protection.

OTC
Over-the-counter creams containing hydrocortisone are commonly used to treat rashes caused by allergic contact dermatitis. Emollients such as Aquaphor or Vaseline can be used on the affected area if the skin becomes dry. Cold-water compresses can help cool and dry up early signs of blistering.

Prescription
A doctor will likely prescribe topical steroids, which have been extensively used for over 40 years to treat various inflammatory skin conditions. There are a large number of topical steroids available.
Topical steroids are available as creams, lotions, gels and ointments; some products can also moisturize the skin. If blisters are present, ointments are not usually prescribed. These medications are to be used both effectively and safely while under the care of an experienced physician. Oral antihistamines and corticosteroids have also been helpful in reducing itching.