Irritant Contact Dermatitis

Irritant contact dermatitis is caused by the breakdown of the skin’s protective barrier by repeated exposure to damaging irritants. This can affect any part of the body that comes into direct contact with the offending substance.

Common chemical irritants include soaps, detergents, cosmetics, household cleaners, and latex. Environmental irritants such as dry, cold air may cause skin irritation (known as winter itch). Redness and swelling are common at the location of contact. The development of blisters is uncommon. Skin that is repeatedly affected by dermatitis may become dry and scaly.

Common features of irritant contact dermatitis include:

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

Rash: An itchy rash, which looks dry and easily develops into painful cracks.

Blisters: If the reaction is severe enough, blisters may appear on the skin, but are typically uncommon.

Causes Irritant contact dermatitis is caused by repeated contact with irritants, many of which are found in everyday products. Common chemical irritants include:

Solvents: Alcohol, xylene, turpentine, esters, acetone, ketones, and gasoline

Surfactants in topical medications and cosmetics: Sodium lauryl sulfate

Latex:Found in household products such as dishwashing gloves

Alkalies: Drain cleaners, strong soap with lye residuesCommon environmental irritants include:

Dry, cold air: Cold air from air conditioners or winter weather may irritate the skin

Water: Repeat exposure to water may cause an irritant dermatitis reaction.

Because irritant contact dermatitis is such a sensitive and inflammatory skin condition, take great care when choosing skincare products. Avoid soaps, especially bar soaps, as they will cause dry skin 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 without damaging 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, dye or other allergens that may irritate the skin. Frequent application of moisturizing creams can help soothe dry and itchy spots.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, and infection. Instead, gently pat the skin, relieving the itch. You can also apply a damp compress for relief.

There is no fool-proof way to prevent irritant contact dermatitis. Keeping the skin healthy and well hydrated is the best protection. Frequent moisturizing is a must. Newer barrier repair creams that containing ceramides and other fats can help repair the barrier function of the epidermis.

OTC
Over-the-counter creams containing hydrocortisone are commonly used to treat rashes caused by irritant 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. Barrier repair creams are new and are often very effective. The newer Ceramide based barrier repair creams may be an important step forward

Prescription
A doctor will likely prescribe topical steroids, which have been extensively used for over 40 years to reduce various inflammatory skin conditions. Topical steroids are available as creams, lotions, gels and ointments; some products also include a moisturizer. If blisters are present, ointments are usually not used. These medications can be used effectively and safely while under the care of a physician.