Understanding contact dermatitis

Contact dermatitis is a common form of eczema that develops when the skin comes into contact with substances that cause irritation or trigger an allergic reaction. It can lead to redness, itching, dryness, cracking, and discomfort. Understanding the causes, symptoms, and treatment options for contact dermatitis can help reduce flare ups and protect the skin barrier.

There are two main types of contact dermatitis: irritant contact dermatitis and allergic contact dermatitis. While they can look very similar on the skin, the causes are different.

What causes contact dermatitis?

Irritant contact dermatitis is the most common type and occurs when the skin is repeatedly exposed to substances that damage the skin barrier. This can include things like soaps, detergents, cleaning products, shampoos, hand sanitiser, and even frequent exposure to water. When the skin barrier is damaged, it loses moisture more easily and becomes dry, cracked, and inflamed.

Allergic contact dermatitis, on the other hand, occurs when the immune system reacts to a specific substance. This is a delayed reaction, which means the rash may appear hours or even days after contact. Common allergens include nickel (found in jewellery and belt buckles), fragrances, preservatives in skincare and cosmetics, hair dyes, rubber, and certain adhesives.

It’s important to understand that allergic contact dermatitis can develop over time. You may use a product for years without any problems and then suddenly develop an allergy to it. Once the allergy develops, the reaction will usually continue every time the skin is exposed to that substance.

Who is most at risk?

Some professions have a higher risk of contact dermatitis due to frequent exposure to irritants and allergens. This is often referred to as occupational contact dermatitis.

People at higher risk include healthcare workers, hairdressers, cleaners, mechanics, chefs, florists, builders, and childcare workers. These jobs often involve frequent hand washing, exposure to chemicals, or working with materials that can irritate the skin.

For example, hairdressers are commonly exposed to hair dyes and shampoos, healthcare workers wash their hands frequently and use hand sanitiser, and cleaners are regularly exposed to strong cleaning products. Over time, this repeated exposure can damage the skin barrier and lead to dermatitis.

People who already have eczema, asthma, or hay fever are also more likely to develop contact dermatitis because their skin barrier is already more sensitive.

Ways to avoid contact dermatitis

Prevention is one of the most important parts of managing contact dermatitis. Protecting the skin barrier can help reduce the risk of developing symptoms.

One of the most effective strategies is to minimise contact with known irritants. This may involve switching to fragrance-free and soap-free products, using gentle cleansers instead of harsh soaps, and choosing cleaning products designed for sensitive skin.

Protective gloves can also be very helpful, particularly for people whose jobs involve water or chemicals. However, it’s important to use gloves correctly. Wearing cotton gloves under rubber or nitrile gloves can help reduce sweating and irritation. Gloves should also be removed regularly to allow the skin to breathe.

Regular moisturising is essential. Moisturisers help repair and protect the skin barrier, making it more resistant to irritation. For people with contact dermatitis, moisturising should be done several times a day, especially after hand washing.

Management and treatment

If contact dermatitis develops, early treatment is important to prevent it from becoming more severe.

The first step is to identify and avoid the trigger. If the cause is not obvious, a doctor may refer you for patch testing. Patch testing is a specialised allergy test that helps identify substances that may be causing allergic contact dermatitis.

Treatment usually involves topical corticosteroids to reduce inflammation and settle the rash. These are prescribed in different strengths depending on the severity and location of the dermatitis. It is important to use these treatments as directed by your doctor.

Moisturisers remain a key part of treatment and should be used regularly alongside any prescribed creams. In more severe cases, other treatments may be required, such as oral medications or referral to a dermatologist.

For people with occupational contact dermatitis, workplace adjustments may also be needed. This might include changing products, modifying tasks, or using protective equipment to reduce exposure.

When to seek medical advice

If you think you may have contact dermatitis, it is important to seek medical advice, particularly if the rash is persistent, worsening, or affecting your ability to work or carry out daily activities. A proper diagnosis is important because different types of dermatitis require different management.

If you have not had a formal diagnosis, you should see your GP or healthcare professional. They can assess your skin, start treatment, and refer you to a dermatologist if needed. A dermatologist can arrange patch testing and develop a personalised treatment and management plan.

With the right diagnosis, treatment, and prevention strategies, contact dermatitis can usually be well managed, and flare-ups can be reduced over time.