UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet CONTACT DERMATITIS WHAT IS IT? Contact dermatitis is a common inflammatory reaction that occurs when the skin comes in contact with an irritant (or allergen). Any substance can act as an irritant if the concentration, duration, and frequency of exposure are sufficient. Irritants can include soaps, detergents, deodorants, perfumes, cosmetics, metals, leather, wool, new clothing (due to chemicals from the manufacturing process), medications, and poison ivy or oak (due to resin from the leaves). Reactions can vary in the same person over time. Certain agents commonly affect certain skin areas: Face and neck: Soaps, mouthwashes, insect sprays, perfumes or hair sprays (neck), cosmetics, eye make-up (eyelids), lipstick or toothpaste (on or around the lips), hatbands (forehead), and nickel metal (earlobes). Hands and forearms: Soaps, hand lotions, wrist bands, metal backs of watches, industrial chemicals, poison ivy, and many other agents. Irritation from soap may begin under rings. Underarm: Deodorant, dress shields, and dry cleaning solutions. Trunk: Clothing (particularly if new and not previously laundered) and rubber or metal attached to clothing (belt buckles). Genital area: Douches, dusting powder, contraceptives (spermicidal gels/creams/foams, rubber from condoms, diaphragms, cervical caps), colored toilet paper, medicated ointments, fabric softeners, and perfumed panty liners. Generalized eruption: Airborne chemicals (spray paint, ragweed), medications applied to large areas of the body, bath powder, and clothing. WHAT ARE THE SYMPTOMS? Some allergens directly irritate the skin, causing an immediate inflammatory reaction, often like a burn. Other irritants cause a delayed allergic reaction, with symptoms developing 24-48 hours later. Sometimes there may be no initial reaction, but regular use (eg, nail polish remover, preservatives in contact lens solutions, or repeated contact with metals in jewelry or clothing) can eventually cause sensitivity and reaction to the product. Symptoms include: • A rash at the site of exposure: o May be red, pimple-like, or blistering. o May be dry, crusting, or weeping. o May become scaly, raw, or thickened. o Note: Poison ivy exposure often results in a linear pattern where the skin has come in contact with branches or leaves. • Itching, sometimes accompanied by a burning sensation. • Possible warmth, swelling, or tenderness of the area. WHAT IS THE TREATMENT? • Avoid the irritant! Wash it off with copious amounts of water if possible. • Do not scratch! Scratching increases the chance of getting a bacterial infection. • Sometimes the best treatment is to do nothing to the area. MEDICATIONS • Oral antihistamines (eg, Benadryl, Zyrtec, Claritin, Allegra) can decrease the allergic response and the itching. • Corticosteroid creams can also be used to decrease the inflammation and itching. They work better if used before blisters develop. Only a thin layer of the medication is needed to be effective. Excessive or long-term use can cause thinning and whitening of the skin. Steroid creams should not be used on the face or neck unless specifically directed by your health care provider. • Oral corticosteroid medications are occasionally prescribed for more severe or widespread symptoms. These medications must be taken as directed. They should be taken with food to decrease the risk of stomach upset. FOR POISON IVY, OAK, OR SUMAC, TAKE THESE ADDITIONAL MEASURES: • An allergic reaction to the oil from the plant (urushiol) usually occurs 12-48 hours after exposure, resulting in an itchy rash. Touching the rash or any oozing blisters will not spread the rash because urushiol bonds to the skin within minutes. However, scratching can increase the risk of developing a bacterial infection. • If you think that you've come in contact with poison ivy, wash exposed areas with plain cool water as soon as possible. Some experts recommend using rubbing alcohol first to remove the oil from exposed skin and any exposed tools, shoes, etc. O Be sure to wash fingernails carefully to remove oil that may remain under the nails. O Don’t use soap yet as soap can move the urushiol around your body, resulting in a more widespread allergic reaction. O The sooner you cleanse the skin, the greater the chance that you can remove the plant oil and prevent further spread on your body. Removing the oil within 10 minutes is ideal because it has probably not bonded to your skin yet. However, even washing off 2 hours after an exposure significantly reduces symptoms. • Over-the-counter products such as Tecnu and Zanfel can be used to remove urushiol from your skin. Zanfel can also be used to remove urushiol from objects that had contact with the plant. These products can be quite effective but are fairly expensive. • After washing exposed areas with cool water, take a shower with soap and warm water. • Because urushiol can remain active and linger on virtually any surface until it’s washed off, be sure to wash your clothes, shoes, tools or anything else that may have touched the plant (like camping, sporting, fishing, or hunting gear). Launder clothing in hot water. Water or rubbing alcohol can be used to remove the oil from tools and other objects. • Also be sure to wash your pet if it may have had contact with the plant. Use pet shampoo and water while wearing rubber gloves. Most pets are not sensitive to poison ivy, but the oil can stick to their fur and cause a reaction in someone who touches them. • A reaction can also result from contact with the smoke of a burning plant or even dried uprooted plants that still have their resin. • Before working in a high-risk area, Ivy Block (available over-the-counter) may be applied to the skin on a preventative basis. It must be reapplied every 4 hours. • Once a rash is present, Burrow’s soaks (also known as over-the-counter Domeboro soaks) can be soothing and help to dry the lesions. Wet compresses applied for 15-30 minutes and Aveeno oatmeal baths can also be soothing. • Calamine lotion is a drying agent that may help the lesions heal faster. Over-the-counter products such as Ivyrest and Caladryl cream contain a combination of Calamine and Benadryl. • If you have lesions involving the face, eyes, mucous membranes, genitalia, or any large body surface area, steroid pills taken by mouth may be prescribed by your health care provider to aid in healing. NOTIFY YOUR HEALTH CARE PROVIDER IMMEDIATELY IF YOU HAVE: • A fever over 100°F. • A rash that is in your eyes, mouth, face, or genital area. • Pus coming from any blisters. • A rash that does not get better in a few days. • A rash that covers large areas of your body. RECOMMENDED WEBSITES: • www.mayoclinic.com • www.aad.org ____________________________________________________________________________________ Published by VCU Division of Student Affairs and Enrollment Services University Student Health Services (804) 828-8828 - Monroe Park Campus; (804) 828-9220 - MCV Campus Wellness Resource Center (804) 828-9355 - 815 S. Cathedral Place Reviewed 6/11
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