Contact Dermatitis: When Symptoms Start and Could End (2024)

Contact dermatitis is characterized by inflammatory skin symptoms that appear after touching an irritating substance or an allergen. It can arise hours to days after contact with the trigger, resulting in itchiness, rashes, and blistering.

Recovering from contact dermatitis can take several weeks, and the symptoms can change throughout the healing process. In addition to identifying and avoiding the trigger, a range of home methods, over-the-counter, and prescribed treatments can manage this condition.

Contact Dermatitis Triggers on Different Body Parts

There are two types of contact dermatitis, determined by the trigger, as follows:

• Irritant contact dermatitis: The most common type, caused by contact with irritating substances and friction, not a true allergy to a substance.
• Allergic contact dermatitis: This type occurs due to an allergy to certain substances.

Various substances can trigger contact dermatitis and affect different body parts. Identifying triggers can help you manage and prevent this reaction.

Hands and Feet

Common materials—often substances you may work with daily—can trigger contact dermatitis on the hands or feet, including:

• Cement
• Certain soaps
• Disinfectants, harsh cleaners, hand sanitizer
• Fertilizer or pesticides
• Gasoline, motor oil
• Hair dye
• Irritating chemicals, such as solvents, bleach, detergents, and degreasers
• Nail polish
• Nickel or other metals (from rings, bracelets, belt buckles, wristwatches, and buttons)
• Poison ivy, poison oak, poison sumac
• Preservatives in certain topical medications
• Rubber or vinyl gloves or boots
• Topical antibiotics (e.g., neomycin)
  

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Face, Head, and Neck Triggers

A range of everyday products and materials trigger contact dermatitis on the face, head, or scalp. These include:

• Balsam of Peru, an ingredient used in certain cosmetics or perfumes
• Fragrances in perfumes, soaps, moisturizers, shampoos, or facial skincare products
• Hair dyes and certain hair products
• Nickel or metals, such as those in necklaces, earrings, or other jewelry
• Skin adhesives, including those used to attach false eyelashes or hairpieces
  

Genital and Groin Triggers

Contact dermatitis can also affect the genitals and skin around the groin due to:

• Certain fabrics and dyes used in clothing, including underwear
• Certain soaps, detergents, and solvents
• Chlorinated water
• Latex condoms
  

Other Triggers

Some triggers cause photoallergic or phototoxic contact dermatitis, meaning symptoms are worsened by sun exposure. After contact, the symptoms arise when the skin is exposed to ultraviolet (UV) rays in sunlight. Triggers for this type may include:

• Certain perfumes
• Certain sunscreens
• Oil derived from lime skin
• Products containing coal tar
• Shaving lotion
• Sulfa ointment
  

Airborne allergens or irritants can also cause contact dermatitis. These include ragweed, certain types of perfume, nail lacquer vapor, and insecticide spray. It most commonly affects the face, forearms, and hands.

How Skin Looks and Feels

An itchy, raised rash is the primary symptom of contact dermatitis, but how this presents varies depending on the trigger, type, and individual case. Symptoms can arise anywhere from several hours to weeks or even months after exposure to the trigger; common signs include:

• Hives and blisters: Fluid-filled hives (itchy welts) and blisters can form on the rash. These can eventually burst or leak fluid and form crusts.
• Irritated skin: Patches of dry, irritated, or flaky skin can also arise; irritant contact dermatitis can cause cracking or fissures.
• Itchiness: In many cases, the first signs of contact dermatitis include itching, burning, stinging, and sensitivity in the affected area. These symptoms can become intense and persist after other symptoms set in.
• Open sores: Painful, open sores can develop on the rash, leaking fluid and crusting over.
  
• Rash: A raised rash can form on the affected area, often adopting the trigger's shape. A rash from contact dermatitis feels swollen, tender, and hot. It can appear purple, dark brown, or gray on darker skin or red on those with lighter-pigmented skin.
• Swelling: The affected area becomes very swollen; this is especially common in the face, around the eyes, or groin.
• Thickened skin: With chronic contact dermatitis, the skin becomes thickened and rough to the touch.

When to Initiate Treatment

If you are experiencing symptoms of contact dermatitis, it’s crucial to identify and remove the trigger. If you can remove the allergen or irritant, the symptoms typically resolve within several weeks of onset.

You do not need a diagnosis to start self-care and home remedies for this condition, and many people can manage without medical treatment. That said, you should seek care from your provider in the following cases:

• Home remedies or treatments are not working
• Severe skin reactions and symptoms, especially if they disrupt sleep or daily function
• Symptoms are persistent or get worse
  
• Symptoms of infection, such as fever, redness or change in color, warmth, and tenderness

Contact Dermatitis Home Remedies

The most important thing you can do to manage contact dermatitis is to avoid the trigger. In addition, the following home remedies can help manage symptoms and prevent them from worsening:

• Cleanse: Wash the affected area thoroughly to help remove any traces of the trigger on the skin. Use a mild soap and lukewarm water.
• Avoid scratching: When you scratch skin affected by contact dermatitis, you can spread the allergen or irritant, worsening symptoms. Scratching these areas can also raise the risk of skin infection.
• Apply a cool compress: Wet a towel with cold water and apply it to the affected areas for 10 to 15 minutes, as needed to manage the itching.
• Take an oatmeal bath: An oatmeal bath can also relieve itch. Use lukewarm water with a cup of oatmeal, and soak for 10 to 15 minutes.
• Moisturize: Keeping your skin moisturized helps keep skin healthy and resilient, and it can manage and prevent contact dermatitis. Use a fragrance-free moisturizer, emollient, or skin-barrier repair cream throughout the day, especially after washing or bathing. Make sure your skin reacts well to it; test out anything you use on a small area of skin first.
• Try medications: A range of topical medications and ointments are available over the counter at drug stores. Examples include calamine lotion, petroleum jelly, or topical corticosteroid anti-itch creams like hydrocortisone (Cortaid or Ala-Cort).

Prescribed Contact Dermatitis Creams

You may need prescription-strength topical medications if your symptoms are severe or chronic. Several classes of drugs may help:

• Calcineurin-inhibitors, such as Elidel (pimecrolimus) and Prograf (tacrolimus)
• Phosphodiesterase-4 (PDE-4) inhibitors, including Eucrisa (crisaborole) and Lotamilast (DMVT 501)
• Prescription-strenth corticosteroids like Omipred (prednisone) or Clobex (clobetasol)

In severe and persistent cases, your healthcare provider may consider oral corticosteroids to manage symptoms. They may also prescribe injections of immunosuppressant or immunomodulating drugs, such as Xatmep (methotrexate), Neoral (cyclosporine), and Dupixent (dupilumab).

Healing in Stages: How Long Does It Take?

Healing from contact dermatitis does not happen overnight. If the trigger is eliminated and avoided, it typically takes two to three weeks for the symptoms to clear completely. Scratching affected areas can prolong your symptoms and lead to complications. If you come into contact with the allergen or irritant again, contact dermatitis comes back.

Secondary Complications and Symptoms

Most cases of contact dermatitis are manageable. However, in rare and severe cases, some may experience permanent effects on the skin and complications, including:

• Lichenified skin: Chronic contact dermatitis or exposure to triggers can cause lichenification, a process in which the skin becomes leathery and thick.
• Infection: Contact dermatitis can cause skin to break, as can scratching affected areas, allowing bacteria on the skin, such as Staphylococcus aureus or Streptococcus, to pass through and cause infection.
• Post-inflammatory hyperpigmentation: Some people can develop a permanent change in skin color after inflammatory conditions like contact dermatitis or acne. The affected areas become permanently darker than the surrounding skin.

Specialists Who Oversee Chronic Contact Dermatitis

Chronic contact dermatitis causes persistent and severe symptoms. In these cases, identifying the trigger and figuring out how to avoid it is often difficult. Your primary care provider may refer you to a specialist.

Diagnosis and treatment are usually led by adermatologist (medical doctor specializing in conditions of the skin, hair, and nails) who can perform allergy testing and guide treatment. Allergists (allergy specialists) and immunologists (doctors who treat conditions affecting the immune system) may also oversee care.

Summary

Contact dermatitis is a set of skin symptoms caused by contact with an irritating substance or allergen. It can occur anywhere on the body and cause itchy or painful rashes, blisters, discoloration, swelling, and sores. If the trigger is not present, symptoms typically resolve within three weeks.

Identifying and avoiding the cause of contact dermatitis is critical in managing it. Home remedies and topical corticosteroids can manage most symptoms. In more severe cases, healthcare providers can prescribe topical medications. If symptoms persist or become severe, you should get medical help.