Allergies, the immune system’s response to foreign substances, can take numerous forms, from hay fever and allergic asthma to food allergies, medication allergies, and more. For those with allergic contact dermatitis — also referred to as allergic eczema — contact with an allergen causes skin inflammation and a rash.
While allergic contact dermatitis can be uncomfortable, painful, or itchy, a healthcare provider can help you identify the underlying trigger and manage symptoms. Read on for more about the condition.
What is allergic contact dermatitis?
Allergic contact dermatitis occurs when exposure to an allergen causes a skin rash. The condition can take different forms, and skin may appear red, swollen, blistering, flaky, or scaling. Many people experience pain or itchiness. There may also be a burning or stinging sensation.
Common allergens that trigger allergic contact dermatitis include:
Poison ivy, poison oak, poison sumac, and other plants
Certain metals used to make jewelry such as nickel
Certain medications including antibiotics
Preservatives used in cosmetic products and household products
Symptoms typically take 24-48 hours to develop, though they may appear within minutes or hours of exposure in some cases. You may be more susceptible to the condition if you have sensitive skin or chronic skin issues that aren’t caused by allergies.
It takes time to develop an allergy, and you likely will not have a reaction to an allergen after a single exposure. Many people become more sensitive to an allergen with each subsequent exposure.
If you develop contact dermatitis several times and are unsure of the trigger, keep a diary of potential factors to identify the allergen.
In rare cases, allergic contact dermatitis overlaps with anaphylaxis, a severe and potentially life-threatening reaction that swells the airways and blocks breathing. This reaction may occur within seconds or minutes of exposure to an allergen.
The signs and symptoms of anaphylaxis include:
Respiratory symptoms including wheezing and a persistent cough
A rapid, weak pulse
Nausea and vomiting
A skin rash
In addition, anaphylaxis is frequently accompanied by hypotension, or low blood pressure, defined as blood pressure under 90/60 mm/Hg or a 30% reduction from your baseline blood pressure.
Anaphylaxis must be treated with epinephrine, a hormone and medication used in emergency treatment. Many people with severe allergies carry injectable epinephrine in a pen. If you experience anaphylaxis and do not have epinephrine, go to an emergency room as soon as possible. If you do not have someone to accompany you to the emergency room, call 911 first.
Allergic contact dermatitis vs irritant contact dermatitis
Allergic contact dermatitis is one of two main types of contact dermatitis. Irritant contact dermatitis is a rash that develops quickly in response to a chemical substance, or irritant, including harsh soaps and detergents, hair dyes, certain household products, and acids.
Symptoms of irritant contact dermatitis are similar to those of allergic contact dermatitis, however the reaction forms more quickly and is often more painful than itchy.
Diagnosing allergic contact dermatitis
If it is possible to avoid an allergen or irritant, you may be able to identify the trigger of your contact dermatitis and prevent a reaction. If this is not possible, additional steps are often required for an official diagnosis.
If your doctor believes that you may have allergic contact dermatitis, patch testing may be used to identify the underlying cause. During a patch test, you’ll wear adhesive patches containing common allergens known to trigger reactions. Your provider will check your skin after 48 hours and again after an additional 48-96 hours to check for a reaction.
If your doctor is unable to confirm a diagnosis of allergic contact dermatitis after patch testing, they may order a biopsy — a procedure that removes a small sample of your skin — to determine if another condition is responsible for symptoms.
There is not a similar test to diagnose irritant contact dermatitis, but a doctor may be able to identify the triggering irritant based on the chemicals you regularly come into contact with.
How to manage contact dermatitis
A variety of treatment options may be used to help you manage allergic or irritant contact dermatitis. Individual treatment plans depend on the severity of symptoms.
As a first step, wash irritated skin with mild soap and water after exposure to an allergen to remove traces of it. In mild cases, this may be sufficient to address symptoms.
If symptoms persist, your doctor may recommend one or more of the following treatments:
Moisturizing creams to hydrate and repair irritated skin
Over-the-counter corticosteroid-based creams to ease itching and inflammation
Colloidal oatmeal-based products to ease itching and inflammation
Calamine lotion to ease itching and discomfort
Over-the-counter oral antihistamines such as Benadryl® or Zyrtec®
Oral steroids such as prednisone to relieve symptoms that don’t respond to over-the-counter medication
Additional immunosuppressive medications including JAK inhibitors — which block immune responses to prevent inflammation — and off-label systemic medications including cyclosporine and methotrexate may be used in severe cases that require multiple rounds of oral steroids.
With effective treatment, symptoms of allergic contact dermatitis are typically resolved within two to three weeks. However, to prevent future reactions, it’s important to identify the underlying cause of your symptoms so that you can avoid it.
Your partner in health
Managing allergic rashes is easier with a reliable pharmacy partner by your side. Our pharmacists can answer any questions you may have about treatment, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.
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This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
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