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Dermatology Blog

Contact eczema

Contact eczema

People with atopic eczema and people who repeatedly work with chemicals and metals suffer from contact eczema most often.

People with atopic eczema also develop contact eczema because their skin function is impaired by the disease. It is dry, fragile and therefore easily irritated.

Healthcare workers, machine tool operators or hairdressers develop contact eczema because frequent handwashing, the use of disinfectants, presence of metal dust or use of hair chemistry disrupt the skin's protective barrier and it reacts with irritation.

Doctors distinguish several forms of contact eczema

Allergic contact eczema is a systemic disease. The skin reacts most often to one or two allergens, which are detected by skin tests. There is a reaction not only of the skin, but also of other organs. In addition to a rash, swelling, choking, temperature, cramps may appear.

Irritant (irritant) contact eczema appears at the point of skin contact with the irritant. It begins with severe itching and reddened skin. A rash or blisters appear. Often keratosis occurs, in which dying skin cells form callous-like patches (crusts). These burst deeply and hurt.

Chronic contact eczema is caused by long-term wear and tear on the skin. It is manifested by redness, peeling, thickening of the skin. The skin is dry, scaly and micro-cracks form. It may or may not itch. The most commonly affected are the backs and palms of the hands.

Contact eczema from body fluids - urine, sweat, saliva and faeces irritate the skin on prolonged contact. A rash in the form of pimples appears, the skin turns red and peels off. Bacteria proliferate on the inflamed areas, the skin smells and burns when touched.

Airborne contact eczema is caused by irritating fumes and microparticles. It occurs on the neck and face, often around the eyes. The skin is red and dry, and bumps and pimples form which may burst into blood.

Dyshidrotic eczema occurs mainly on the palms of the hands and the interdigital area or on the soles of the feet. Underneath the skin, blisters form and blossom on the surface of the skin. The skin peels and itches very badly. The eczema forms swollen deposits.

Acute toxic contact eczema affects everyone who comes into contact with the substance. The burned skin reacts by forming very deep blisters and peeling off in patches.

Treatment of contact eczema

Only symptoms such as itching, cracking, peeling skin, swelling and blisters are treated. When hypersensitivity is known, the main point of success is to follow a preventive approach that limits irritation. First and foremost, attention must be paid to the skin and on a daily basis. For its protective function, it needs to be well hydrated, and the body needs to receive the necessary vitamins and minerals.

It takes about 30 days to restore damaged skin. Therefore, sensitive and damaged skin must be protected from contact with irritating substances. Dermaguard barrier cream is used for this purpose.

If contact eczema occurs to a small extent, over-the-counter products available in pharmacies are sufficient.

The rule of thumb is dry on dry, wet on wet.

This means that we treat the wet manifestations with compresses and baths (burdock, yarrow, black tea, strongly diluted hypermanganese) and apply ichthoraxyl ointment or zinc oil. We do not use powders or oily ointments.

For dry manifestations we can try zinc ointment and creams with moisturizing, healing and anti-itching effect. We try not to scratch the skin. If the skin is scratched, it should be lubricated with a soothing ointment and a sterile covering should be used to avoid secondary infection. Do the same for blisters. Do not puncture or scratch and use sterile cover.

Prescription drugs

The most effective medications are corticosteroids in the form of ointments, or in severe cases in the form of tablets or injections. They have different strengths of action. With commonly prescribed ointments, the risk of side effects is minimal. They are not used for so long that corticosteroids upset the hormonal system. Problems can arise when a very strong medicine needs to be prescribed, or when eczema recurs over and over in short intervals.
Frequent use of corticosteroid ointments results in so-called parchment skin. This is pale, delicate and prone to damage. It is therefore a good idea to use Dermaguard barrier cream daily after corticosteroid treatment to give the skin time to regenerate.



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