How to recognize allergic contact dermatitis and what helps

What does dermatitis look like?
Allergic contact dermatitis has the following symptoms:
– redness,
– itching,
– burning,
– dry, cracked, and irritated skin,
– swelling or blisters,
– so-called allergic pimples, which may resemble acne.

This itchy rash usually appears 48 to 72 hours after contact with the allergen. Allergic contact dermatitis occurs when a substance to which you are sensitive (allergen) triggers an immune response in your skin. T-lymphocytes, white blood cells that can remember substances that harm the body, play a key role. Upon repeated contact with the substance, they identify it and trigger an inflammatory reaction that manifests itself externally as skin irritation.
The reaction most often appears at the site of contact, but it can also spread elsewhere—for example, from your fingers to your eyelids when you unknowingly touch the affected area.
However, not everyone reacts the same way. A substance that causes an allergy in you may be completely harmless to others. Skin allergies can appear after a single exposure, but you can be in contact with an allergen for years before a reaction occurs.

How long does contact dermatitis last?
Milder cases often subside within a few days if the skin is no longer in contact with the allergen or irritant. However, in more severe reactions, the rash may persist for longer, even two to four weeks.
If you repeatedly come into contact with the allergen, you may develop chronic allergic dermatitis. The longer you are in contact with the allergen, the longer the treatment will take.

Most common areas affected
• Face, neck, and scalp – reactions to cosmetics (creams, shampoos, perfumes, etc.).
• Hands, fingers, and wrists – contact dermatitis on the hands often occurs after cleaning, washing dishes, or contact with metals.
• Armpits – a common site of reaction to deodorants or laundry detergent residue in clothing.
• Genital area – sensitive skin may react to hygiene products, detergents, textiles, or latex.
• Mouth, gums and around the lips – an allergic reaction may also occur after the insertion of a dental implant, manifesting as gum inflammation, burning in the mouth or irritation in the chin area. This is usually caused by metals or acrylates contained in cements or temporary replacements.
• Feet and soles – usually after contact with shoes, socks, or creams.
If you repeatedly scratch the affected area, weeping and crusting may occur. This creates a favorable environment for the growth of bacteria or fungi and can cause infection.

Causes of allergic dermatitis
Allergic contact dermatitis is often caused by substances that we commonly encounter. It doesn't take much for the skin to react with irritation or a rash. What should you watch out for?
• Cosmetics (including perfumes and cleaning products) – hair dyes, nail polish and nail polish removers, deodorants, creams, perfumes, sunscreen, and aftershave. Many contain fragrances, preservatives, or dyes that can irritate the skin.
• Cleaning and household products – dishwashing detergents, various cleaners, and laundry detergents may contain irritating chemicals.
• Medicated skin products – such as antibiotic ointments, antihistamines, or products containing local anesthetics.
Allergies to adhesive tape are common, as a reaction to rosin, a substance commonly found in adhesives.
• Textiles and footwear – chemicals used in the manufacture of clothing or shoes, such as dyes, antioxidants, tannins in leather or vulcanization accelerators used in the manufacture of gloves, shoes or rubber bands in underwear.
• Metals – allergies to metals are among the most common. A well-known allergy is to nickel, which is commonly found in jewelry, buckles, buttons, cell phones, and older dental fillings. Allergies to gold are not as common as those to nickel, but they can cause unpleasant reactions in sensitive individuals, especially when gold is mixed with other metals.
• Plants – such as poison ivy – contain strong natural allergens that can cause a severe reaction.
• Rubber and latex – gloves, shoes, balloons, condoms, or catheters – often cause irritation in people with allergies to latex or additives used in its processing.
• Household fragrances – hidden allergens can also be found in everyday items such as fabric softeners, air fresheners, or scented candles.

Which conditions can be confused with allergic dermatitis?
Not every itchy rash means allergic dermatitis. Itching, redness, or irritation can have a variety of causes.

1. Irritant contact dermatitis
Unlike the allergic variant, this is not a reaction of the immune system, but a direct irritation of the skin.
It is caused by irritants that come into contact with the skin, such as water, soap, cleaning agents, and solvents.
Typically, it can occur immediately after a single contact with an irritant, for example when using a strong cleaner without gloves. However, it sometimes develops gradually after repeated exposure, for example in people who wash their hands frequently or work in a humid environment.

2. Atopic dermatitis
While contact dermatitis occurs after direct contact of the skin with an irritant or allergen, atopic dermatitis is more related to a congenital hypersensitivity of the immune system. It occurs in people whose skin has a weakened protective barrier – triggers can include stress, dry air, or sudden changes in temperature.

3. Contact urticaria
It appears a few minutes after contact with an irritant (such as latex) and disappears quickly.

4. Fungal infections
Fungi often manifest themselves in a similar way to dermatitis – with redness, flaking, and itching of the skin. While dermatitis is an inflammation of non-infectious origin, fungi are microbial infections that require antifungal treatment.

5. Sweat allergy (cholinergic urticaria)
Some people react to their own sweat with a rash – during physical exertion, hot showers, or stress. Symptoms appear quickly after sweating, often in the form of itchy pimples.

Who suffers from allergic dermatitis?
Interestingly, allergic dermatitis affects women more often than men, which is not surprising. Common triggers include nickel-containing jewelry and nail cosmetics with acrylates. But dermatitis does not only affect adults; even small children can be sensitive to nickel. Seniors, on the other hand, often develop allergies to topical antibiotics.

What about professions? Those who come into daily contact with chemicals are most at risk, such as hairdressers, healthcare workers, cleaners, painters, and florists. If you also have sensitive skin or a chronic skin condition, your skin may be more prone to allergic reactions.

How can allergic contact dermatitis be prevented?
Prevention plays a key role in allergic contact dermatitis. In most cases, changing just one thing in your daily routine is not enough; a combination of several simple steps is much more effective:
• Avoid known allergens. Check the ingredients of cosmetics, cleaning products, and textiles. Watch out for fragrances, preservatives, metals (e.g., nickel), latex, or plant extracts.
• Wash your skin. In the case of poison ivy, etc., you can remove most of the substance causing the rash by washing your skin immediately after contact. Use a mild, unscented soap and warm water. Also wash any clothing or other items that have come into contact with the allergen.
• Wear suitable protective gloves, goggles, and other protective clothing. If you are allergic to latex, use nitrile or vinyl gloves. Make sure they are powder-free and fit well—and avoid wearing them for long periods of time without a break.
• Moisturize your skin regularly. Dry, cracked skin is more susceptible to absorbing irritants. Emollient creams should be part of your daily routine, especially after washing your hands.
• Use Dermaguard barrier cream. It creates an invisible film on the skin that protects it for 4–6 hours, even after repeated washing. It is suitable for working with water, chemicals, metals, and cosmetics. It does not contain perfume or lanolin and can be used by people with sensitive skin. You can find it in our e-shop.

How is allergic contact dermatitis diagnosed?
Diagnosis begins with a thorough interview with a dermatologist – a medical history. The doctor will ask you about the products you use, what your skin comes into contact with, where the rash appears, and how long it lasts. This often indicates whether it is an allergic reaction or another skin problem.
In some cases, however, the medical history alone is not enough and tests are necessary:
1. Open application test
This is a simple but useful procedure, especially if you suspect a specific cosmetic product, such as a cream or shampoo. The product is applied several times a day to a small area of sensitive skin, most often on the inside of the arm, for several days. If irritation appears at the application site, this is a clear sign that the product is not suitable for your skin.
2. Patch tests (epicutaneous tests)
These are used when the reaction recurs or is more pronounced. A dermatologist uses special patches to apply a small amount of potential allergens to the back. The patches are left on for 48 hours and then evaluated to see if a reaction has occurred.
3. Microscopic examination
When it is necessary to rule out other causes of the rash, especially fungal infection, a scraping of the skin is taken from the affected area. The sample is examined under a microscope or cultured. The result will show whether it is an infection that requires antifungal treatment.
4. Nickel test
In some cases, a patch test can be performed to detect the presence of nickel in jewelry, buttons, watches, and other metal objects. It is used as a supplementary method when contact allergy to metals is suspected.

What works best for allergic dermatitis?
The basis for treating contact eczema is avoiding the allergen and choosing the right therapy.
1. Emollient creams and ointments (emollients)
These should form the basis of daily care. They moisturize, soothe irritated skin, and help restore the damaged skin barrier. As first aid for itching or redness, you can also use one of the commonly available rash ointments—ideally unscented and with anti-inflammatory properties.
2. Corticosteroids
Corticosteroid ointments for contact dermatitis are used for more severe inflammation, redness, and itching of the skin. They are applied directly to the affected areas, usually for a short period of time. Weaker preparations are suitable for sensitive areas (e.g., the face), while stronger ones are used for more extensive symptoms.
For more severe reactions, corticosteroids are administered in tablet form for a short period of time. They help to quickly relieve severe inflammation, but are only used to a limited extent due to their side effects.
3. Antibiotics
If the irritated skin becomes infected (e.g., as a result of scratching), antibiotics must be used.
4. Phototherapy
For recurrent or chronic symptoms that do not respond to conventional treatment, a dermatologist may recommend UV therapy. In some cases, this is combined with special medications that increase the skin's sensitivity to light—this method is called photochemotherapy.
5. Immunosuppressants
In more severe cases, drugs that suppress the immune system may be used. However, these are used only in exceptional cases.
6. Immunomodulatory agents
An alternative to corticosteroids – suitable for long-term use or for sensitive areas such as the eyelids, neck, or face. They have an anti-inflammatory effect and do not cause skin thinning.

Living with allergic dermatitis
Allergic contact dermatitis can be managed with appropriate treatment – if you know what triggers it. Pay attention to the ingredients in the products you use and give your skin time to calm down. Even a small change in your skincare routine can have a big effect.

Sources:
https://www.mayoclinic.org/diseases-conditions/contact-dermatitis/symptoms-causes/syc-20352742
https://my.clevelandclinic.org/health/diseases/6173-contact-dermatitis
https://www.nhs.uk/conditions/contact-dermatitis/