Irritant Contact Dermatitis

1.    What is Irritant Contact Dermatitis?

Irritant dermatitis is an irritated skin reaction to specific compounds or agents outside of the body that the skin contacts repeatedly, such as chemicals, detergents, or oils.  It may involve swelling, redness, itching, blistering, “weeping” clear fluid, crusting, formation of clear vesicles, pustules, dryness, peeling, or allergic-like reactions of the involved area.  Irritant dermatitis may continue for months at a time. 

2.    What Does Irritant Contact Dermatitis Look Like?

Acute cases of irritant dermatitis may involve multiple small, clear fluid-filled blisters on well-bordered, raised, red patches.  These small blisters often burst and cause a yellow crust to form around the irritated region.  Irritant contact dermatitis lasting longer than one week may appear as red bumps forming entire plaques across the skin having indistinct borders, as well as dryness, itching, peeling and scabbing throughout the affected region.  This appearance may be difficult to discern from other types of dermatitis, such as atopic dermatitis (i.e. eczema) or allergic contact dermatitis (i.e nickel allergy).  Secondary bacterial infection may cause the formation of pustules, which may become tender and eventually burst.  Chronic cases involve dull red, extremely itchy, cracking, peeling, thickened and leathery skin.   Symptoms are localized only to areas in which the irritating chemical or causative agent has contacted.  

3.    Who Does Irritant Contact Dermatitis Affect?

Irritant dermatitis may affect individuals of all ages working with or around irritants such as abrasive substances, detergents, acids, alkaline agents, oxidants, reducing agents, plants, animals, enzymes, or particulate fibers such as fiberglass or wood dust.  Irritant dermatitis may affect anyone, given sufficient exposure to irritants, but those with atopic dermatitis are particularly susceptible. 80% of cases of occupational hand dermatitis are due to irritants, most often affecting cleaners, hairdressers and food handlers.

4.    What Causes Irritant Contact Dermatitis?

Irritant dermatitis is caused by the immune system’s reaction to chemical or mechanical damage to the skin.  With each new exposure, the irritating agent kills or damages skin cells, causing an amplified release of inflammatory agents from the immune system.  These agents promote itching, redness, and flaking.  The end result is a chronic inflammation of the skin, as well as a perpetual migration of blood cells and immune system cells to the affected location.

5.    What Triggers Irritant Contact Dermatitis?

Certain factors may trigger irritant dermatitis, especially in workers exposed regularly to chemicals, powders, or the irritating agents listed above.  Factors exacerbating the condition include continued exposure to the causative agent, previously diagnosed atopic eczema, and activities such as car maintenance, gardening, or hobbies causing repeated skin abrasion.  In all cases of irritant dermatitis, rubbing and scratching are behaviors that worsen the condition by introducing secondary bacterial infections to the involved areas.

6.    How Can My Irritant Contact Dermatitis Be Treated? 

Identification and reduction of exposure to specific irritant in an individual’s daily environment is the primary means of preventing irritant dermatitis.  For recurring flares, topical anti-itch lotions may be given to control excessive itching and rubbing.  Topical steroid creams may help reduce inflammation, and topical anti-bacterial lotions or oral antibiotics may be given to decrease secondary bacterial infections, reducing pustules at the site.  Laser treatments may also be used to treat small areas.  Hydration using unscented moisturizing lotions is important in preventing dryness, and non-liquid soaps should be avoided.  For more information on available treatments for irritant dermatitis, or to schedule a visit, please call and speak with a representative at the Berman Skin Institute.