Contact dermatitis

Contact eczema or contact dermatitis is a skin disease that manifests as redness, itching, small blisters, scaling and shedding of the skin and can occur as an allergic and irritant eczema. Allergic contact eczema occurs in sensitive people who develop an allergic reaction to certain allergens coming into contact with their skin. Irritant contact eczemaoccurs during long-term and frequent use of aggressive agents to which the skin might be sensitive.

Symptoms of contact dermatitis

In acute phase, the symptoms are pronounced and the skin is red, swollen, there is intense itching, and blisters may appear that break open, scabs form and the skin sheds. If the contact with the allergen is constant and long-lasting, chronic dermatitis occurs. Then the skin becomes thick, dark red to brown, it flakes, painful fissures can form, and the itching is mild, but constantly present and it exacerbates in phases. In order for the treatment to be as successful as possible, it is necessary to discover the cause, i.e. the substance that triggers the allergy. To detect allergens that cause unwanted skin lesions, epicutaneous testing is performed on standard allergens of the European series. It contains allergens that most often cause allergies in this part of the world. They include various substances that we come into contact with every day, from metals found in jewellery, belt buckles, through paints, preservatives, substances found in glues, cement, rubber, etc. Epicutaneous tests are simple to perform, the patches with allergens are stuck on the back and removed after 48 hours, 72 hours, and sometimes 96 hours, to verify if it is irritant or contact dermatitis. A special form of contact dermatitis (eczema) is often caused by some plants, such as poison ivy, but also other plants that are used for medicinal purposes. Sometimes the combination of the plant’s leaves and the sun is responsible for an allergic reaction. Many so-called natural cosmetics with herbal components or for example propolis can be strong allergens and cause allergic reactions in sensitive people. Therefore, it is recommended to use preparations that do not have these additives and are intended for sensitive and allergy-prone skin. When we suspect that a cosmetic product is what triggers an eczema (usually on the face, neck and hands), it is recommended to do an epicutaneous test with a standard battery of allergens, but also with the products used by that patient.

Allergy to jewellery (nickel)

Among the most common allergens that cause eczema is nickel, that can be found in most metal items, such as jewellery, watch bracelets, metal frame for glasses, and money coins. It is also found in silver and gold jewellery, but in small amounts, so it rarely causes allergic reactions. In some people, allergies occur only when the weather is warm because sweating helps the dissolution of nickel from metal objects. Allergies caused by nickel are most often manifested on the outer ear, the belt area that comes into contact with metal buttons or the area of the wrist where the watch is worn.

Rubber allergy

Latex and other additives used in the production of rubber are also common allergens, which, apart from skin lesions, can cause hives, conjunctivitis, but also suffocation.

Hair dye allergies

When redness appears on the scalp after hair dyeing, most often the responsible substance is paraphenylenediamine, which is found in dark hair dyes, both permanent or semi-permanent. This substance can also be found in colours for temporary tattoos, as well as in dark clothes, especially those made of synthetic materials and can also cause allergic reactions.

Cosmetic allergies

Beauty products such as creams and lotions, can trigger allergies, primarily preservatives and fragrances that they contain. Therefore, it is better to use products marked as fragrance free. Also, if you are allergic to preservatives in cosmetics, you should use medical cosmetics for sensitive and intolerant skin that are preservatives free. Natural cosmetics can also trigger allergic dermatitis because they may contain herbal components with insufficiently tested characteristics.

Plant allergies

Different plants can cause contact dermatitis. It can manifest only at the place of contact, for example on a florist’s hands, but plant pollen i n the air causes lesions on the eyelids, face, hands, and all uncovered body parts. Allergies can be caused by herbal balms containing allergenic plants, which are often used in traditional medicine (for example, comfrey is used to reduce swelling and joint pain). A special type of allergic reaction to plants is phytophotodermatitis. The skin reacts when in contact with plants, and during sun exposure, and red blisters or dark skin discoloration appear. Plants that often cause this type of reaction are celery, parsnip, lemon, and some types of flowers.

Chromium allergy

Chromium allergies occur in people who are in contact with cement, leather, some types of paints and products against rust. Exposure to cement dust can cause eczema of the feet, but lesions can also appear throughout the body.

Treatment of contact dermatitis

The most important thing when treating contact dermatitis is to try and find the cause of eczema. Anamnesis is accompanied by epicutaneous testing, making it possible to give advice and information about substances that should be avoided. If the lesions are mild, creams with corticosteroids are prescribed. If they recur, corticosteroid creams should be combined with immunomodulators. When intense itching is present, antihistamines are included in the therapy. If the reaction is intense and affects a larger area of the body, systemic corticosteroid therapy may be necessary.
Svetlana Đurišić specijalista dermatovenerologije

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