Do you have a new itchy rash?

If you have ever had a new itchy rash and you talk to a Health Care Professional about it, you know the standard questions they are going to ask you: have you switched laundry detergents? New soaps or lotions? Are you wearing new unwashed clothes? They are asking you because these are common reasons that people get an itchy red rash known as contact dermatitis.

What is contact dermatitis?
It is an inflammation of the skin caused by direct contact with an irritant. Usually it is something new that comes in contact with your skin, and it can be caused by new lotions, soaps, laundry detergent (irritant dermatitis), and also by poison ivy or sumac (allergic dermatitis).  But it can also occur from something that is really irritating that you may have interacted with numerous times; for example, when HCPs were using latex years ago, after years of exposure, people started having reactions.

What are the most common irritants?
Metals (nickel)
Plants (poison ivy, poison sumac)
Soaps (detergents, lotions, body wash, bar soap, shampoo)
Medications (antibiotics, other oral or topical medications)
Latex (or other rubber)
Make-up
Clothes/fabric (specific types or f clothes are worn without washing first)
Adhesives (like tape when in the hospital or bandaids)
Perfumes/Cologne
Chemicals (household cleaners, or other chemical exposures at work, etc.)

Does anything increase my risk of having this reaction?
If you have a history  of allergies (food, seasonal, etc) you are at a higher risk of contracting a contact dermatitis, but it isn't always true.  For example, I have a very strong food allergy to tree nuts and seasonal allergies, but (knock on wood), I don't react to poison ivy or sumac and I have had a contact dermatitis only once in my life.  It isn't a hard and fast rule, but most people with allergies to other things, are at risk for having more sensitive skin too.

What are the symptoms?
Itchiness and redness of the skin
Inflammation and heat from the area exposed
There can be lesions or blisters with allergic dermatitis

Diagnosis?
Diagnosis is based purely on history and assessment of the area.  If this happens a few times to you and you are not sure what the cause is, your HCP can perform skin patch tests, in which they apply little drops of irritants to the skin, and assess for a reaction, then you can learn what causes you to react.  Most often, people make a few changes and the reaction doesn't occur again, or they know what caused it.

How do I treat this?
Treatment is pretty simple. Wash the area thoroughly with lots of water to get rid of the irritant from your skin.  Next you can use a hydrocortisone cream to make the rash and itchiness go away (can be purchased over the counter, and follow directions on the box).  If the rash is widespread or extreme, you may need to take oral corticosteroids.  Sometimes using a benadryl cream/lotion to the area will help to take away the itchiness or taking an oral antihistamine can help as well.

How do I prevent it?
Stay away from what you know you are allergic to and wash your skin thoroughly if you do come in contact.  If you have sensitive skin, stick to very mild (like baby formulated) soaps, detergents, and lotions.  Talk to your HCP about what is best for you and how you can prevent further reactions.  But always wash new clothes before wearing them, and its a good idea to keep hydrocortisone cream and benadryl on hand in your first aid kit at home!

Yours in Good Health
B