Contact dermatitis is the name for any skin inflammation that occurs when the skin's surface comes in contact with a substance originating outside the body. There are two kinds of contact dermatitis, irritant and allergic.
Thousands of natural and man-made substances can cause contact dermatitis, which is the most common skin condition requiring medical attention and the foremost source of work-related disease. Florists, domestic workers, hairdressers, food preparers, and employees in industry, construction, and health care are the people most at risk of contracting work-related contact dermatitis. Americans spend roughly $300 million a year in their quest for relief from contact dermatitis, not counting the considerable sums devoted by governments and businesses to regulating and policing the use of skin-threatening chemicals in the workplace. But exactly how many people suffer from contact dermatitis remains unclear; a 1997 article in the Journal of the American Medical Association notes that figures ranging from 1% to 15% have been put forward for Western industrial nations.
Causes and symptoms
Irritant contact dermatitis (ICD) is the more commonly reported of the two kinds of contact dermatitis, and is seen in about 80% of cases. It can be caused by soaps, detergents, solvents, adhesives, fiberglass, and other substances that are able to directly injure the skin. Most attacks are slight and confined to the hands and forearms, but can affect any part of the body that comes in contact with an irritating substance. The symptoms can take many forms: redness, itching, crusting, swelling, blistering, oozing, dryness, scaliness, thickening of the skin, and a feeling of warmth at the site of contact. In extreme cases, severe blistering can occur and open sores can form. Jobs that require frequent skin exposure to water, such as hairdressing and food preparation, can make the skin more susceptible to ICD.
Allergic contact dermatitis (ACD) results when repeated exposure to an allergen (an allergy-causing substance) triggers an immune response that inflames the skin. Tens of thousands of drugs, pesticides, cosmetics, food additives, commercial chemicals, and other substances have been identified as potential allergens. Fewer than 30, however, are responsible the majority of ACD cases. Common culprits include poison ivy, poison oak, and poison sumac; fragrances and preservatives in cosmetics and personal care products; latex items such as gloves and condoms; and formaldehyde. Many people find that they are allergic to the nickel in inexpensive jewelry. ACD is usually confined to the area of skin that comes in contact with the allergen, typically the hands or face. Symptoms range from mild to severe and resemble those of ICD; a patch test may be needed to determine which kind of contact dermatitis a person is suffering from.
Howard Baker, The Gale Group Inc., Gale, Detroit,