Last updated date: 13-Oct-2022
Originally Written in English
Contact dermatitis refers to an itchy red rash that affects children of all ages. It can be due to an allergic reaction to a substance or direct contact. Although the rash is not contagious or fatal, it can be extremely uncomfortable. Soaps, fragrances, cosmetics, jewelry, and certain plants are examples of substances that can trigger such reactions.
By identifying and causing the substance that causes the problem, contact dermatitis normally improves or disappears completely within a short period. There are also available treatments that can help alleviate the associated symptoms.
Types of Contact Dermatitis
Contact dermatitis is classified into two major types, including;
- Irritant contact dermatitis
Irritant contact dermatitis accounts for up to 80 percent of all contact dermatitis. It is, however, not associated with an immune system allergic reaction. Instead, it can occur if the skin cells get damaged as a result of exposure to irritants like detergents, solvents, bleach, soaps, or jewelry containing nickel.
Makeup, hair dye, belt buckles, nickel-containing scissors, or clothing with metal snaps or zippers may also cause reactions. Other possible triggers include excessive hand-washing using hot water with soap and putting on scratchy wool.
- Allergic contact dermatitis
This refers to a delayed allergic reaction that manifests in the form of rash one or two days following contact with an allergen. Poison ivy is a frequent example. Following exposure or touch, the body produces a strong inflammatory response to the plant's oils. This results in an itchy rash in one or two days. Nickel, fragrances, and thimerosal, a preservative present in certain topical antibiotics, are all possible triggers of allergy contact dermatitis.
Signs and Symptoms of Contact Dermatitis
Contact dermatitis typically develops on the parts of the body that directly get exposed or come into contact with the allergen (reaction-causing substance), such as alongside a calf that has brushed on poison ivy or beneath a watchband. The rash typically appears a few minutes to hours following exposure and may last for about two or four weeks.
The common symptoms and signs of contact dermatitis in babies include:
- A red rash on the skin
- Itchiness that can be severe
- Skin dryness, cracking, and scaly skin
- Bumps and blisters, associated with oozing and crusting at times
- Burning, swelling, or tenderness of the skin
If the rash causes severe discomfort that makes the child lose sleep or distract their regular activities, consult a pediatric dermatologist right away. Also, seek medical help if your child’s rash appears suddenly and doesn’t clear up after three weeks. Genital or vaginal contact dermatitis and those affecting the face require prompt medical attention as well.
Causes of Contact Dermatitis
When the condition is due to an allergy, then it involves the child’s immune system. When he or she comes in contact with something, the immune system wrongly assumes that the body is under attack. As a result, it goes into action, producing antibodies to combat the invader. A series of events results in the generation of chemicals, such as histamine. Histamine is what triggers the allergic reaction, which in this case is an itchy red rash (allergic contact dermatitis).
Typically, the child will not develop a rash when the skin comes into contact with something they are allergic to for the first time. However, the exposure sensitizes the skin, and one may experience a reaction the next time. When the child develops an allergic rash, there is a possibility that he/she has already been exposed to the trigger and didn't realize it.
Some of the causes of allergic contact dermatitis in toddlers and older children are:
- Certain medications that you apply to your skin
- Citrus fruit, particularly the peel
- Fragrances present in soaps, lotions, shampoos, cosmetics, and perfumes
- Latex rubber
- Leather, including chemicals found in tanning leather
- Nickel metal that is used in jewelry and belt buckles.
- Poison ivy, poison sumac, and poison oak
- Straighteners or hair dyes
At times, rashes appear to be allergic responses yet are not because the body's immune system was not involved. Rather, they could occur since the child came into contact with something that removed the surface oils that protect the skin. The longer it remained on the skin, the more severe the reaction (irritant contact dermatitis).
Irritant contact dermatitis can thus occur due to the following allergens:
- Abrasive soaps and detergents
- Certain drain cleaners
- Epoxies, resins, and plastics
- Hair dyes
- Nail polish remover
- Plants like poinsettias and peppers
- Saliva, urine, and other bodily fluids
- Varnishes and paints
Contact Dermatitis Diagnosis
The pediatric dermatologist may detect contact dermatitis and determine the underlying cause during a physical exam. It involves inquiring about the symptoms, asking about the potential trigger substance, and examining the skin to know the pattern and severity of the rash.
The pediatrician can suggest a patch test to check if the child is allergic to a substance. This test may be beneficial when the rash trigger is unknown or if the rash frequently reappears.
The patch test involves applying a small amount of the possible allergens to the adhesive patches and placing them on the skin. These patches will stay on the skin for about two or three days. Within the period, the child has to maintain the back dry at all times. After that, the provider examines the skin for any reactions beneath the patches and identify if additional testing is required.
Contact Dermatitis Treatment
Based on the severity of your child’s symptoms, you can treat and manage contact dermatitis while at home. Alternatively, you might have to consult a pediatric dermatologist.
You can attempt the following home remedies to help ease and soothe your child’s skin:
- Immediately cleaning the skin using mild soap with cool water.
- Avoiding or removing the allergen or irritant triggering the rash
- Applying hydrocortisone cream to affected areas.
- Applying a cold, moist compression for about 30 minutes at least three times a day for blisters.
- Apply moisturizers to damaged skin many times per day to aid in the restoration of the protective layer.
- To relieve itching, take prescribed oral histamine or antibiotics for bacterial infection.
Preventing Contact Dermatitis
The following are some general contact dermatitis precautions to take:
Cleanse your child’s skin: If you clean the skin immediately after being in contact with the rash-triggering substance, you may remove the majority of it. Warm water and a fragrance-free, mild soap are recommended, after which you should rinse thoroughly. Also, clean any clothing and the things that contact a plant allergen, including poison ivy.
Avoiding allergens and irritants: Always ensure that you identify the substances that cause irritation or an allergic reaction on your child’s skin and tell him/her to stay away.
Put on gloves or protective clothes: Glove, face masks, goggles, and other protective equipment can help protect you from irritants such as household cleaners.
Use a barrier cream or gel to protect the skin: These products are essential in providing a layer of protection for the skin. An over-the-counter skin cream that contains bentoquatam (IvyBlock), for example, can help prevent or reduce the reaction of the skin to poison ivy.
Apply a moisturizer: Using moisturizing lotions on a regular basis might assist in restoring the outermost layer of the skin and keep it supple.
Cover any metallic fasteners close to the skin with an iron-on patch: This could help avoid having an allergic reaction to things like jean snaps.
Take precautions when around pets: Plant allergens, like poison ivy, may sometimes stick to pets, which can then spread to humans.
Complications of Contact Dermatitis
Allergic contact dermatitis is typically a Type IV hypersensitivity reaction. It is triggered by a particular immunologic mechanism other than angioedema, hives, or anaphylaxis. In rare cases, children may experience immunologic dysfunction, resulting in multiple forms of concurrent hypersensitivity responses.
As a result, children who have contact dermatitis may get swelling (angioedema) and hives (urticaria) after being in touch with an allergen or substance. Hives are welts of red, itchy, raised skin. Angioedema is a type of swelling that occurs deep beneath the skin.
Allergic contact dermatitis is extremely rare, but it can coexist with anaphylaxis, a severe, fatal allergic reaction that can swell and close the airways. Therefore, if you think your child is suffering from anaphylaxis, seek prompt medical attention or contact 911.
To counteract such an allergic reaction, the child will require an epinephrine injection right away. Patients who have known allergies are advised to carry an injectable epinephrine brand on hand.
Contact dermatitis is a rash that appears on the skin when it comes in contact or reacts to a specific substance. It's usually red and causes itchiness and discomfort though it's not life-threatening. The contact dermatitis rash can be a result of an allergy or damage to the skin's protective layer.
To effectively address contact dermatitis, you must first identify and keep off the triggers of the reaction. By avoiding the offending substance, the rash typically resolves in about two or four weeks. You may attempt anti-itch creams, cool and wet compresses, and self-care measures to soothe your child’s skin.