TL;DR:
- Contact Eczema: A skin condition causing itchy, red, and painful lesions from contact with irritants/allergens. Common in both allergic and non-allergic forms.
- Causes:
- Allergic eczema: Nickel, latex, fragrances, preservatives, fabric dyes, certain plants.
- Irritant eczema: Detergents, solvents, soaps, water exposure, irritant plants.
- Symptoms: Itching, redness, swelling, blisters, thickening, peeling, and fluid oozing.
- Diagnosis: Patient history, clinical examination, patch tests, blood tests, and keeping a product/activity diary.
- Prevention:
- Avoid irritants/allergens (e.g., nickel, fragrances).
- Use hypoallergenic cosmetics and mild detergents.
- Wear protective gloves.
- Moisturize regularly and wear natural fabrics.
- Avoid excessive water exposure.
- Early action (e.g., moisturizing, avoiding triggers) is crucial.
Contact eczema is a common skin disease that can affect anyone of any age. It is characterized by itchy, red and painful lesions on the skin that develop as a result of contact with irritants or allergens. It usually results from everyday activities, such as wearing jewelry, using cosmetics or working with detergents. Check out the causes and symptoms of contact eczema and prevention options.
What is contact eczema?
Contact dermatitis is an allergic disease that can occur on the face and body after direct contact with an allergen or irritant. Usually this ailment affects adults, but it can also occur in children and infants. The incidence is similar when it comes to men and women. It depends primarily on the predisposition, the strength of the irritant and the time of exposure. Under the influence of contact with the allergen, the skin becomes hypersensitive, which leads to the formation of characteristic skin lesions. Contact rash is also sometimes referred to as eczema, but the terms are not synonymous. The very word “eczema” refers to inflammatory eczema of the epidermis and papillary layer of the dermis – so it is not a specified disease entity, but a type of skin lesions that accompany a dermatological ailment.
The most common causes of contact eczema
If we are dealing with allergic contact eczema, its most common cause is hypersensitivity of the immune system to a variety of small-molecule compounds. In the induction stage, the allergen comes into direct contact with white blood cells, which leads to further development of the immune response. At this stage, the timing of contact with the symptom-causing substance, its concentration, chemical specificity and the condition of our skin are of great importance. In the full-blown phase, also known as the disclosure phase, rapid hypersensitivity of the body occurs, even after minimal contact with the allergen.
Types of contact eczema – causes and symptoms
Contact eczema comes in two forms – as allergic contact eczema and non-allergic contact eczema, also known as irritant eczema. Both forms have different mechanisms of formation and causes, although the symptoms may be similar.
Allergic contact eczema
Allergic contact eczema is an immune reaction that occurs when the immune system reacts to skin contact with a specific substance. Unlike irritant eczema, the reaction is not immediate. After the first contact with an allergen, the body "learns" to recognize it, which can take from a few days to several years. On subsequent exposures to the same allergen, the skin often responds with inflammation. The most common allergens in this case are:
- Nickel (present in jewelry, buttons, buckles),
- latex (gloves, some medical devices),
- fragrances and preservatives in cosmetics,
- fabric dyes,
- certain plants, such as ivy.
Symptoms, in addition to itching, burning, redness and rash, include swelling and blisters filled with serous fluid. Small wounds may rupture and lead to oozing of fluid. In some cases there is also thickening and peeling of the skin.
Non-allergic contact eczema
Irritant contact eczema, unlike allergic contact eczema, is not the result of an immune system reaction, but direct damage to the skin's protective layer by irritants. It can appear after the first contact with a harmful substance, especially if the contact was prolonged or intense. This is the most common form of contact eczema, which can affect anyone, regardless of previous contacts with the substance. The most common triggers of irritant eczema are:
- strong detergents and cleaners,
- solvents and industrial chemicals,
- soaps and disinfectants,
- frequent contact with water (e.g. working in a wet environment),
- certain plants that have an irritant effect.
Although both types of contact eczema can manifest similar skin lesions, they differ in their mechanism of onset and causes. Understanding these differences is important for proper treatment and prevention of these conditions.
Diagnosis of contact eczema – how to recognize the problem?
Correctly diagnosing contact eczema, whether allergic or irritant, can be a challenge, as the symptoms often resemble other skin diseases. To accurately diagnose the problem, it is necessary to take a detailed medical history, perform a clinical examination and, if necessary, perform additional tests. The first step in diagnosis is to interview the patient. The doctor will ask questions about the frequency and circumstances of the appearance of symptoms, exposure to potential allergens or irritants, the presence of eczema in other family members or previous skin diseases. During the clinical examination, the dermatologist will evaluate the skin lesions for their location, appearance and severity. Contact eczema can manifest as redness, swelling, blisters, skin cracking or peeling. The location of the lesions is also of great importance – for example, on the hands, face or neck, which may suggest contact with a particular substance. If allergic contact eczema is suspected, the doctor recommends patch tests (epicutaneous tests). The test involves applying small amounts of potential allergens to the patient's skin, which are covered with special patches. These patches remain on the skin for about 48 hours, after which the doctor evaluates the skin's reaction to the individual allergens. In some cases, especially when another cause for the appearance of disturbing skin lesions is suspected, the doctor may order additional tests, such as:
- skin tests – other types of skin tests, such as spot tests, may be useful in the diagnosis of contact allergy,
- blood tests – tests that assess immunoglobulin E (IgE) levels to detect systemic allergy may be helpful, although they are not specific for contact eczema.
Sometimes, when the diagnosis is not clear, the patient may be asked to keep a diary in which he or she records all products used on a daily basis, as well as places and activities that could be related to the occurrence of eczema. The doctor may also order a so-called provocation test, which involves deliberately exposing the skin to a suspected allergen or irritant to assess the reaction.
Daily habits to help avoid contact eczema
By introducing the right habits into your daily life, we can minimize the risk of contact eczema. If you know you have a nickel allergy, avoid jewelry, watches and other accessories containing the metal. Choose products made of hypoallergenic materials, such as stainless steel, titanium or gold. Use cosmetics designed for sensitive skin that are free of fragrances, dyes and preservatives. Use mild laundry detergents and cleaners that are free of harsh chemicals. You can also wear protective gloves while cleaning to limit skin contact with detergents. Latex, vinyl or nitrile gloves work best. If you tend to have dry skin, limit contact with water, especially hot water, which removes natural lubricants from the skin. After washing your hands or taking a bath, carefully dry your skin and immediately moisturize it with emollients. Choose clothes made of natural, airy materials, such as cotton, which are less irritating to the skin. Avoid synthetic fabrics, which retain moisture and promote irritation. Also, bedding and towels should be made of soft, natural materials to minimize the risk of irritation.
If you notice the first worrisome symptoms of eczema, such as redness, itching or dry skin, react right away. Avoid further contact with the potential irritant and moisturize your skin. Before buying new products, always check their composition. Go for high-quality products that are dedicated to sensitive or allergy-prone skin.
Introducing these simple habits into your daily life can significantly reduce the risk of contact eczema. The key to success is to avoid contact with substances that can irritate the skin, and to make sure that your skin is properly protected and moisturized.
Conclusion
Contact eczema is a manageable condition when you understand its triggers and symptoms. By identifying whether it’s allergic or irritant, you can take specific steps to avoid harmful substances. Prevention starts with building simple habits like using protective gloves, choosing hypoallergenic products, and moisturizing regularly. If symptoms appear, act quickly: avoid exposure to irritants and seek professional diagnosis for effective treatment. Healthy skin requires care and awareness. Remember, proactive choices can help you protect your skin and minimize future outbreaks.
