Contact allergy (contact dermatitis)
What is a contact allergy?A contact allergy first causes skin lesions. Within one to three days after contact with the allergen, the skin turns red and swells at the affected site.
© Artemida-psy - stock.adobe.com
Contact allergy, allergic contact dermatitis or contact dermatitis is an allergic skin reaction that results from direct skin contact with an allergenic allergen.
Typically, the allergens are substances that the person concerned regularly deals with. This can be in the private sphere as well as often in professional life. Allergens are artificially produced substances and natural substances, such as plants or plant parts.
Contact dermatitis does not occur on first contact with the allergen. The formation of eczema occurs as a delayed reaction of the immune system until some time after contact. In the treatment of contact dermatitis, the avoidance of contact with the causative agent is the decisive factor. This often leads to the fact that the previous profession or a long-standing hobby can no longer be exercised.
The causes of contact allergy are hypersensitivity to substances that may cause an allergic reaction through direct body contact. The allergenic substances are different in every human being.
However, it is mostly substances such as flavorings in make-up or comsemic articles, hair dyes and tannins. But cobalt chloride, nickel sulfate, preservatives, detergents, medicines, solvents and plasticizers can also trigger contact allergy.
But not only chemicals cause contact dermatitis in some people. Also, plants such as arnica and marigolds, similar to hay fever, can lead to an allergic reaction.
For women, costume jewelery with nickel content often leads to allergic contact dermatitis. This is then referred to separately as nickel allergy closer. In addition, different professional groups may suffer more frequently from contact allergy.
Beautician: solvents, make-up, cosmetics, perfume
Hairdressers: hair dye, hair spray, hair shampoo
Baker and confectioner: Hypersensitivity to flour
Craftsmen: Cement, paints, synthetic resin, adhesives, silicone
Caretaker or cleaning specialists: cleaning agents, cleaning fluids, room sprays
Symptoms, complaints & signs
A contact allergy first causes skin lesions. Within one to three days after contact with the allergen, the skin turns red and swells at the affected site. In most cases, oozing bubbles or wheals develop, which in turn form crusts and dandruff. Accompanying this, there is an increasing itching and burning sensation.
Prolonged contact with the allergen may develop chronic contact dermatitis. This forms a cornea that hurts when touched and can break after a while. Finally, a chronic skin disease sets in, through which the person suffering permanently pain, itching and a strong malaise.
In rare cases, the mucous membranes are affected. Then it comes in the area of the mucous membranes to redness, swelling and rarely to ulcers. When the respiratory tract is involved, breathing difficulties, dysphagia and acute pain reactions are possible. Occasionally, a contact allergy can cause an asthma attack.
The symptoms of contact allergy can occur throughout the body. Typically, hands, face, chest area, neck, neck and ankle are affected. The skin reactions can spread and sometimes affect large parts of the skin. If the allergy is treated early and the allergen avoided, the symptoms usually resolve within a few days.
Diagnosis & HistorySchematic representation of the anatomy of the skin and the causes and symptoms of allergic skin eczema. Click to enlarge.
The formation of a contact allergy takes place in two sections. The first section is called Sensitization Phase. In this phase, the body comes in contact with the allergen recurrently. The exact procedure and influencing factors are not fully understood. What is certain, however, is that the process of sensitization corresponds to the processes of defense against infections, and thus the basis for this exists for every human being.
As part of the sensitization special cells are activated in the lymph nodes, which then proliferate. In the second phase, the triggering phase, recurrent contact with the allergen leads to the corresponding symptoms.
The skin reactions typical of contact dermatitis usually occur two to three days after renewed contact with the trigger. This time shift often makes the assignment to a particular substance difficult.
Contact dermatitis has the same symptoms as other eczema disorders. At the beginning of the disease, redness and swelling of the affected area of the skin are evident. In the further course, vesicles and nodules form, the so-called papules. Later, the spot dries and spills.
If the contact with the allergy-causing substance is not avoided, the contact allergy can also take the course of a chronic eczema. In this case, the skin becomes coarser and form cornifications, so-called hyperkeratoses, and cracks.
A contact allergy can lead to various reactions or complaints. As a rule, complications can generally be avoided if the person concerned completely avoids contact with the respective substance. However, this can significantly limit the patient's life and is not always completely possible.
For this reason, the quality of life of the person affected is often significantly reduced by the contact allergy. This causes a reddening of the skin and itching occurs at various points of the body. As a rule, the itching increases when the patient scratches the respective spot. It can also lead to the formation of papules, which also lead to a reduced aesthetics.
In many cases the symptoms are characterized by inferiority complexes or reduced self-esteem. Most patients are ashamed of the symptoms and therefore no longer actively participate in life. Avoiding a particular ingredient can also lead to depression and other mental health problems.
The contact allergy can be limited with the help of medication. However, complete healing is often not possible. The treatment does not lead to complications and the life expectancy of the person affected is not reduced by the contact allergy.
When should you go to the doctor?
If the typical symptoms of contact allergy limit the quality of life, a doctor should be consulted. Often complaints can be avoided by avoiding contact with the triggering substances. Medical advice is needed if the causes of contact allergy are unknown or if unusual symptoms and discomfort occur. Especially redness and itching are warning signs that require a clarification by the doctor. Also pustules and other skin changes as well as shortness of breath, fever and circulatory complaints of all kinds.
People who feel any pustules or redness as a cosmetic blemish should consult the family doctor. Further contacts are the dermatologist or an internist. An allergist can also be called in. With children the best thing to do is go to the pediatrician for the symptoms mentioned. Severe shortness of breath and serious ailments of the cardiovascular system are a medical emergency. The victim should immediately call the ambulance or visit the nearest hospital. If there is a loss of consciousness, the rescue service must be alerted. The contact allergy is then treated in a hospital and the patient is provided with an allergy pass and emergency medication.
Treatment & Therapy
A contact allergy is treated in acute onset usually with glucocorticoidhaltigen ointments. Alternatively, a UV therapy can provide relief. This is usually used when there are other diseases in the patient that make the use of glucocorticoids impossible.
The treatment of contact dermatitis is only promising if at the same time the allergenic substance is avoided. The most important thing in the treatment of contact dermatitis, therefore, is to find their trigger. In some cases, despite treatment and avoidance of contact with the allergen suspected to be the cause, there is no improvement in eczema.The prick test is an allergy test to check for example allergic reaction to pollen or animal hair. In this case, possible allergic substances are dripped onto the skin and then easily pierced with a lancet. After 20 minutes the skin redness and wheal size are assessed.
It must then be assumed that there are other substances that trigger the allergy. In this case, it has to be investigated which other substances could be involved. With recurring contact allergies, the cause may be a lack of contact with the allergen. In individual cases, it is often difficult to avoid the allergen, when dealing with it, for example, for professional or private reasons almost every day is required.
It is also possible that the complaints are not due to a pure contact allergy. Sometimes contact allergy and other allergic reactions or other forms of eczema occur at the same time, making diagnosis and treatment difficult.
Outlook & Forecast
The chances of finding a complete cure for a contact allergy (contact dermatitis) vary. Healing prospects may be present if the cause of the contact allergy can be determined. If this is the case, a professional treatment can be carried out. In the process, it must be the effort to avoid or eliminate the causative agents of contact dermatitis. This is often not, or only partially possible.
In most cases, contact dermatosis is life-long. By administering corticosteroids, the eczema can be kept in check. For chronic contact allergies, exposure to UV light may be helpful. Especially on the hands can initiate an improvement. However, since the immune system is involved in a contact dermatitis, the prognosis is usually not so positive. The contact with the allergen can often not be completely avoided.
The healing prospects depend on several parameters. If the triggering substance can be kept completely out of life, the healing of contact dermatitis is possible. Contact allergy is dependent on the presence of the allergen. In the case of professional contact dermatoses, a career change may be advisable or mandatory.
For mild allergic reactions, cortisone ointments can be enough. In severe and chronic skin dermatoses, however, the affected skin may become more susceptible to bacterial or fungal attack. It is more often affected by infections than healthy skin.
Prevention of the formation of contact allergies is not possible according to current research. It is never foreseeable which person will react to which substance with the development of contact dermatitis.
Those who are prone to allergies should try to protect their skin with protective gloves and clothing, especially when handling cleaning agents or disinfectants.
In addition, the use of pH neutral products is recommended. Many allergen-rich products from daily life, such as soaps, deodorants and softeners can be replaced by other products. However, the emergence of a contact allergy can not be completely ruled out.
The attending physician informs patients about target-oriented behaviors as part of the initial diagnosis. In addition, it occurs only in acute problems. The patient has a high degree of personal responsibility for freedom from complaints. Scheduled follow-up, as they are known from tumor diseases, are rare and are associated with recurrent, severe symptoms.
Especially at first it can be time consuming to determine all triggers correctly. Complications occur when the skin is attacked for a long time. Often only an acute treatment with antibiotics helps. Everyday support particularly includes the transfer of knowledge. The affected person learns how to behave in an allergic reaction.
Ointments and tablets should be in stock. The complaints are best avoided by not occurring at all. For this, the patient must bypass the typical triggers or remove them from his environment. Aids such as gloves and clothing prevent infections. The success of the measures is determined by the patient's actions.
You can do that yourself
The best form of self-help in a contact allergy is to identify the allergen and avoid it as much as possible. If finding the trigger is difficult, an allergy diary can help. In this diary the person concerned records his activities and the observed symptoms. The records must be kept for several weeks and then often reveal statistical correlations between a specific action and an allergic reaction. These evaluations help the attending physician to narrow down the possible allergen.
There are widespread allergic reactions to fragrances and other auxiliaries in cosmetics and household cleaners. In this case, only care products that are labeled as "hypoallergenic" should be used. Meanwhile, there is a wide range of both toiletries and decorative cosmetics, which have been formulated taking into account the special needs of allergy sufferers. With an allergy to detergents, it is usually enough to wear gloves when doing household chores.
If there is a danger that the present profession can no longer be exercised due to a contact allergy, it is extremely important that the patient receives not only medical but also legal advice. A victim should promptly contact his union or a specialist social lawyer. In larger cities, charities often offer free legal advice to people in such situations.