fullcortex.net

WHAT IS IT?
Your skin is your body’s largest organ-and one of the hardest working. It protects you from the sun, stores water and fat, helps control your body’s temperature, and fends off assaults from invaders such as dirt, insects, germs, and smoky air.
Contact dermatitis-crusty, dry, itchy red patches or rashes, and sometimes blistering, oozing sores-is a skin ailment caused by something your skin touches. The things that trigger contact dermatitis, also called contact eczema, vary from person to person, though doctors aren’t sure why. Some common triggers include soaps, chemicals, clothing, and metal jewelry. Wet or dry air or skin can also make contact dermatitis worse.

Most of the time dermatitis isn’t serious, though it can be painful and itchy and get in the way of your daily routine. But you and your doctor can manage the symptoms and take steps to prevent future attacks.
WHAT IS HAPPENING?
Your skin has two main layers. The epidermis, the one on top that you see, is a tough but thin cover that protects the softer layers below. It sheds old cells that are replaced by fresh ones as the skin renews itself to remain strong. The dermis, just beneath the epidermis, contains blood vessels, hair follicles, nerve endings, and oil and sweat glands. Together, the two layers of skin shield you like a coat of armor. But the armor has weaknesses. Contact dermatitis is one of them.

There are two main types of contact dermatitis:

Irritant contact dermatitis
This type of dermatitis occurs when something directly irritates skin cells, causing symptoms such as blisters, itching, or a rash. For example, diaper rash is a type of irritant contact dermatitis caused by urine and feces on a baby’s skin. And most people’s skin reacts to products such as lye, chemicals in paint stripper, or cleansers, which is why it’s a good idea to wear gloves when using these products. Some people have skin that’s irritated even by substances that don’t bother most people.

Allergic contact dermatitis
You get this form of dermatitis when you touch something you’re allergic to. When you’re allergic to something, your disease-fighting system-the immune system-reacts to normally harmless things as if they were threats. In some people, the allergic reaction is an upset stomach, asthma, or hay fever (sneezing and watery eyes). In others, the reaction is dermatitis. Instead of coughing, sneezing, wheezing, or having cramps, you itch and get a rash. Your skin cells release histamine, a chemical that swells the tiny blood vessels in the dermis, causing a rash or blisters. A rash may show up under a necklace or where a wool shirt touched your arm. Rubber, metal, leather, wool, polyester, or any of the thousands of things in skin care products may be a problem for you. Even the itching from poison oak or ivy is caused by an allergy that almost all people share.
WHAT CAUSES IT?
Contact dermatitis is something of a mystery. No one can say why some people get it and others don’t. Thousands of things can cause contact dermatitis, but you only need to figure out which ones bother you. Noticing where you feel an itch or see a rash helps to narrow down the causes; so does recalling what was on or near your skin before you had symptoms.

THINGS YOU CAN’T CHANGE

Allergies
You don’t know whether you’re allergic to something until after you have a reaction such as contact dermatitis. And allergies can change. Something that never bothered you in the past may begin to bother you. Your genes may play a role here, too: Allergies often run in families.

Climate
Dry weather can dry your skin and make you itch. Hot, humid weather can also cause an itchy rash.

Random contact
Even if you know what poison oak or ivy looks like and manage to avoid it, you can still get the poisonous oil on your skin from a dog that brushed a plant, for instance, or from clothing.

THINGS YOU CAN CHANGE

Exposure to poisonous plants
Urushiol, the oil on the leaves and stems of poison oak, poison ivy, and poison sumac, causes severe cases of contact dermatitis. Most people are allergic to this oil.

Choice of skin care products, clothing, and jewelry

Substances in makeup and lotions may bother your skin. Lanolin is a common troublemaker. Jewelry metals, wool, rubber, leather, and polyester can cause itching and skin rashes.

Use of hair dyes
Some people are allergic to paraphenylene-diamine (PPD), a chemical used in permanent hair dyes. You can try a temporary dye or rinse, but be careful: Some people who are sensitive to PPD will also react to these products. To be safe, test the dye on a small patch of skin. (Read the packaging for instructions.)

Skin care
Dry or dirty skin can cause an attack. If your skin is chapped and dry, even water can cause the problem.

Use of harsh cleansers
Harsh soaps, cleansers, and solvents, such as alcohol and paint thinner, can cause contact dermatitis.
WHAT YOU CAN DO FOR YOURSELF
You can ease the discomfort of contact dermatitis and avoid outbreaks later by taking care of your skin.

During an attack:
Over-the-counter hydrocortisone creams can help clear up outbreaks. These creams may be too harsh for babies; use them only for children over age one and adults.
Calamine lotion and hydrocortisone cream ease most itches. Soothe dry skin by rubbing petroleum jelly on it.
To ease swelling and itching, toss a half cup of cornstarch or oatmeal (the kind sold in drugstores, not the type you cook) into a warm, not hot, bath. Soak your skin for only 30 minutes to keep from losing too many of the oils your skin needs. Use a mild, fragrance-free soap. Or use the oatmeal as a compress on your skin. Leave it on for only 30 minutes.
Over-the-counter oral antihistamines can help relieve itching and let you get some sleep. Most make you drowsy, so take them before you go to bed.
Don’t scratch. Scratching makes the problem worse. Bacteria can infect broken skin, causing a new problem. Keep fingernails short; wear lightweight mittens or gloves at night to prevent scratching during sleep. This is an especially good idea for children.
Wash right away
If you know you’ve touched a chemical, plant, or fabric that might bother your skin, wash right away with mild soap and water. For poison oak, ivy, or sumac, rinse the area well with water or rubbing alcohol. Don’t use soap; its lather can spread oil to other parts of your body. Before you enter the house, rinse off any clothing, pets, or gear that may have come into contact with the oil. This helps prevent contact later.

Try a lotion containing bentoquatam
This lotion, which you can buy at drugstores as IvyBlock, acts like a shield to protect your skin from poison oak, ivy, or sumac. Just rub it on exposed skin before heading for the woods. Do not use the lotion if you already have a rash from these plants. Stop using the lotion if a rash develops.

Protect your skin
Defend your skin from the effects of too much sun, wind, water, cold, or heat with hats, gloves, clothing, and nonirritating sunscreens.

Cleanse your skin gently
Harsh soaps, chiefly deodorant soaps and those with germ fighters, dry out your skin. Use alcohol-free soaps that say “mild” on the label. Protect your hands when you put them in water by wearing cotton gloves-which help keep your hands dry-under rubber gloves.

Moisten your skin
Moisturizers are really oils, and they help keep your skin smooth and healthy. Give them a try if you have dry skin or an allover itch but no rash. If your lips are chapped because of weather, chances are your skin is dry, too. Use a lip moisturizer and body lotions that have no scents or preservatives.

Choose products with care
Many skin care products contain things that someone is allergic to. Just about everything you can buy to put on your skin can cause contact dermatitis: perfume, aftershave, face and eye makeup, soap, shampoo, deodorant, suntan lotion, and skin cream.

Avoid lanolin if you think it bothers your skin. Lanolin is used in many moisturizers, and lots of people are allergic to it.
Change your makeup if it bothers you. If you get a rash, try changing brands or giving up the makeup for a week or two. If the rash goes away, then returns when you use the product again, chances are you’re allergic to something in it. Try another brand that’s labeled “hypoallergenic”-not likely to cause an allergic reaction.
The right clothes
Wear loose-fitting clothes that don’t make you sweat and don’t rub your skin.
When you can, wear clothes made of natural fibers, chiefly untreated cotton. They bother skin less and also keep you cool so you sweat less.
Wash clothes with a mild, scent-free laundry soap. Rinse twice. Don’t use fabric softener.
Take a patch test
A little work on your part can find what’s causing the problem. Test yourself at home before using a new product or to find out what’s troubling your skin. Put a small dab of the suspected troublemaker on the smooth, hairless inside part of your forearm. Cover it with a bandage (if you’re allergic to adhesive, use gauze and paper tape). If the spot turns into a red, itchy rash within 48 hours, you know you’re allergic to that product.

Use a humidifier
Dry air can lead to dry skin, which makes contact dermatitis worse. Use a humidifier to adjust the moisture in your home or office.

Try other fabrics
Wool gives many people a rash, and so can other fabrics. If you break out in a rash only where a certain fabric touched your skin, there’s a good chance you’re allergic to it. Cotton seems to bother the least number of people. For very sensitive skin, untreated raw cotton or other natural-fiber fabrics may be best.

Try other jewelry
Many metals and metal alloys can cause rashes. Surgical steel is the least likely to cause a problem, and most people aren’t bothered by sterling silver, platinum, or 24-karat gold.
WHAT YOUR DOCTOR CAN DO FOR YOU
You don’t really need to go to your doctor unless you’ve had contact dermatitis for two or three weeks and home care hasn’t worked. You should also call your doctor if your contact dermatitis becomes infected or turns into oozing open sores, and you know these symptoms were not caused by poison oak, ivy, or sumac.

Find out what’s really wrong
Your doctor may find that you don’t have contact dermatitis at all. Scabies, for example, caused by a tiny insect that lives under your skin, has symptoms like those of contact dermatitis.

Patch tests
Your doctor can try to find out what’s bothering you with better patch tests than you can do on your own.

Medicines
If over-the-counter drugs or home cures don’t stop the itching and rash, your doctor can prescribe antihistamines, hydrocortisone pills, or strong hydrocortisone creams that may help.

Hydrocortisone creams, lotions, and ointments come in over-the-counter forms and much stronger prescription forms.

Pro
Work to relieve the redness, swelling, and itching of many skin problems, including contact dermatitis.
Con
Side effects may include a stinging or burning feeling where the lotion is applied.
Oral hydrocortisone, which you take as pills or capsules, is used for more severe cases that need even stronger doses.

Pro
These are strong drugs that can work well to provide relief for inflamed skin.
Con
Side effects may include change in skin color, upset stomach, nervousness, and trouble sleeping. Long-term use may cause stunted growth in children and weakened bones in adults.
Antihistamines, most often taken as pills or capsules, help relieve allergy symptoms common to contact dermatitis, such as itching and swelling. They work by blocking the effects of histamine, a substance the body releases as part of its effort to heal a wound or fight off germs.

Pro
Work well to relieve the main symptoms of contact dermatitis.
Con
Side effects may include drowsiness, thick mucus, dizziness, feeling faint, and faster heartbeat.
Ultraviolet light therapy
Long-lasting dermatitis that doesn’t respond well to drugs may improve with exposure to certain wavelengths of ultraviolet light.

Pro
Can help severe cases not helped by other treatments.
May help if you can’t avoid the cause of your dermatitis.
Con
Can cause itching and may raise the risk of skin cancer.