Contact dermatitis: Signs and symptoms

Allergic contact dermatitis: Testing revealed that this woman is allergic to an ingredient in her shampoo. Rinsing off the shampoo caused this rash.

Irritant contact dermatitis: Handling fish irritated this patient’s skin, causing a painful rash.

Allergic contact dermatitis: Some people have an allergic reaction only when they sweat or UV light hits their skin. Sunlight triggered this bartender’s severe reaction to lime juice.

 

When to seek immediate medical care

A few people develop a severe allergic reaction known as anaphylaxis (an-uh-fuh-lax-sis). Symptoms occur within seconds or minutes. A person may have:

  • Difficulty breathing due to swelling in the throat
  • Swollen face and/or eyes
  • Confusion

In short, the entire body reacts. If you have any of these symptoms, you need immediate medical care.

Allergic contact dermatitis

This skin condition occurs when you have an allergic reaction to something that comes in contact with your skin.

Signs and symptoms rarely appear on contact. It may take a few hours for your skin to react. If this is your first time that your skin has an allergic reaction to that substance, weeks may pass before you notice anything.

When signs and symptoms appear, you may have:

  • Itchy skin (often intense)  
  • Rash (skin red, swollen, and hot)
  • Excessively dry skin
  • Burning 
  • Stinging
  • Hives (round welts on the skin that itch intensely)
  • Fluid-filled blisters
  • Oozing blisters that leave crusts and scales

If exposure to the allergen continues, your skin may:

  • Flake and crack
  • Become scaly
  • Darken, thicken, and feel leathery

Irritant contact dermatitis

Many substances can irritate our skin. Soap, shampoo, food, and water are mild irritants. With lots of exposure, these can cause irritant contact dermatitis. Getting a strong irritant like battery acid or fiberglass on your skin just once also can cause irritant contact dermatitis.

The signs and symptoms differ for mild and strong irritants. 

Mild irritant: The signs and symptoms develop over time. You’ll gradually notice:

  • Dry, chapped skin. 
  • With repeat exposure, patches of itchy, red, swollen, and scaly skin develop. By this time, each time something that can irritate the skin touches the affected skin, you may feel stinging and burning right away.
  • If exposure continues, the skin may crack, get scaly, and become excessive dry. 
  • Sores and blisters may develop and erupt, causing crusts and scales.
The face, neck, and hands are most susceptible to irritant contact dermatitis.Strong irritant: On contact or within a few hours, the skin can:

  • Burn, sting, and/or itch
  • Become inflamed (red and swollen) 
  • Develop fluid-filled blisters 

When you have irritant contact dermatitis, many things can irritate your skin. You may feel pain on contact. With repeat exposure, the condition worsens.

Reduced quality of life

This skin condition often affects a person’s quality of life. The rash can make many daily activities painful, especially when the rash forms on the hands. The rash can cause:

  • Missed work days
  • Inability to enjoy leisure activities
  • Loss of sleep

Some people are more likely to develop contact dermatitis. You can find out whether you have an increased risk by reading Contact dermatitis: Who gets and causes.

Learn more:

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References:

Kadyk DL, McCarter K. “Quality of life in patients with allergic contact dermatitis.” J Am Acad Dermatol. 2003;49:1037-48.

Lewin Group (prepared for the Society for Investigative Dermatology and the American Academy of Dermatology Association). “The Burden of Skin Diseases.” 2005. p. 37-40.

Wentworth AB, Yiannias JA, et at. “Trends in patch testing,” J Am Acad Dermatol. 2014;70:269-75.