Don’t Forget Contact Dermatitis
By Tracey S. Cloninger, PA–C at Southern Dermatology
In North Carolina when spring comes around, a lot of our immune systems mistake pollen for a dangerous and invasive substance. The body (as we’ve all seen many times) literally gets sick over it. And so people buy Benadryl, Claritin, or Zyrtec just to keep life manageable.
Perhaps this yearly ritual is why when people think of allergies they think of allergens like pollen, dust mites, mold, pet dandruff, etc. But contact allergens begin through physical contact rather than inhalation. These allergies can be triggered by substances found in a variety of household goods like lotions, shampoos, cosmetics, formaldehyde, formaldehyde releasing preservatives, and even topical therapies used to treat patients.
This kind of allergy often manifests itself as a rash that typically itches. But unlike inhaled allergens, contact dermatitis is often avoidable. If people know which substances cause the allergic reaction, they can normally avoid physical contact with those substances and improve their quality of life.
The best way to determine this type of disruptive allergen is through a patch test. Three kinds of patients are ideal candidates for a patch test.
- The first ideal candidate is a patient who shows a reaction to a known contact dermatitis allergen—for example, someone with a rash on their abdomen right where the belt buckle would hit or on their ears where earrings are likely to touch.
- The second type of patient that should be referred for patch testing is someone with known atopic dermatitis. That involves someone who typically suffers from the “atopic triad II of asthma, rhinitis (hay fever), and skin eczema.
- The third ideal patient would be someone whose current rash never seems to improve.
Too often physicians keep trying new lotions rather than referring patients to get a simple patch test performed. At Southern Dermatology, we use the North American Series. This series tests 70 of the most common allergens by carefully taping patches on the back of the patient. These patches contain an organized matrix of allergens. The patches are worn for a few days. During the test, patients are not allowed to shower because they must keep the patients can experience–itching or minor discomfort, but generally the procedure is simple and painless.
By the end of the test, the patches are removed and by identifying. which areas are inflamed, providers ‘are able to identify the specific substances that are causing the allergic reactions. Once identified, dermatology providers can also provide information and strategies to help patients avoid contact with the harmful substances.
Successful results can drastically improve a patient’s quality of life. For many people, rashes cause the double discomfort of physical irritation and social anxiety because many rashes are unattractive and appear in hard to hide areas like the face, neck, and legs. The good news: many of the most common allergens are easily avoided. You just need to know what to avoid.