What is Allergic Contact Dermatitis?
Allergen contact dermatitis is a blanket condition that incorporates many different forms of contact dermatitis. What all of these forms of dermatitis hold in common is their causal origin in the form of allergic reaction. It is impossible to suffer from allergic contact dermatitis without a pre-existing allergy.
Allergen contact dermatitis varies in severity and symptoms. It contrasts heavily with irritant contact dermatitis, although they share a number of similar qualities. Allergic contact dermatitis can be more or less tenacious than irritant contact dermatitis, may incorporate a number of symptoms that irritant contact dermatitis does not, may affect the body in ways that irritant contact dermatitis cannot, may persist even after exposure has ceased, may become systemic, may originate systemically following multiple exposures to multiple substances—allergic contact dermatitis is an altogether more complicated ailment.
Allergic contact dermatitis is characterized by physical exposure to an allergen; that is, direct skin contact.
Allergic contact dermatitis may overlap with irritant contact dermatitis. It is entirely possible that an individual is allergic to a substance that they are simultaneously irritated by. This generally results in a far more severe case of dermatitis that can be substantially more difficult to treat.
Allergic contact dermatitis is the most common form of allergy in humans, statistically.
Who gets Allergic Contact Dermatitis?
Allergic contact dermatitis may afflict anyone with a hypersensitivity (allergy) to a substance. This is, of course, a gross oversimplification. The number of possible substances that one can be allergic to are incredible, and frequently surprising.
The very young and very old have a tendency to be more susceptible to allergic contact dermatitis, as their skin has a tendency to be somewhat more fragile. This may augment the symptoms and discomfort felt considerably. Unlike many dermatitis conditions, the physical sex of the subject is irrelevant, as the hormonal makeup of their body is unlikely to come into play. The dryness or oiliness of the skin may have some very slight impact on the nature of the symptoms that present, but this should be mostly irrelevant.
Allergic contact dermatitis may be augmented by certain pre-existing conditions. Individuals who suffer from auto-immune conditions that can affect the skin may find that they are subject to additional symptoms, or that the symptoms of the allergic reaction and their pre-existing autoimmune condition interact.
What causes Allergic Contact Dermatitis?
Allergic contact dermatitis is a fairly complex ailment resulting from a lot of different systems acting out all at once. The initial trigger is always physical exposure to an allergen, however, specifically an allergen that an individual has a pre-determined hypersensitivity to.
Under normal circumstances, when an individual is exposed to a substance that provokes a reaction, this is all that occurs: the exposure happens, and the body reacts to compensate. Allergies are the result of overcompensation due to hypersensitivity. This causes the body’s systems to be thrown out of whack and results in a case of allergic contact dermatitis.
The full process of allergic contact dermatitis is very difficult to explain without dropping a number of technical dermatological terms. Effectively, allergic contact dermatitis results from two phases: the induction phase, in which the exposure to the allergen occurs, and the elicitation phase, in which the rash is actually brought to the fore.
The very, very short version is this: the body is exposed to a foreign substance in the form of an allergen. Following this, the allergen binds to various skin components that it can permeate. The resulting compounded form of skin cell and allergen is identified by the body erroneously as foreign. This provokes an immune response against the body itself. This results in the symptoms of allergic contact dermatitis.
The immune system adapts to threats as best it can. The reason it is impossible to contract some ailments more than once is because the disease is identified by the immune system and subsequently destroyed before it can become a problem again. Once it fights something off once, it can usually do so again much more easily, and every subsequent outbreak of the illness will be as easily repelled. However, this is handily subverted with allergic contact dermatitis: because the immune system is the origin of the symptoms and an erroneous, false-positive response is what triggers it, subsequent allergic exposure will result in a far worse onset of symptoms. Owing to this, allergic contact dermatitis may not always occur due to an initial exposure. It may be that only subsequent exposures that provoke much faster and harder responses from the immune system will actually present with any notable symptoms. This can make identifying allergic contact dermatitis difficult.
There are a number of common triggers for allergic contact dermatitis. Most of them are encountered in day-to-day life, rather than in special circumstances, allowing multiple exposures to build up over time until a noticeable immune reaction occurs. Formaldehyde is a common trigger, found in a number of cosmetics; steroids may be a possible offender; various metals including gold, nickel and chrome may all provoke allergic reactions; cobalt as found in hair products may be the source of the trouble; rosin as used for bows may qualify as well. The list goes on.
What does Allergic Contact Dermatitis cause?
Allergic contact dermatitis causes a severe rash. This rash may vary, but redness is an effective given. In addition to redness, one may look forward to various forms of skin ailments related to immune response, especially pustules. The skin may feel hot or tight to the touch, much like skin affected by a sunburn. Symptoms may be similar or identical to those of irritant contact dermatitis.
Every case of allergic contact dermatitis provokes the hyperactive immune system to action. Every time the immune system engages a threat, it uses what are known as t-cells to profile it. These cells linger in the immune system, subsequently, and are used to more quickly identify and assault recurrent threats. This is the reason the second case of the same ailment can be shaken off much more quickly (albeit oftentimes with more severe symptoms to accompany the shorter tenure, as a result of the very same accelerated immune response).
Thus, every case of allergic contact dermatitis causes subsequent cases of allergic contact dermatitis to be much more severe. Every time an allergen is identified, it is met with t-cells and a greater immune response; every additional time this same threat is identified, it is met with an even greater response. Thus, allergic contact dermatitis fuels the severity of its own symptoms with each secondary exposure.
The rash can be quite uncomfortable and may result in severe losses of productivity. Depending upon the location of the rash, it may be quite aesthetically displeasing, which may in turn make it quite demoralizing for the individual suffering from it. This will vary from social circle to social circle.
Allergic contact dermatitis may become systemic in some ways (it could be argued that all cases of it are systemic). Because the allergic response occurs due to the binding of allergens to human cells, it is possible for the allergic reaction to progress beyond the area of exposure and even possible for the immune response to hit other systems if they should also be affected by the allergen.
As a further contrast to irritant contact dermatitis, allergic contact dermatitis generally presents itself in rash form several days after the initial exposure. It takes some time for the binding to occur between the allergen and the skin cells, and it takes further time for the body to react, and further time still for this reaction to culminate in a rash outbreak. This time may be shortened with subsequent exposures as the immune system is better prepared to repel the threat it perceives in the form of the combined allergen/human cells, but there is still generally some form of delay between exposure and rash. This can make allergic contact dermatitis difficult to identify, for the plain reason that the cause and effect is not so direct.
How serious is Allergic Contact Dermatitis?
Allergic contact dermatitis is a serious condition that is not to be underestimated or taken lightly. The cumulative nature of every case of allergic contact dermatitis means that every outbreak is worse than the last, making the pain and suffering worse and making the symptoms more difficult to assuage.
Allergic contact dermatitis is an indicator of pre-existing allergies. These hypersensitivities can be very important with respect to disease prevention. If an individual suffers from skin exposure to an allergen, they may also suffer from exposure due to inhalation, injection, or any other vector of contact. While allergic contact dermatitis can be very painful, allergic reactions in systems other than the skin can be far more severe, even life-threatening.
Allergic contact dermatitis is otherwise severe relative to the severity of its symptoms, which may range from a mild annoyance to a severe disability. Repeated allergic exposure only worsens this.
The nature of allergic contact dermatitis being difficult to identify makes it somewhat difficult to diagnose and consequently somewhat more serious. Because it is difficult to properly diagnose, it may be difficult to identify the actual hypersensitivities of the patient, thus causing them to risk further exposure simply because they are not aware of what they should be avoiding assiduously.
What does Allergic Contact Dermatitis treatment look like?
Allergic contact dermatitis treatment consists, initially, of removal of the individual from the allergen and its source. This is considerably more crucial than it is with irritant contact dermatitis. While irritant contact dermatitis may grow more severe with continued exposure, allergic contact dermatitis will grow more severe from continued exposure and in fact will be even worse with every subsequent exposure following the initial phase. Thus, it is very critical that an individual be gotten away from the allergen with all haste.
Stripping away any remnant allergen contact with warm water and a mild soap can help to arrest many severe reactions and reduce the impact, but will generally not succeed in completely preventing an outbreak of allergic contact dermatitis. Allergic contact dermatitis is much more inevitable than irritant contact dermatitis.
Removal of an individual from the source of the allergen is considerably less negotiable than it is with irritant contact dermatitis. While an individual prone to suffer from irritant contact dermatitis may usually take a simple cautionary step to avoid exposure, it can be more difficult for an individual suffering from allergic contact dermatitis to do the same. While some cases of irritant contact dermatitis can be out-and-out prevented by a proper scrub within a short period of time following exposure, allergic contact dermatitis primes itself very shortly after exposure, and washing away the allergen only dampens the ultimate effect, rather than preventing it. It may be necessary for an individual that discovers a hypersensitivity to a workplace allergen to change positions or quit their job entirely. This is only made more pertinent by the potentiality for the allergic reactions to grow progressively worse as the immune system scales up its offensive defense against the perceived threat.
Symptomatic treatment is possible for the rash itself formed in a case of allergic contact dermatitis. The redness and swelling may be addressed by an anti-inflammatory. Very severe cases may require that a steroid be prescribed. This may be applied topically to the inflammation, or may be injected at the site. If the rash should be severe enough and widespread enough to dominate a significant portion of the skin, the steroid may be administered systemically through an orally-taken capsule or tablet. In very severe cases, a combined approached will be used, with injections tapered down over a certain period of time and the outbreak itself maintained with topical and oral steroids.
Pain relief may be provided in the form of an analgesic, either ingested orally or applied topically. An antihistamine may be used to deal with the nearly inevitable itching. Some forms of allergic contact acne can be assuaged by oatmeal baths and the use of epsom salts. This will not necessarily accelerate healing but it may aid greatly in soothing the skin. Drying lotions such as calamine can help to alleviate itching, as well.
Avoiding the allergen is, however, the most crucial element of treatment. This cannot be stressed enough. Further exposure to the allergen will cause an allergic reaction, and each subsequent reaction will be worse than the last. Exposure should not be let to persist for any length of time.
How do I know if I have Allergic Contact Dermatitis?
Allergic contact dermatitis can be very difficult to identify and diagnose. This is for several reasons. The first is that there is almost always a delay between exposure and outbreak. Unlike irritant contact dermatitis, allergic contact dermatitis takes several days to develop. The second is that the resulting rash is very frequently very similar to the rash formed with other forms of dermatitis, including irritant contact dermatitis. Thirdly, while allergic contact dermatitis is statistically the most common allergic reaction in humans, it is less common than irritant contact dermatitis, so symptoms may be mislabeled and the wrong trigger may be sought out by mistake. Lastly, it is possible for a number of different triggers to be relevant to allergic contact dermatitis. Some individuals suffer from only one, some suffer from several, but if exposure to any number of them at once is possible and only a few are actually causing an outbreak, it can be difficult to pick out which is actually causing trouble.
A dermatologist can diagnose allergic contact dermatitis and can elucidate the cause of the rash. However, this does take time. If a unique agent cannot be identified and connected directly to the formation of a rash, patch-testing may be called for. With patch-testing, an individual is subjected to very small exposures to several different potential allergens. The allergens that provoke a reaction are thus singled out. The complications of such a procedure are obvious, however. This is primarily only used for individuals suffering from chronic dermatitis.
Under ideal circumstances, the hypersensitivity can be identified with a simple glance at medical history and a physical examination. This is not always the case, however. Luckily, patch testing is nearly always successful and, while it sounds harsh, the minor symptoms resulting from the patch test are superficial compared to those that would be suffered in an actual outbreak. For individuals suffering from chronic dermatitis that cannot be explained and subsequently avoided, a patch test is more than worth the minor trouble it can cause.