Irritant Contact Dermatitis

What is Irritant Contact Dermatitis?

Irritant contact dermatitis is one potential form of contact dermatitis. It is a blanket condition that covers a number of other, more specific forms of contact dermatitis. Generally, the divisions are made based on the trigger of the dermatitis outbreak.

Irritant contact dermatitis is a form of contact dermatitis brought on by direct contact with an irritating agent. This irritating agent may be chemical in nature or physical in nature. The former involves reactions due to toxins such as those found in poison ivy and other plants, while the latter involves long, extended rubbing or scraping against the same material. The former is far better researched than the latter, as it is much easier to differentiate different types of chemical irritation than physical irritation (friction from paper and friction from some fabrics may look very similar, for instance).

Irritant contact dermatitis is not uncommon in the slightest. Many suffer from it daily with no exceptional predisposition, and many suffer from it without even noticing.

Because the number of possible irritants is so broad, this explanation only covers the very basic core mechanics. Some forms of chemical and physical irritant contact dermatitis are fairly unique.

Who gets Irritant Contact Dermatitis?

Irritant contact dermatitis may afflict nearly anyone. Physical irritants have a tendency to be particularly widespread in the number of individuals they can afflict.

Irritant contact dermatitis does not have a gendered component; men and women are equally likely to suffer from irritant exposure and have a dermatitis reaction. The usual differences in dermatological health and condition do not have a tendency to affect the incidence of irritant contact dermatitis. Those with oily skin (men are more likely to have oily skin) are roughly as equally likely as those with dry skin (women are more likely to have dry skin) to suffer from irritant contact dermatitis.

The very young and very old are more likely to suffer from irritant contact dermatitis, somewhat, as their skin has a tendency to be weaker and more vulnerable than those in adolescence or middle age.

Irritant contact dermatitis is not the same thing as allergen contact dermatitis. Something may simultaneously exacerbate irritant contact dermatitis and allergen contact dermatitis, but they are separate conditions completely. Having an allergy does not make one more susceptible to irritant contact dermatitis, it simply means that an individual may be more likely to suffer from additional symptoms due to exposure to an irritant/allergen.

What causes Irritant Contact Dermatitis?

Irritant contact dermatitis is caused by contact with an irritating agent. Irritating agents contrast plainly from allergic agents. Whereas allergic agents can cause localized (in the area of contact) or systemic (all over the body) reactions, irritating agents are always exclusively local in their effects. Irritating agents do not provoke a reaction, but rather irritate the skin directly. This usually comes in the form of damage.

Many plants, for instance, come equipped with defensive hairs. These are far more subtle than cactus spines or the thorns on a rose. They are very fine, and seem nearly soft if they’ve been spotted. Plants in possession of these defenses generally maintain them on their leaves. In any case, even light contact with the plant will cause the hairs to rub off onto the skin, where they will dig in. They do not need to pierce or penetrate, because they are fine enough to settle right in. This is a very minuscule intrusion, but with potential thousands of hairs stacked up in close proximity, the effect is cumulative—and frequently, very painful. The result is redness, pain, and sometimes a tightness to the skin, and possibly pustules.

A milder example comes in the form of irritant contact dermatitis caused by friction. This friction will usually originate in fabrics or paper—whatever an individual uses on a regular basis, enough for it to have an effect. Ordinarily, the friction of a piece of paper or a bit of fabric will go unnoticed. However, thousands and thousands of microabrasions over the course of a long period of time can have a cumulative effect, and this can be quite irritating for those subjected to it.

Chemical irritants also fit into this spectrum. Chemical irritants primarily include acids and bases (bases including chemicals such as lye). However, these exposures are more commonly linked to chemical burns rather than simple irritation, as they have a tendency to cause heavy skin damage and simply destroy layers of skin rather than irritating what skin exists. However, mild exposure to some chemical agents can also cause contact dermatitis, which specifically will be counted as irritant contact dermatitis as no allergic reaction occurs.

What does Irritant Contact Dermatitis cause?

Irritant contact dermatitis is defined by a rash resulting from the irritating contact. This rash is frequently uncomfortable, but rarely dangerous. This rash is always present at the site of irritation, as a sharp contrast to allergen contact dermatitis, which may be systemic (spread through the system and not necessarily related directly to the site of contact).

The rash will almost always present with erythmia (redness). This redness is usually accompanied by a feeling of tightness, much like the aftermath of a sunburn. It may be somewhat swollen and will usually be warm to the touch. The swelling may be somewhat painful.

The rash may present with various other symptoms. The primary symptom possible is pustules, or small bubbles of pus that form as a result of immune response to intrusion.

This rash may additionally itch, and may be somewhat painful. Other symptoms frequently depend upon the nature of the irritant; some are more likely to itch than others, and some may itch more or less than others. Some may cause more damage to the skin and leave it fairly raw.

How serious is Irritant Contact Dermatitis?

Irritant contact dermatitis varies in seriousness. This is primarily dependent upon its original cause. Cases of irritant contact dermatitis caused by something so mundane as a rough shirt are only barely worthy of attention, and that attention goes no further than ‘Stop wearing that shirt’ or ‘Wash that shirt with some fabric softener next time so it doesn’t chafe’. However, irritant contact dermatitis may be caused by far more exotic and far more dangerous materials, such as carbon fiber shavings. These can be very difficult to remove from the skin, allowing them to cause ongoing damage. Some materials may, in addition to causing irritant contact dermatitis, be quite toxic.

Exposure to an irritant such that it causes irritant contact dermatitis may similarly indicate that a dangerous irritant is present or situationally relevant when it otherwise would have gone unnoticed. This makes it something of a blessing, no matter how much of a curse the rash might be: it is far better to find one’s hand tight, itchy and red after touching something that is shedding carbon fibers than it is to discover the presence of carbon fibers by inhaling them into one’s lungs.

Irritant contact dermatitis can cause quite a lot of pain and discomfort that can very easily come to interfere with one’s day-to-day life. This is the primary cause of concern and renders irritant contact dermatitis worthy of concern. This discomfort is effectively the baseline assumption: it will be uncomfortable but probably not horrible. However, more severe cases are possible from here. Some irritants are very difficult to get rid of, leading to continual irritation. Severe enough irritation can leave the skin vulnerable to infections. Scarring may occur in the worst cases.

What does Irritant Contact Dermatitis treatment look like?

Treatment of irritant contact dermatitis starts with first aid. Washing the area with water and a mild soap can clean away many remaining irritants (assuming a too-caustic soap wasn’t the original cause, of course). This can sometimes abate irritant contact dermatitis before it can truly break out and escalate to its worst. This is recommended even if the rash has already broken out. Irritant contact dermatitis is almost always a cumulative process. A mild exposure will result in a mild case of irritant contact dermatitis, and a severe exposure will result in a severe case. Thus, if there is any chance that the exposed skin is still subject to the influence of the irritant, it would be best to clean it and eliminate this exposure as quickly as possible. (While rubbing the skin is necessary to remove the offending substance, it should be noted that scrubbing the skin hard can actually make irritant contact dermatitis worse; much like treatment of acne, scrubbing the skin raw is more likely to complicate things than actually aid in the purification process.)

The next course of action is, if at all possible, to remove the individual suffering from irritant contact dermatitis from the source of irritation. This goes without saying, but it may be difficult to do this if the irritant is a component of their employment. When it is simply a matter of avoiding touching that one plant in the garden or not machining carbon fiber in one’s spare time, this is considerably easier, but it can be difficult if not impossible if their job requires them to work with plants or other possible physical irritants. In this circumstance, it is best to try to avoid exposure to the source of the pain, usually through the use of gloves. If this absolutely cannot be achieved, then the affected area should be thoroughly cleaned after every exposure. This may prevent any sort of dermatitis outbreak from occurring.

If there has already been an outbreak of irritant contact dermatitis, treatment will be symptomatic. Analgesics may be prescribed for the resulting pain. Antihistamines may be employed for any itching, burning or tightness. These may assuage the trouble of the symptoms somewhat, but they will not necessarily contribute to the cure of the rash. Even severe rashes will eventually go away and heal on their own, but this process may be somewhat accelerated with an anti-inflammatory which can reduce the swelling and resulting symptoms. For the very worst cases of irritant contact dermatitis, a local steroid may be administered in the form of a cream or via injection. If the rash should cover most of the body, this steroid may be prescribed systemically (that is, to the general whole of the body rather than a specific area) and administered through an ingested supplement.

How do I know if I have Irritant Contact Dermatitis?

Irritant contact dermatitis can be very easily identified by the outbreak of a rash following exposure to a particular substance. This contrasts heavily with allergen contact dermatitis, which generally takes substantially longer for its symptoms to manifest as the allergic reaction progresses.

The exception to this can be in the form of irritant contact dermatitis from friction. It can be difficult to identify the source of some rashes simply because they have originated from a thousand individual interactions over a period of time. However, even this can be overcome with a bit of careful analysis: someone who finds their thumbs and fingers growing red and irritated may be able to identify that the paper their office uses is the cause, someone who finds that their shoulder is beginning to chafe may be able to identify the cause as their stiff, starched work shirt, and so forth.

For particularly confusing cases, a dermatologist may wish to initiate patch-testing. This is effectively a brute-force method of diagnosis that involves exposing different patches of skin to different potential irritants in a controlled environment to determine which one is actually the offending substance. This is generally invoked only when the irritants are (likely to be) related to the patient’s profession and the irritants are unknown. However, the risks involved in patch testing are diminished considerably with irritant contact dermatitis, as there is no way for the ailment to expand beyond its point of exposure (unlike with allergen contact dermatitis, which can become systemic if unchecked and spread to other parts of the skin or even other systems of the body entirely).

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