Contact Dermatitis

Contact dermatitis is a physiological reaction that occurs after skin comes in contact with certain substances. Irritants to the skin cause the vast majority of these reactions. The remaining reactions are caused by allergens, which trigger an allergic response.  

The most common causes of irritants to children include the following:

• Soaps

• Saliva

• Urine (common cause of diaper rash) 

• Different foods

• Detergents

• Baby lotions

• Perfumes

Plants, as well as metals, cosmetics, and medications, may also cause contact dermatitis:

• Poison ivy. Poison ivy, the plant family that also includes poison oak and sumac, is a common cause of a contact dermatitis reaction.

• Metals. Nickel, chrome, and mercury are the most common metals that cause contact dermatitis:

  • Nickel is found in costume jewelry, belt buckles, and wristwatches, as well as zippers, snaps, and hooks on clothing.

  • Contact with objects that are chrome-plated, which contain nickel, may also cause skin reactions in children who are sensitive to nickel.

  • Mercury, which is found in contact lens solutions, may cause problems for some children.

• Latex. Some children have an allergy or sensitivity to latex (rubber). Reactions can be seen when products made from latex come in contact with the child's skin. Latex is found in products made with natural rubber latex, such as rubber toys, balloons, balls, rubber gloves, and pacifiers or nipples.

• Cosmetics. Many types of cosmetics can cause allergic contact dermatitis. Permanent hair dye that contains paraphenylenediamine is the most common cause. Other products that may cause problems include dyes used in clothing, perfumes, eye shadow, nail polish, lipstick, and some sunscreens.

• Medications. Neomycin, which is found in antibiotic creams, is a common cause of medication contact dermatitis. Local anesthetics may also cause contact dermatitis.

The following are some of the other symptoms associated with contact dermatitis. However, each child may experience symptoms differently. Symptoms may include:

• Mild redness and swelling of the skin

• Blistering of the skin

• Itching

• Scaling and temporary thickening of the skin

The most severe reaction is at the contact site. The symptoms of contact dermatitis may resemble other skin conditions. Always consult your child's doctor for a diagnosis.

Specific treatment for contact dermatitis will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history

• Extent of the disorder

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the reaction

• Your opinion or preference

The best treatment is to identify and avoid the substances that may have caused the allergic contact dermatitis. The following is recommended by the American Academy of Allergy, Asthma, and Immunology for mild to moderate reactions:

• Thoroughly wash skin with soap and water as soon after the exposure as possible.

• Wash clothing and all objects that touched plant resins (poison ivy/oak) to prevent re-exposure.

• Use wet, cold compresses to soothe and relieve inflammation if blisters are broken.

• Corticosteroid creams may help to reduce the inflammation.

• Oral antihistamines may help to relieve itching. You should ask for advice from your pediatrician to select the best over-the-counter oral antihistamine for your child.  

• For severe reactions, always contact your child's doctor.