Contact Dermatitis In Children: What Parents Need to Know

October is Eczema Awareness Month. Here at Ready, Set, Food!, we're dedicating the month to answering common questions about eczema and sharing eczema care tips.

Contact dermatitis is a type of eczema that causes flare-ups when irritants or allergens come in contact with the skin. Learn how to identify and treat contact dermatitis.

What is contact dermatitis?

Contact dermatitis is a type of eczema. It causes the skin to react, and flare up in a rash, whenever certain irritants or allergens come in contact with the skin.

Contact dermatitis is different from atopic dermatitis (atopic eczema). But if your child already has atopic dermatitis, they are at increased risk for contact dermatitis. 

Still, any child can develop contact dermatitis, whether they already have atopic dermatitis or not.

Contact dermatitis triggers

If a child develops contact dermatitis, the irritants or allergens that "trigger" the rash may vary. So, you'll need to pay attention to what your child's skin is exposed to when the rash appears.

Here are some of the most common contact dermatitis triggers. 

Irritants

Irritants are the most common contact dermatitis triggers. The National Eczema Association estimates that 80% of contact dermatitis rashes are caused by irritants.

When irritants come in contact with the skin, they aggravate and damage the skin cells. 

As a result, the irritants directly, and often immediately, cause the skin to become inflamed.

Some irritants that may cause a contact dermatitis rash include:

  • Soaps and detergents
  • Lotions
  • Fragrances and perfumes (can be found in soaps, lotions, detergents, and several other products that come in contact with skin)
  • Dyes
  • Bleach
  • Cosmetics
  • Saliva (spit)
  • Urine and feces, when baby wears a diaper 
  • Nickel and chrome (these metals are often found in jewelry, zippers, snaps, and buckles)
  • Wool

Allergens 

Allergens can also trigger contact dermatitis, although less often than irritants do. 

When someone has an allergy to a certain substance, their immune system mistakes the substance for a harmful invader and over-defends the body against that substance. This causes an allergic reaction to develop.

In the case of contact dermatitis, when the allergen comes in contact with the skin, the immune system triggers a mild allergic reaction on the skin. This causes the rash of contact dermatitis.

But often, the rash doesn't appear right away. The itchy rash may only emerge a day to several days after the person's skin was exposed to their allergen.

Some allergens that may cause a contact dermatitis rash include:

  • Poison ivy, poison oak, and poison sumac
  • Metals, including nickel and chrome
  • Cosmetics 
  • Fragrances
  • Dyes
  • Latex (found in balloons, bandages, pacifiers, some rubber gloves, and some toys)
  • Neomycin, an antibiotic (it is the active ingredient in some topical antibiotic treatments)
  • Preservatives (including one called thimerosal, which is also included in some topical antibiotic treatments)

Learn more about contact dermatitis from board-certified Dermatologist Dr. Tamara Lazic Strugar and Mount Sinai Health System: 

 

Contact dermatitis symptoms: What does the rash look like?

A contact dermatitis rash is usually itchy, and often makes the skin look inflamed. 

But it can appear in several different ways, which vary from child to child:

  • An inflamed-looking, itchy rash
  • A swelling, painful or burning rash
  • Blisters that can sometimes ooze, drain or crust
  • Dry, cracked, peeling or bleeding skin  

Arm with contact dermatitis

Source: North Texas Allergy and Asthma Center


On lighter skin, a contact dermatitis rash is usually red. On darker skin, the rash can be purple, dark brown, or grey.

The rash can appear anywhere on the body that comes in contact with the irritant or allergen.

 

Diaper rash and contact dermatitis 

Although a diaper rash can have several causes, contact dermatitis is the most common cause of diaper rash in babies. 

When a baby has this type of contact dermatitis, the urine and feces in the diaper irritate baby's skin, which causes the skin under the diaper to become inflamed.

It usually causes skin under the diaper to look red and shiny. It may affect any skin under the diaper, including the buttocks, thighs, waist, and lower stomach.

This article from Johns Hopkins Medicine has more information on diaper rash, including diaper contact dermatitis. 

How is contact dermatitis diagnosed?

If you think your child has contact dermatitis, visit a doctor.

Your doctor will ask you about possible irritants or allergens your child's skin came in contact with, immediately before to within a few days before your child developed the rash.

Your doctor will examine your child's skin,  and may run tests such as skin tests or blood tests.

They will likely refer your child to a dermatologist for further examination and treatment. 

Dermatologists have specialized training in identifying and treating skin conditions. 

Since contact dermatitis can look similar to other skin conditions, a dermatologist will make sure that your child has contact dermatitis (and not a different condition). 

They will ask about your child's history of rashes. 

They may also run a patch test, where they apply small "patches" of several possible irritants or allergens to your child's back or arm. They will then check your child's skin after 48 hours to see if a rash appears.

They will also advise you and your child about how to manage contact dermatitis, and may prescribe topical steroids to help treat it.

Your doctor or dermatologist may also refer your child to an allergist, if allergic contact dermatitis is suspected.

 

 

Caring for your child's contact dermatitis

Keeping your child away from their contact dermatitis "triggers" is key to managing their contact dermatitis. When the irritant or allergen is removed, contact dermatitis rashes will usually go away on their own after several days.

So, with help from your dermatologist, identify and remove your child's contact dermatitis "triggers" if possible. This may include:

  • Swapping out detergents and lotions for less irritating options (make sure they're fragrance-free and dye-free!)
  • Swapping out soaps for fragrance-free, dye-free mild cleansers
  • No longer using the cosmetics that cause irritation
  • Making sure your child doesn't wear jewelry containing the metal types that irritate their skin 

And in the meantime, or if you can't completely eliminate your child's exposure to an irritant or allergen, caring for your child's skin may involve:

  • Washing your child's skin as soon as possible when they come in contact with the irritant or allergen. Wash all areas of the skin with soap (or cleanser) and water.
  • Applying ointment to moisturize rash 
  • Using cold compresses (wet, cold cloths) to soothe rash areas
  • Using wet dressings on rash areas, if the rash is oozy
  • In the case of diaper contact dermatitis, changing baby's diapers frequently and cleaning their diaper areas well with wet cloths or wipes.
  • In the case of contact with poison ivy, oak, or sumac, wash your child's clothing right away as well as their skin

Your dermatologist may also prescribe a topical steroid to help relieve contact dermatitis symptoms. If they do, follow their instructions for applying the steroid exactly.

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