Contact eczema describes two skin conditions that result in rash, irritation, and itchiness on the skin. These are divided into allergic and direct irritant contact dermatitis or eczema. The first is a true histamine response to allergy-provoking substances, such as metals, perfumes, latex, or plant oils, and it can occur anywhere these irritants touch the body. Direct irritant contact dermatitis most often appears on the hands and is an ongoing skin reaction to irritating substances like chemicals of varying types. Avoidance of the offending irritant or allergen usually improves the condition, but this may be very difficult with the direct irritant form, since many people must work with substances that continue to irritate the skin.
The symptoms of contact eczema may vary depending on its type. Allergic dermatitis, could occur anywhere on the body where contact with an allergen has taken place. The rash associated with allergy is usually itchy, and it can sometimes weep or develop blistering of the skin.
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Anyone who has ever experienced an allergic reaction to poison oak or poison ivy can quickly recognize allergic dermatitis. This rash should be differentiated from a profuse rash called uticaria or hives that covers the whole body, as part of an allergic reaction. The main difference is contact; with allergic dermatitis, the skin only reacts where the offending substance touched.
Irritant contact eczema is also location specific. The area where the rash develops is the area where the body comes in contact with irritants. In many occupational settings the hands are most affected, and a red, itchy and scaly rash may develop as people repeatedly touch irritating materials.
There are many settings where irritant contact eczema is common, including in hospitals, especially among nurses, at beauty salons, in dental offices and in plant nurseries. The hands seem most vulnerable, not only because they can have direct exposure to chemicals or irritants like latex, but also because they are frequently washed. Repeated handwashing may worsen this skin condition.
There are several goals in treating both types of contact eczema. The first is to get the rash under control. An allergic rash could be treated with antihistamines and possibly steroid creams to accelerate healing. Irritant contact dermatitis can also respond to steroid treatment and moisturizing creams. This is only half the battle; exposure to the irritant or allergen must be minimized, too.
Where possible, people avoid the substance creating the problem, but in work settings, they may need to find ways to work around irritants. Using moisturizers frequently and wearing cotton lined, non-latex protective gloves can be helpful. These measures aren’t always adequate, and some people will need to be reassigned to work that doesn’t use the substances creating the problem. Others simply live with the condition, but this can be uncomfortable. In many countries, employers are legally obligated to provide different job assignments, if an employee is medically advised to avoid certain substances.