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Contact Dermatitis in Children

What is contact dermatitis?

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

What causes irritant contact dermatitis?

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 medicines, may also cause contact dermatitis:

  • Poison ivy. Poison ivy is the plant family that also includes poison oak and sumac. It 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. And in zippers, snaps, and hooks on clothing.

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

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

  • Latex. Some children have an allergy or sensitivity to latex (rubber). Products made from latex can cause reactions when they come in contact with the child's skin. Latex is found in products made with natural rubber latex, like 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.

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

What are the symptoms of 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

  • Crusting and oozing

The most severe reaction is at the contact site. The symptoms of contact dermatitis may resemble other skin conditions. Always talk with your child's health care provider for a diagnosis. Irritant contact dermatitis happens soon after contact with the offending agent. Allergic contact dermatitis appears 1 to 2 days after exposure to the allergen. 

What are treatments for contact dermatitis?

Specific treatment for contact dermatitis will be decided by your child's health care provider based on:

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

  • Extent of the disorder

  • Your child's tolerance for specific medicines, 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 or poison 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 and topical 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 health care provider. Oral steroids or a steroid injection may be indicated for more severe or widespread reactions.