George Woodbury MD 3/1/2023
What is Contact Dermatitis?
Contact Dermatitis is a term used by Dermatologists for an event caused by physical interaction with a substance or chemical resulting in a rash or eruption in the skin. Some skin condition – like Psoriasis or Atopic Dermatitis (Eczema) can be made much worse with interaction with a chemical or substance – meaning that people can have both Psoriasis and Contact Dermatitis going on at the same time – requiring a Memphis Dermatologist like myself to craft a care plan that addresses both of the underlying skin conditions.
What are the two different types of Contact Dermatitis?
Contact Dermatitis comes as either Irritant Contact Dermatitis and as Allergic Contact Dermatitis. These two types of Contact Dermatitis have entirely different properties.
Below is a photo of a patient with Irritant Contact Dermatitis, which results from physical interaction with a substance or chemical that would cause a skin reaction in anyone who comes in contact with enough of that substance, resulting in a rash. A common example is a hand rash in parents doing lots of hand washing and laundry. Enough laundry – and just about anyone would develop a dry itchy Hand Eczema.
Below is a photo of a patient with Allergic Contact Dermatitis. With Allergic Contact Dermatitis, a patient’s immune system has come into play, causing a reaction to very small amounts of a chemical that that patient is sensitized to. A common example is Poison Ivy Dermatitis, also called Poison Ivy for short. Only certain people develop a rash when coming into physical interaction with Poison Ivy or Rhus plants, and it only takes a very small amount of the Toxicodendron chemical to cause a severely itchy and painful skin eruption. But remember – about 90% of people will become allergic to this chemical is exposed to it several different times – so “if there are leaves of three, leave them be!”
What type of testing can help patients with Contact Dermatitis?
Dermatologists such as myself generally consider one of about three types of tests to evaluate Contact Dermatitis. First, we sometimes do a skin biopsy or skin excision to look for whether a given case is actually Contact Dermatitis, or whether it may be another type of skin condition, such as Dermatitis Herpetiformis (which is due to a sensitivity to wheat gluten), or even possibly an autoimmune condition such as Lupus.
Secondly, sometimes Dermatologists do a scraping for a Fungal Culture test or a KOH test to evaluate whether a yeast of fungal organism is causing a true skin infection. The results of a Fungal culture take a full month, so we sometimes start treatment before we have this test result back from the laboratory. The results of a KOH test take only a few minutes.
Thirdly, a third type of testing – Allergy Patch Testing – can be quite helpful in evaluating for causes of Allergic Contact Dermatitis. In my Memphis Dermatology practice, at Rheumatology and Dermatology, I have been offering Allergy Patch Testing since 2004. I am also a member of the American Contact Dermatitis Society, an 1100 Dermatologist organization focused on this type of testing that meets at least once a year to discuss updates on the panels of chemicals to which we offer testing. For instance, the 2023 yearly meeting, of which I was an attendee, was over a da,in New Orleans, Louisiana, attended by over 100 Dermatologists focusing on Contact Dermatitis, from all over the world. For more on Allergy Patch Testing, see the topic Allergy Patch Testing on this same web site: https://www.Rheumderm.com.
What treatment options tend to be helpful for patients with Contact Dermatitis?
Dermatologists often consider either oral steroid tablets (called prednisone or methylprednisolone tablets) or a steroid shot (called a Medrol Shot) for patients with severe reactions. We also commonly consider one of about sixty “topical steroid creams or ointments,” meaning prescription medicines for use “on top of” or “superimposed upon” the skin. These include Clobetasol, Halobetasol, Diflorasone diacetate, and Betamethasone dipropionate cream. These topical steroids are available as creams, ointments, foams, sprays, gels, and many other types of preparations, depending upon what type of substance the medicine is put into – what type of “vehicle” is involved. So Dermatologists such as myself work to develop a ‘care plan’ that uses the most appropriate prescription product to match the condition that our patients are suffering from.
Can the office recommend any cosmetics or toiletry products if I am found to have reactions to certain chemicals?
In addition to being a Cordova Dermatologist, I am the President of Big River Silk™ Skincare, focused on skincare products with lower risk of allergies for people of all ages, from babies to seniors, using a minimal number of chemicals, to minimize the risk of allergic reactions. We offer HypoShea Moisturizer Cream, free of fragrances, dyes, and propylene glycol, as well as HypoShea Oil, convenient for use after bathing or showering (1 oz: $7.97/2 oz: $12.95), and also a new preparation as of 2022: HypoShea Moisturizer Lotion, which is less moisturizing and also fragrance-free. All Big River Silk Skincare products are available in 1 oz: $12.95/2 oz: $18.95/4 oz: $29.95/8 oz: $39.95, on-site at our international headquarters at 8143 Walnut Grove Road, Cordova TN 38018 (1-901-753-0168). Of products can also be ordered at https://www.Bigriversilkskincare.com ($5.00 shipping and handling for orders under $40.00, otherwise free shipping and handling ($10.00 for Canadian orders under $75.00).
All products are available at www.Bigriversilkskincare.com, or at our international headquarters, at 8143 Walnut Grove Road, Cordova, TN 38018, Monday-Friday, from 7:30 AM to 4:30 PM. Or you can call us at 1-901-753-0168. We do offer free shipping and handling or US orders above $40.00 ($70.00 Canadian). Otherwise, $5.00 shipping and handling for US orders/$10.00 Canadian.
If you or a friend would like to come in for a skin consultation, my Memphis Dermatology practice has been with Rheumatology and Dermatology, 8143 Walnut Grove Road, Cordova TN 38018 since 1993 (1-901-753-0168). Or you can find a Dermatologist closer to you by going to the American Academy of Dermatology website, https://www.AADA.org, then plugging your zip code into the “Find a Dermatologist” tab. Never itch in silence!