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Allergic

Medically reviewed by Dr. A.M. van Coevorden, dermatologist

± 4 min read

Contact eczemaeczema from contact with substances

Contact eczema is a rash on the skin (eczema) caused by contact with certain substances. There are two types: allergic contact eczema and irritant contact eczema. Sometimes both occur at the same time.

How does contact eczema develop?

There are different forms, each with its own cause.

Allergic contact eczema

The cause is an allergic reaction to a certain substance, the allergen. You only get this if earlier skin contact has made you allergic to that substance. Once you are allergic, a small amount is enough to cause symptoms. A contact allergy often lasts a lifetime.

Irritant contact eczema

You get eczema from irritation, for example from water, soap, washing-up liquid, rubbing or cold. Anyone can get this. Frequent contact with water makes it develop faster and more severely. This is not an allergic reaction.

Photoallergic contact eczema

Sometimes allergic contact eczema only develops when the allergen reaches the skin together with light. This can happen with a sunscreen or a perfume, for example.

What does contact eczema look like?

You see red skin with small bumps, blisters and flakes. Sometimes the blisters leak and the skin becomes wet. The skin itches. The eczema appears where the substance touches the skin. That is where the reaction is often worst. Sometimes you also get eczema on the surrounding skin. Allergic contact eczema can even spread to other parts of the body, but this is rare.

Is contact eczema contagious or hereditary?

N

No. Allergic and irritant contact eczema are both not contagious to other people.

Contact eczema is also not hereditary. People with a hereditary predisposition to eczema, asthma and/or hay fever are somewhat more likely to develop contact eczema or to have it more severely.

Which substances can cause a contact allergy?

The number of substances that can cause a contact allergy is very large. The most common contact allergens are in the European standard series:

  • Base metals, such as nickel, chromium and cobalt, found in cheap jewellery, cement and leather among other things
  • Fragrances, such as those used in perfumes and most toiletries
  • Preservatives in products that spoil quickly, such as cosmetics, toiletries and hand creams
  • Rubber components
  • Glues
  • Medicines in creams and ointments
  • Plants and flowers (such as chrysanthemums and alstroemeria)
  • Substances used in certain occupations, such as hair dye and perming fluids at hairdressers

What are patch tests?

Your dermatologist can carry out tests on your skin to find out which substances you are allergic to. The substances are applied to the back in small chambers with plasters and removed 2 days later. The reaction is checked on the 3rd, the 4th and sometimes the 7th day. Testing is almost always done with the European standard series. A test is positive if the substance causes eczema at the site where it was applied.

How is contact eczema treated?

  • Treatment of the eczema itself with creams: corticosteroids (hormone ointment), tacrolimus or pimecrolimus
  • Treatment of persistent contact eczema with UV light therapy
  • For widespread and severe eczema, treatment with corticosteroid tablets is sometimes needed to calm the eczema

Eczema can trouble you for a long time. If you avoid the substances you are allergic to, the symptoms can lessen or disappear completely.

What can you do yourself?

Avoid contact with the substance you are allergic to. To prevent irritant contact eczema you can:

  • Apply moisturising creams after washing your hands and after every contact with water
  • Grease your hands before dirty work, for example with petroleum jelly, so you do not have to wash them at length afterwards
  • If you have contact eczema on your hands, also read the Hand eczema leaflet

Frequently asked questions about contact eczema

Is contact eczema contagious?

No. Allergic and irritant contact eczema are both not contagious to other people.

Does a contact allergy ever go away?

A contact allergy often lasts a lifetime. If you avoid the substance you are allergic to, the symptoms can lessen or disappear completely.

What is a patch test?

In a patch test, your dermatologist applies small chambers with possible allergens to your back. They are removed after 2 days, and the reaction is checked on the 3rd, 4th and sometimes 7th day. A test is positive if the substance causes eczema at that spot.

Can I get contact eczema from my work?

Yes. Some occupations carry more risk, such as hairdressers, cleaners, nurses, metalworkers and food industry work. Wet work is the main cause of irritant contact eczema.

Does 'hypoallergenic' mean I cannot get eczema?

No. Terms like hypoallergenic, dermatologically tested or pH-neutral do not mean you cannot get eczema from a product. You can be allergic to such a product too.

Sources and more information

Source: Dutch Society of Dermatology and Venereology (NVDV).

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Hand eczema

Eczema on the hands, often from wet work or allergy.

Atopic eczema

Hereditary eczema, also known as constitutional eczema.