The Ins and Outs of Allergic Contact Dermatitis

Allergic Contact Dermatitis (ACD) is commonly affiliated with severe allergens such as poison ivy. More commonly, ACD is triggered by household and workplace allergens. If you're noticing a rash popping up around the days when you change into hospital-laundered scrubs, these two variables may be related. These simple allergies can be resolved by switching to a different laundry detergent. However, if the reaction is unbearable and affects your daily activities, you should consult your doctor to treat the new onset of a dermatologic condition.

What is ACD?

ACD falls under the umbrella of contact dermatitis. An allergen triggers an immune-mediated response which then manifests on the skin. Contact occurs through an allergen touching the skin, being digested, or inhaled.

Signs of ACD

The presence of a skin rash most often identifies ACD. The inflammation typically presents as:

• Red
• Itchy
• Raised due to swelling

In more severe reactions, such as those to poison ivy, blistering and a burning sensation may occur. These symptoms can onset quickly, on the same day as the exposure, if no more immediately.

Not every allergen will trigger an identifiable immune response after just one exposure. ACD may begin to manifest outwardly after repeated exposures to the same allergen. This makes identifying the allergen more difficult. It is essential to understand that every immune system is different, and our sensitivities will fluctuate depending on the person and the allergen.

Common Allergens

Any substance can be an allergen, yet several categories and specific substances have a reputation for flaring up ACD.

1- Plants

Balsam of Peru and the chemical compound sesquiterpene lactone found in Asteraceae species are commonly noted allergens. Both substances can be found in your home's essential oil blends, perfumes, and other fragrances. Consumable plants, such as artichokes (an Asteraceae), may innocently be triggering your ACD when digested.

2- Nickel

When we think of metals, we often think of jewelry. Yes, a nickel-containing pendant can result in a rash across a sensitive chest.  Unfortunately, nickel can also be found in many other unexpecting everyday objects. Wearable sources such as buttons and zippers often rub or brush up against the skin. Other things such as children's toys, handheld tech devices, scissors, and kitchen appliances may contain enough nickel to initiate an immune response.

3- Cosmetics

Components of your favorite beauty and personal care product are significant contributors to the health of your skin in general. Be wary of fragrances containing limonene and linalool. Search for preservative inclusions such as quaternium-15 and methylisothiazolinone and nix them from your regimen. Excipients, commonly known as the color components, fillers, and carrier products in cosmetics, can also be harmful compounds. Closely read labels for propylene glycol, lanolin, and colorants. Even products seldomly used, such as acrylic nail glues, sunscreens, and hair dyes, contain potential allergens.

Identifying the Source

Again, talk to your doctor if your ACD has a robust negative effect on your daily life. Call in professional help if symptoms are severe. If you suspect ACD and are experiencing mild symptoms, follow this method to begin ruling out suspicious allergens:

• Think back to any product or food introduced around the same time as your most recent flare-up. Remember that these may be new or existing products; recall the discussion of repeat exposures.
• Strategically eliminate potential allergens one at a time.
• Allow several days to pass while observing for improvement. If nothing has changed, you can safely move on to the following suspected allergen until symptoms begin to improve.

Of course, this may not be an effective system for all, but it is a place to start. Pinpointing an allergen correctly and with confidence can be difficult. If symptoms persist despite your best efforts, additional counseling and management may be warranted. Schedule an appointment with your primary care physician and see if you can be connected to a dermatologist in your area for formal allergy testing.  

References

Asteraceae species as potential environmental factors of allergy

Poison Ivy

Contact dermatitis

Management of allergic contact dermatitis