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Pediatric Contact Dermatitis
What is contact dermatitis?
Contact dermatitis is a physiological reaction that occurs when skin comes in contact with certain substances. Irritants to the skin cause 80 percent of these reactions, while the remaining 20 percent are caused by allergens, which trigger an allergic response.
Adults are affected by allergic contact dermatitis more than young children or the elderly.
What causes irritant contact dermatitis?
The most common causes of irritants to children include the following:
- Different foods
- Baby lotions
Plants, as well as metals, cosmetics, and certain medications, may also cause contact dermatitis. These include:
- Poison ivy. the plant family that also includes poison oak and sumac, is a common cause of contact dermatitis
- Metals. Nearly 3,000 chemical agents are capable of causing allergic contact dermatitis. Nickel, chrome, and mercury are the most common metals that cause contact dermatitis
- Nickel is found in costume jewelry, belt buckles, and wristwatches, as well as zippers, snaps, and hooks on clothing. Contact with objects that are chrome-plated, which contain nickel, may also cause skin reactions in children who are sensitive to nickel
- Mercury, which is found in contact lens solutions, may cause problems for some children
- Latex. Some children have an allergy or sensitivity to latex (rubber). Latex is found in products made with natural rubber latex, such as rubber toys, balloons, bells, 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 clothing dyes, perfumes, eye shadow, nail polish, lipstick, and certain sunscreens
- Medications. Neomycin, which is found in antibiotic creams, is a common cause of contact dermatitis. Local anesthetics, such as novocaine or paraben, are other possible causes
What are the symptoms of contact dermatitis?
The most severe reaction is usually at the contact site. The following are some of the other symptoms associated with contact dermatitis. However, each child may experience symptoms differently.
- Mild redness and swelling of the skin
- Blistering of the skin
- Scaling and temporary thickening of skin
The symptoms of contact dermatitis can resemble other skin conditions, so always consult a physician for the correct diagnosis.
What is the treatment for contact dermatitis?
The best treatment is to identify and avoid the substances that may have caused the allergic contact dermatitis. The following recommendations from the American Academy of Allergy, Asthma, and Immunology are geared 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/oak) to prevent re-exposure
- Use wet, cold compresses to soothe and relieve inflammation if blisters are broken
- For severe reactions, always contact a physician or call 911
The Division of Dermatology at Children's National Hospital continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair and nails.
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Sometimes a mom’s intuition is all it takes to get her child to the right physician. When 8-year-old Xavion Chisley developed a fungal infection on his toe, his mother, Nikki, immediately took him to see a dermatologist who removed his toenail to treat the infection. However, when Xavion’s toenail grew back, the infection had not diminished but actually appeared to be spreading to his foot.
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