Pediatric Contact Dermatitis

Contact dermatitis is a skin reaction from contact with certain substances. The substances may be:

• Irritants. These cause direct skin irritation and inflammation. They are the most common cause of contact dermatitis. 
• Allergens. These cause the body's immune system to have an allergic reaction. The body releases defense chemicals that cause skin symptoms. Allergens are a less common cause of contact dermatitis.

Common irritants that can cause contact dermatitis in children include:

• Soaps and detergents
• Spit (saliva)
• Urine in a diaper
• Lotions and perfumes

Common allergens that can cause contact dermatitis in children include:

• Poison ivy, oak and sumac. These are plants with oil that causes skin allergies.
• Metals. These include nickel, chrome and mercury. Nickel is found in costume jewelry, belt buckles, and wristwatches, as well as zippers, snaps, and hooks on clothing. Chrome-plated items may also contain nickel. Mercury is found in contact lens solutions. It may cause problems for some children.
• Latex. Latex is found in products such as rubber toys, balloons, balls, rubber gloves, bandages, and pacifiers or nipples.
• Cosmetics. Products include dyes used in hair color, clothing, perfumes, eye shadow, nail polish, lipstick and some sunscreens.
• Medicines. Neomycin may also cause contact dermatitis. It’s found in some kinds of antibiotic cream and local anesthetic.

Contact dermatitis can occur in any child. If your child has atopic dermatitis (eczema), he or she is at increased risk for contact dermatitis.

Symptoms can be a bit different for each child. The skin may be:

• Itchy
• Painful
• Red
• Swollen
• Dry, cracked, peeling
• Bleeding
• Oozing, draining, crusting
• Blistering

Symptoms are often worse where the substance came in contact with the skin. Larger areas may also be affected. Many of these symptoms may be caused by other skin conditions. Have your child see their healthcare provider for a diagnosis.

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a skin exam. The provider will also ask about recent contact with any irritants or allergens. Your child may also have tests, such as skin tests or blood tests. Your child may need to see an allergist or dermatologist. An allergist is a doctor with special training to treat allergies. A dermatologist is a doctor with special training to treat skin problems.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Treatment may include:

• Washing your child’s skin with soap and water as soon as possible after contact. Wash all areas, including the face, neck, hands and in between the fingers.
• Using wet, cold cloths (compresses) on the skin. This is to help reduce symptoms and ease inflammation.
• Using wet dressings for oozing areas. They may help decrease itching and improve healing. Ask your child's healthcare provider or nurse for instructions. 
• Putting corticosteroid cream or ointment on the skin. This may help to lessen itching and other symptoms. The cream or ointment may be over-the-counter or prescription.
• Giving your child antihistamine pills or liquid. This may also help to ease itching. Talk with your child's healthcare provider about what your child should take.    

If your child has contact dermatitis from poison ivy, oak, or sumac:

• Wash all clothing and all objects that touched the plant oil.
• Be aware that pets allowed outdoors may have the plant oil on their fur. Your child can get allergic dermatitis from the oil on your pet. Wash your pet’s fur, if possible.

For more severe reactions, contact your child's healthcare provider. They may prescribe corticosteroid pills or liquid, or other medicines.

You can help prevent contact dermatitis in your child by making sure they stay away from any substances that caused the problem in the past.

Call the healthcare provider if your child has:

• Symptoms that affect a large area
• Symptoms around the eyes or genitals
• Symptoms that get worse
• Signs of a skin infection, such as increased redness, warmth, swelling or fluid
• New symptoms

Call 911

Call 911 if your child has contact dermatitis with trouble breathing.