Contact dermatitis is a common inflammatory reaction that occurs when the skin comes in contact with an
irritant (or allergen). Any substance can act as an irritant if the concentration, duration, and frequency of
exposure are sufficient. Irritants can include soaps, detergents, deodorants, perfumes, cosmetics,
metals, leather, wool, new clothing (due to chemicals from the manufacturing process), medications, and
poison ivy or oak (due to resin from the leaves). Reactions can vary in the same person over time.
Certain agents commonly affect certain skin areas:
Face and neck: Soaps, mouthwashes, insect sprays, perfumes or hair sprays (neck), cosmetics, eye
make-up (eyelids), lipstick or toothpaste (on or around the lips), hatbands (forehead), and nickel metal
Hands and forearms: Soaps, hand lotions, wrist bands, metal backs of watches, industrial chemicals,
poison ivy, and many other agents. Irritation from soap may begin under rings.
Underarm: Deodorant, dress shields, and dry cleaning solutions.
Trunk: Clothing (particularly if new and not previously laundered) and rubber or metal attached to clothing
(belt buckles).
Genital area: Douches, dusting powder, contraceptives (spermicidal gels/creams/foams, rubber from
condoms, diaphragms, cervical caps), colored toilet paper, medicated ointments, fabric softeners, and
perfumed panty liners.
Generalized eruption: Airborne chemicals (spray paint, ragweed), medications applied to large areas of
the body, bath powder, and clothing.
Some allergens directly irritate the skin, causing an immediate inflammatory reaction, often like a burn.
Other irritants cause a delayed allergic reaction, with symptoms developing 24-48 hours later.
Sometimes there may be no initial reaction, but regular use (eg, nail polish remover, preservatives in
contact lens solutions, or repeated contact with metals in jewelry or clothing) can eventually cause
sensitivity and reaction to the product.
Symptoms include:
• A rash at the site of exposure:
o May be red, pimple-like, or blistering.
o May be dry, crusting, or weeping.
o May become scaly, raw, or thickened.
o Note: Poison ivy exposure often results in a linear pattern where the skin has come in contact
with branches or leaves.
• Itching, sometimes accompanied by a burning sensation.
• Possible warmth, swelling, or tenderness of the area.
• Avoid the irritant! Wash it off with copious amounts of water if possible.
• Do not scratch! Scratching increases the chance of getting a bacterial infection.
• Sometimes the best treatment is to do nothing to the area.
• Oral antihistamines (eg, Benadryl, Zyrtec, Claritin, Allegra) can decrease the allergic response and
the itching.
• Corticosteroid creams can also be used to decrease the inflammation and itching. They work better if
used before blisters develop. Only a thin layer of the medication is needed to be effective. Excessive
or long-term use can cause thinning and whitening of the skin. Steroid creams should not be used on
the face or neck unless specifically directed by your health care provider.
• Oral corticosteroid medications are occasionally prescribed for more severe or widespread
symptoms. These medications must be taken as directed. They should be taken with food to
decrease the risk of stomach upset.
• An allergic reaction to the oil from the plant (urushiol) usually occurs 12-48 hours after exposure,
resulting in an itchy rash. Touching the rash or any oozing blisters will not spread the rash because
urushiol bonds to the skin within minutes. However, scratching can increase the risk of developing a
bacterial infection.
• If you think that you've come in contact with poison ivy, wash exposed areas with plain cool water as
soon as possible. Some experts recommend using rubbing alcohol first to remove the oil from
exposed skin and any exposed tools, shoes, etc.
O Be sure to wash fingernails carefully to remove oil that may remain under the nails.
O Don’t use soap yet as soap can move the urushiol around your body, resulting in a more
widespread allergic reaction.
O The sooner you cleanse the skin, the greater the chance that you can remove the plant oil and
prevent further spread on your body. Removing the oil within 10 minutes is ideal because it has
probably not bonded to your skin yet. However, even washing off 2 hours after an exposure
significantly reduces symptoms.
• Over-the-counter products such as Tecnu and Zanfel can be used to remove urushiol from your skin.
Zanfel can also be used to remove urushiol from objects that had contact with the plant. These
products can be quite effective but are fairly expensive.
• After washing exposed areas with cool water, take a shower with soap and warm water.
• Because urushiol can remain active and linger on virtually any surface until it’s washed off, be sure to
wash your clothes, shoes, tools or anything else that may have touched the plant (like camping,
sporting, fishing, or hunting gear). Launder clothing in hot water. Water or rubbing alcohol can be
used to remove the oil from tools and other objects.
• Also be sure to wash your pet if it may have had contact with the plant. Use pet shampoo and water
while wearing rubber gloves. Most pets are not sensitive to poison ivy, but the oil can stick to their fur
and cause a reaction in someone who touches them.
• A reaction can also result from contact with the smoke of a burning plant or even dried uprooted
plants that still have their resin.
• Before working in a high-risk area, Ivy Block (available over-the-counter) may be applied to the skin
on a preventative basis. It must be reapplied every 4 hours.
• Once a rash is present, Burrow’s soaks (also known as over-the-counter Domeboro soaks) can be
soothing and help to dry the lesions. Wet compresses applied for 15-30 minutes and Aveeno
oatmeal baths can also be soothing.
• Calamine lotion is a drying agent that may help the lesions heal faster. Over-the-counter products
such as Ivyrest and Caladryl cream contain a combination of Calamine and Benadryl.
• If you have lesions involving the face, eyes, mucous membranes, genitalia, or any large body surface
area, steroid pills taken by mouth may be prescribed by your health care provider to aid in healing.
• A fever over 100°F.
• A rash that is in your eyes, mouth, face, or
genital area.
• Pus coming from any blisters.
rash that does not get better in a few days.
• A rash that covers large areas of your body.
• www.mayoclinic.com
• www.aad.org
Published by VCU Division of Student Affairs and Enrollment Services
University Student Health Services
(804) 828-8828 - Monroe Park Campus; (804) 828-9220 - MCV Campus
Wellness Resource Center
(804) 828-9355 - 815 S. Cathedral Place
Reviewed 6/11