Contact allergy on the face and hands – symptoms and treatment

Contact allergy is a type IV immune reaction, a cell-type reaction and a delayed reaction characteristic of contact eczema. It is characterized by itching, rash, or hives. This ailment occurs in both women and men with the same frequency. The hapten is the antigen responsible for an allergic cell-type reaction.

What is contact allergy?

Contact allergy is a cell-type allergic reaction characteristic of allergic contact eczema. The prevalence of this ailment in the population is estimated at 1-10%, the disease accounts for 5-15% of inflammatory skin diseases, with the same frequency in both sexes. Skin allergies are nowadays a significant problem and are characterized by itching and rashes on exposed parts of the body. The most common cause of contact allergy is substances that come into direct contact with our skin. Longer exposure to a given allergen it may even make it impossible to perform work, e.g. hairdresser allergy to a given hair dye or a nurse’s allergy to latex wearing gloves.

Examples of allergens

The list of allergens causing an immune reaction is still growing, and the most common ones include:

1. nickel – is the most popular contact antigen, which sensitizes women more often. Nickel can be found in, among others, jewelry, zippers, scissors and watches, because it is found in metal alloys. It is found in margarine in trace amounts;
2. cosmetics – this type of allergen most often affects women, and examples include substances contained in powders, mascaras, lipsticks, perfumes and paraphenylenediamine contained in henna. Soaps, shampoos and shower gels can also be allergenic; it is best to use hypoallergenic products, eg HYDRA ESSENCE Comfort Mask Moisturizing and protecting Sensilis;
3. chrome – is a popular metal that can be found in paints, ink, cement and various detergents;
4. formalin – is a substance used, inter alia, for the production of fabrics, therefore, when wearing some clothes containing even trace amounts of formalin, allergy symptoms may occur. Formalin is also a preservative and a compound found in some adhesives;
5. medications – some ointments containing antibiotics can sensitize the skin;
6. cleaning products – these include fabric softeners and washing powders, which may contribute to the development of allergy symptoms (e.g. inaccurate washing of clothes from washing powder). In addition, some dishwashing and window liquids can be allergenic;
7. Plants – An example of a skin-inducing plant is poison sumac;
8. plastics – these include latex gloves, cannulas, toys and floor coverings. This is a serious allergy that may make it impossible for, for example, nurses or other health professionals to work. 

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Contact allergy – causes

The antigen responsible for the occurrence of an allergic cell-type reaction is happed – that is, an incomplete allergen that acquires sensitizing properties only after it binds to the proteins of the epidermis or plasma.

In turn, the process of contact allergy can be divided into two phases:

1. induction – lasts about 10-14 days, the T lymphocytes are primarily sensitized or the T lymphocytes recognize the allergen in a secondary response. The antigen is absorbed by Langerhans cells, then presented to Th1 lymphocytes with the participation of class II histocompatibility antigens – HLA-DR;
2. disclosure – starts after 24-48 hours after re-contact with the allergen. Th1 CD4 + memory lymphocytes from the lymph nodes play an important role. It is mediated by pro-inflammatory cytokines secreted by activated Th1 lymphocytes. IFN-gamma (interferongamma), TNF alpha (tumor necrosis factor alpha, tumor necrosis factor) and numerous interleukins. IL-2, IL-4, IL-6, IL-8, leading to disease symptoms characteristic of allergic contact eczema.

Important! The location and location of skin lesions depends on the type of sensitizing substance and the way of exposure to the allergen.

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Symptoms of contact allergy and contact eczema

The benchmark model for a Type IV allergic reaction is allergic contact eczema, both acute and chronic. It is characterized by skin lesions that appear as a result of direct contact of the allergen with the skin (this is the main symptom of contact allergy). Then, bubbles filled with fluid begin to appear on the patient’s skin, causing persistent itching. Rarely, contact eczema will spread to parts of the body other than those that have been in direct contact with the allergen. Contact eczema is more common in adults.

The risk of contact eczema increases when the skin’s defenses are disrupted by mechanical and chemical factors, such as wearing too tight clothes. Then the fabric in which the allergen is located has close contact with the skin and rubs against the same parts of the body, leading to their mechanical irritation. The consequence of this situation is the formation of contact eczema.

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The causes of contact eczema can be divided according to the location of the disease focus:

1. skin changes on the legs – ointments, creams, tights, fabrics;
2. skin changes on the face – using sunscreen, mascaras, eye drops, nose drops, powder, glasses frames, soap, shadows and eyeliners;
3. skin changes around the mouth – lipstick, dentures, toothpaste, lip liner;
4. skin changes on the feet – rubber shoes, socks, footwear material;
5. skin changes on the neck – jewelry, collar, e.g. shirt, scarf, perfume;
6. skin changes on the trunk – perfumes, shower cosmetics, clothes, creams and lotions, washing powder, rinsing liquid.

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Contact allergy – diagnosis

It is used in the diagnosis of contact allergy epidermal patch tests, used to assess the contact reactivity of the skin and indicative of a contact hypersensitivity reaction. Then, a certain amount of hapten is applied to the patient’s skin for 48 hours, and then the skin reaction is observed at specified intervals. In addition, it plays a big role medical interview with the patient, in whom attention should be paid to the course of the disease and under what circumstances skin changes appeared (new clothes, work, hobbies, taking medications). During physical examination the doctor examines the patient’s skin very carefully, as they often focus only on the face, hands and other visible parts of the body. Meanwhile, a thorough examination of, for example, the feet may reveal a form of allergic contact dermatitis of the feet.

Sometimes the diagnosis of the disease is very difficult, because its existence may be caused by another condition or it may be a secondary complication of local treatment of another skin disease.

Treatment of contact allergy

Treatment of contact allergy should be based on avoiding contact with the allergen and occupational prophylaxis. In local treatment it is important:

1. care,
2. emollients,
3. glucocorticoids,
4. antibiotics
5. antiseptic drugs,
6. inhibitory kalcyneuryny,
7. keratolytic preparations.

In the general treatment of contact allergy, the patient is given antihistamines, and in severe and resistant forms – glucocorticosteroids, retinoids (alitretinoin), phototherapy. In the case of secondary bacterial infection – both local and systemic antibiotic therapy is used. Another method of treatment may also be desensitization, which consists in administering the allergen to the patient in small amounts so that the patient’s body does not react with an allergy, but gets used to it and thus becomes immune.

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Skin prone to irritation and allergic reaction should be cared for with the appropriate type of cosmetics. We recommend, for example, HYDRA ESSENCE Moisturizing and protecting Sensilis cream, which has soothing properties and can be used even in the case of allergic skin.

How to prevent contact allergy?

In the prevention of contact allergy, it is important to:

1. avoiding contact with specific irritants and allergens,
2. using cosmetics and paraben-free, color and fragrance-free products, antiallergic, you can use, for example, Night Cream for oily skin and combination skin with imperfections Peach Perilla Cream.
3. using protective gloves when washing dishes or hand washing (especially when you use detergents that previously caused contact eczema) – we recommend, for example, 100 nitrile gloves – different sizes,
4. avoiding work with bare sleeves with unknown substances,
5. conducting an allergy test before applying new cosmetics, e.g. apply a small amount of cream to the skin and wait for its reaction,
6. using protective creams (try cold-pressed wild carrot seed oil, which revitalizes the skin and soothes and moisturizes the skin),
7. avoiding the use of harsh cleansing or coarse-grained scrubs, which may irritate the skin and damage the epidermis.

Lit .: [1] Brasch J., Fartasch M.: Standardization in Contact Dermatitis – a highly desirable aim. Contact Dermatitis 2009, 60(6); 351-2. [2] Nedorost S.: Contact dermatitis. Preface. Dermatol Clin 2009, 27(3); xi-xii.

Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House