contact dermatitis

One of these days when I retire, I plan to write a book on practical skin care. Towards that end, I am slowly starting to write stuff which I hope may develop further into chapters later on. With this in mind, I'm posting info that might be of use for folks in this forum. If any of you find it helpful, or can think of other areas related to the skin that would be helpful, let me know.

For starters, I want to talk about contact dermatitis, which I deal with quite a bit in my work. With all of the skin products people use around here on their skin, I think its a good subject for our group.

Contact dermatitis is more common than people appreciate, and lots of topical products can produce skin reactions. For example, neosporin causes a contact allergy in about 1% of all people (thats why dermatologists, despite neosporin's advertising claims, rarely recommend this product). The second most common type of contact allergy is to certain metals, especially nickel. For that reason, if you see a small itchy circular rash just below the belly button, its usually due to a nickel trouser snap or belt buckle.

Because us shavers use a variety of things on our skin, preshave, shave or post shave, products, colognes, sunscreen moisturizers etc., if you do develop a rash on the skin, sometimes its hard to know which product you are putting on your skin might be causing it, or is it just razor burn. This is when a bit of knowledge about contact dermatitis comes in handy.

Contact dermatitis is a delayed hypersensitivity reaction. What this means is that if you put something you are allergic to on the skin, it will take 1-2 days for you to actually see the rash. Poison ivy or poison oak are good examples. You usually see the rash only a day or two after you went hiking or were clearing brush, not immediately afterwards.

Because of this delayed timing, many people do not immediately connect the application of the skin product with the onset of a facial rash. Its also good to keep in mind that people can become sensitized or develop an allergy over time. That means that something that might have worked just fine on your skin, could eventually start to cause a rash.

If you are getting a rash on your skin and want to determine whether a particular topical product might be producing a contact dermatitis, an easy way to test this is to do what is called a use test. You simply rub a small amount of the substance in question on a small area of your inner forearm, once a day. Keep applying small amounts to the very same area on the forearm once a day for a week. Don't apply anything else to that area. If you have a reaction to that substance, you should see redness and itching sometimes a couple small blisters.

If thru this test you do have an allergy to a particular product, then its a good idea to go to the dermatologist and get a patch test. In that way, you can find out what ingredient in the particular skin product you are allergic to. That way, anytime you consider a new product for the skin, you can look at the label and see if the substance you are sensitive to is listed in the ingredients. Usually its the preservatives, but sometimes its the fragrances and other stuff.

I hope this is helpful to some of the folks here.

Cheers

Pete

Neat stuff. Thanks!! I occasionally get a rash on my chin but only if I don't shave for more than 3 days. If I shave regularly it never rears its ugly head.

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Originally Posted by JMS

Neat stuff. Thanks!! I occasionally get a rash on my chin but only if I don't shave for more than 3 days. If I shave regularly it never rears its ugly head.

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Obviously, no one can provide a diagnosis just based on a description in a forum. But there is a skin disease called pseudofolliculitis, which can produce the type of symptoms you describe. Its caused by ingrowing of hairs after a couple days. The sharp points of hairs cut by razors can curl backward with continuing growth and they loop back into the skin, causing little red bumps.

I would have dismissed contact dermatitis years ago as a temporary condition of little consequence. Then, about ten years ago, I developed a case on Christmas Eve of that particular year. It was mainly on the sides of my trunk, under my arms and up to my neck. I was miserable and it was painful. I trip to the doctor and some prescribed cream and it was gone in a few days. I traced it back to using some Dial brand deodorant soap while staying with some relatives; I never use deodorant soap.

Chris L

Interesting topic. Epidermolisys bulosa runs in my family, and in addition to easily forming blisters, it causes an increased risk of a variety of skin problems including chronic eczema and an increased rate of contact dermatitis.

Fortunately for me, I didn't get the gene that causes it, but I've seen more than my share.

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Originally Posted by VeeDubb65

Interesting topic. Epidermolisys bulosa runs in my family, and in addition to easily forming blisters, it causes an increased risk of a variety of skin problems including chronic eczema and an increased rate of contact dermatitis.

Fortunately for me, I didn't get the gene that causes it, but I've seen more than my share.

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VeeDubb, its funny you bring this up, EB is a big area of interest for me. I have been working on a cure for this in my lab for a number of years. Finally these efforts are paying off and we are starting a clinical trial on gene therapy for the recessive dystrophic form of this disease at Stanford and are screening patients for it right now.

If anyone in your family needs help with this, let me know. We are one of the major centers in the US for EB.

here is the link for our EB clinic page:

Visits - Epidermolysis Bullosa Clinic - GSDC - Dermatology - Stanford University School of Medicine

here is a link for the clinical trial:

EBMRF - Epidermolysis Bullosa Medical Research Foundation

and here is a fairly comprehensive internet resource on EB, which I wrote and keep updated:

Epidermolysis Bullosa: eMedicine Dermatology

Thanks for the links, I'll pass them along. (Like I said, I lucked out and didn't get the gene)

Since my entire family lives in Oregon, Stanford is more than a little out of the way, but I'll take a look through and see if any of my fmily members are interested.

I get a little bit mixed up on the types, as there are several variations of the disease. The form that runs in my family is the non-lethal type that still allows people to lead a more or less normal life. One of my brothers for instance, actually worked for a number of years in a machine shop in spite of the disease. Just just had to wear shoes that were a size too big with multiple pairs of seamless socks so he wouldn't get blisters on his feet from standing all day.

For anybody who has no idea what we're talking about, the two main layers of the skin are the dermis and epidermis. In "normal" people, these layers are anchored together with a particular type of collagen. In people with EB, the body either under produces that collagen, produces a malformed version of it, or doesn't produce it at all.

That means that something that might give you a tiny little friction rash, like playing basket ball in new shoes, or spending too much time honing, would cause somebody with EB to break out in large, deep, painful blisters.

Something that would make you or I get a small blister on the ball of the foot, would cover the soles of the feet in debilitating blisters that would heal slowly.

They are also generally not able to form callouses.

In the more severe form, where the body doesn't produce any of that particular collagen, even slight friction can literally tear a person's skin apart.

One of my sisters met a 10 year old boy with the "severe" form when he started public school. (He was kept out of public school until that age for safety) In a playground when he was 6, another child had tried to give him an "Indian burn" on his forearm, and had torn most of the epidermis off his arm from the elbow to wrist.

VeeDub, it is fortunate your family members seem to have one of the mild forms. Also it sounds like they have learned how best to deal with the skin fragility. Like you say, there are people with really bad disease too, and its really heartbreaking to work with these kids. But it inspires those of us who are trying to find new treatments. There will be a national geographic special on EB coming out later this year, concerning what its like to have one of the more severe forms of this disease. Again, if I can be of any help, just let me know. sincerely, Pete

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Originally Posted by VeeDubb65

Thanks for the links, I'll pass them along. (Like I said, I lucked out and didn't get the gene)

Since my entire family lives in Oregon, Stanford is more than a little out of the way, but I'll take a look through and see if any of my fmily members are interested.

I get a little bit mixed up on the types, as there are several variations of the disease. The form that runs in my family is the non-lethal type that still allows people to lead a more or less normal life. One of my brothers for instance, actually worked for a number of years in a machine shop in spite of the disease. Just just had to wear shoes that were a size too big with multiple pairs of seamless socks so he wouldn't get blisters on his feet from standing all day.

For anybody who has no idea what we're talking about, the two main layers of the skin are the dermis and epidermis. In "normal" people, these layers are anchored together with a particular type of collagen. In people with EB, the body either under produces that collagen, produces a malformed version of it, or doesn't produce it at all.

That means that something that might give you a tiny little friction rash, like playing basket ball in new shoes, or spending too much time honing, would cause somebody with EB to break out in large, deep, painful blisters.

Something that would make you or I get a small blister on the ball of the foot, would cover the soles of the feet in debilitating blisters that would heal slowly.

They are also generally not able to form callouses.

In the more severe form, where the body doesn't produce any of that particular collagen, even slight friction can literally tear a person's skin apart.

One of my sisters met a 10 year old boy with the "severe" form when he started public school. (He was kept out of public school until that age for safety) In a playground when he was 6, another child had tried to give him an "Indian burn" on his forearm, and had torn most of the epidermis off his arm from the elbow to wrist.

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Hey Vee,
Just FYI, here is an updated information page for our epidermolysis bullosa clinical trial:

Community Academic Profiles - Faculty & Researchers - Stanford Medicine

I have had a few products cause this an its very anoying.
Most antiperpirants give me trouble, but recently Ogallala Bay Rum either the after shave or the cologne has given me some trouble. I am waiting for the skin to calm down and I am going to give the arm trick a try and see which one was the trouble maker. I have 2 pucks of soap that I need to try too and see it this is ok. Contact dermatits can be a tricky thing to track down, I should have a skin test done but never seem like there is a good time to do it.

Crom

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Originally Posted by cromagnum

I have had a few products cause this an its very anoying.
Most antiperpirants give me trouble, but recently Ogallala Bay Rum either the after shave or the cologne has given me some trouble. I am waiting for the skin to calm down and I am going to give the arm trick a try and see which one was the trouble maker. I have 2 pucks of soap that I need to try too and see it this is ok. Contact dermatits can be a tricky thing to track down, I should have a skin test done but never seem like there is a good time to do it.

Crom

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Crom, are you getting just redness and stinging or small blisters and significant itching from the Bay Rum? If the former, its an irritant reaction, if the latter then an allergic reaction. if you can post the ingredient list, I will make a stab at what might be the most likely offending agents.

Update on the ogallala. The cologne and the after shave give me an elevated red rash, it is palpable, very itchy but no blisters. One test does stayed red for over a week but stopped itcing in 3 or 4 days.

I tested clubman bay rum and Master bay run both have not given me any trouble.


The ogallala cologne has a few more oils (clove lime sage rosemary, ginger, orange, cinnamon and wintergreen) than the aftershave (bay rum fragrance) but both give me the same reaction. Their antiperspirant also give me a problem, so I am sure I have a few different things that give me trouble.
I use dickerson witch hazel with no reaction as well since their aftershave has witch hazel but I don't think that is the trouble.

I am going to start trying their soap this week and see how it goes. If they use the same bay oil fragrance it may not work, but I love the smell of their products.

I find it very interesting as well that all three products smell nothing alike. (Master, Clubman and ogallala)

Thanks for you help as well RazorPete


Crom

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Originally Posted by cromagnum

Update on the ogallala. The cologne and the after shave give me an elevated red rash, it is palpable, very itchy but no blisters. One test does stayed red for over a week but stopped itcing in 3 or 4 days.

I tested clubman bay rum and Master bay run both have not given me any trouble.


The ogallala cologne has a few more oils (clove lime sage rosemary, ginger, orange, cinnamon and wintergreen) than the aftershave (bay rum fragrance) but both give me the same reaction. Their antiperspirant also give me a problem, so I am sure I have a few different things that give me trouble.
I use dickerson witch hazel with no reaction as well since their aftershave has witch hazel but I don't think that is the trouble.

I am going to start trying their soap this week and see how it goes. If they use the same bay oil fragrance it may not work, but I love the smell of their products.

I find it very interesting as well that all three products smell nothing alike. (Master, Clubman and ogallala)

Thanks for you help as well RazorPete


Crom

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The prolonged redness and especially the itching sounds like an allergic contact dermatitis to me. Its possible, as you suspect, that you are reacting to one of the essential oils, but which one remains a mystery because there seem to be a lot in this product. At any rate, when you have another one of those itchy reactions with another product, compare which ingredients are shared between it and the ogallala bay rum, then you can further narrow down which is the offending oil or other chemical. Its sort of like a detective job. Once you figure out the offending agent, all you need to do when considering future skin products is to read the ingredients list to find if it contains that chemical. Anyway, I am glad you found another product for now which you can use.