Nail & Skin Disorders

Under the Microscope: Allergic Contact Dermatitis

Caused by allergens that come into contact with the skin, allergic contact dermatitis often clears up on its own when sufferers avoid the offending agent.

What is it? Contact dermatitis is a form of hypersensitivity. Literally defined as “inflamed skin,” dermatitis appears in a localized area as a rash, small blisters, swelling, or redness. Contact dermatitis falls into two categories: irritant contact dermatitis and allergic contact dermatitis. Irritant contact dermatitis is caused by a substance that is likely to cause a reaction in nearly anyone who is exposed to it in large quantities. Allergic contact dermatitis is caused by your body coming into contact with an allergen and reacting.

How do you get it? The body may come into contact with an allergen through direct contact, such as touching, or through airborne contact, such as an allergen landing on the skin. Nearly anything can be the cause of allergic contact dermatitis, because each person’s body responds differently to allergens. So, jewelry, plants, lotions, glues, polish, acrylics, wool, gasoline, perfume — the list goes on and on — could cause the skin to react and swell in one person, but be completely benign to another. Another complexity of allergic contact dermatitis is that a person could have been in contact with a substance — a lotion, detergent, salon products — for years with no reaction and then suddenly develop a reaction without explanation.

How is it treated? Treatment for contact dermatitis begins by avoiding the allergen, which can be identified by a patch test. However, topical creams are also prescribed to clear up the condition and ease the itch. Left untreated, allergic contact dermatitis tends to become less inflamed, red, and bubbly. Instead, the skin gets thicker and more scaly. Sometimes the thickened skin will split and cause painful fissures. In these severe cases, an oral prednisone may be necessary. 

What can a tech do? When a tech realizes that a client has developed a reaction to a product in the salon, she should advise the client to visit a dermatologist to try to determine the specific cause of the allergic reaction, such as an epoxy or a particular ingredient. In the meantime, remove the enhancement product, offer the client natural nail services, and wait for the reaction to clear. Once the skin is clear and healthy, it is safe to try different products for enhancement services to see which work on the client without a reaction.

What else? In some cases, a tech will develop allergic contact dermatitis herself from coming into repeated contact with the allergens at the salon. When this happens, she can often continue working by wearing a protective barrier, such as gloves and long sleeves, to prevent the product from coming into contact with her skin. She may need to research product ingredients to determine the cause of her reaction and then find a product that doesn’t contain the offending ingredient.

Dr. Peter Schalock contributed to this article.

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