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Unexpected reaction? It could be contact dermatitis.

See a Contact Dermatitis Specialist in St. Louis, Missouri

What triggers contact dermatitis? We explain the most common causes below, including soaps, fragrances, nickel, plants, and preservatives. Visit us at St. Louis Family Allergy to better understand your triggers, get tested, and learn what treatment options will work best for you. Schedule your visit today!

“Had my first appointment with Dr. Cajigal. She’s wonderful. A different doctor had said there wasn’t much I could do for my allergies, except maybe move out of state. I was desperate and came to the doctor for help. She listened and was very thorough in her diagnosing my problems. I’m not better yet but I’m very pleased with how this appointment went and I’m optimistic about my health!”

– Rosana B, November 2021

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↓ Learn More About Contact Dermatitis

Contact Dermatitis Specialist Doctor Sonia Cajigal of St. Louis Family Allergy in St. Louis, Missouri

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About Contact Dermatitis

Overview

Common Causes

Less Common Causes

Symptoms

Allergy Testing

Contact dermatitis is a common skin rash that develops when the skin reacts to something it has touched. It may cause itching, redness, dryness, burning, scaling, swelling, or blistering. There are two main types: irritant contact dermatitis, which happens when something damages the skin barrier, and allergic contact dermatitis, which happens when the immune system reacts to a specific substance. Irritant dermatitis is generally more common overall.

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in St. Louis, Missouri

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Skin patch testing for allergic contact dermatitis

The Most Common Causes of Contact Dermatitis

Soaps, Detergents & Cleaning Products

Frequent exposure to soaps, hand sanitizers, dishwashing liquids, household cleaners, and other cleansing products can dry and irritate the skin. This is one of the most common reasons people develop contact dermatitis, especially on the hands. Repeated washing and “wet work” can gradually weaken the skin barrier over time.

Fragrances in Skin Care & Personal Products

Fragrance is one of the most common causes of allergic contact dermatitis. It can be found in lotions, soaps, shampoos, deodorants, cosmetics, and perfumes. Even products labeled “unscented” may still contain masking fragrance ingredients, so “fragrance-free” is usually the better choice for sensitive skin.

Metals Such as Nickel

Nickel is a very common trigger for allergic contact dermatitis. It is often found in jewelry, watchbands, belt buckles, zippers, snaps, and eyeglass frames. The rash usually appears where the metal touches the skin, such as the ears, neck, wrists, or waistline.

Preservatives & Ingredients in Cosmetics or Creams

Preservatives used in skin care products, cosmetics, wipes, and topical products can also trigger allergic reactions. In some cases, patients think they are reacting to the main product, when the actual cause is a preservative or another inactive ingredient in the formula.

Plants Such as Poison Ivy, Poison Oak & Poison Sumac

These plants are classic causes of allergic contact dermatitis. The rash often becomes very itchy and may blister. Exposure can happen directly outdoors or indirectly through contaminated clothing, gloves, tools, or pet fur.

Rubber, Latex & Adhesives

Gloves, elastic materials, rubber products, bandages, and medical adhesives can all trigger contact dermatitis in some patients. When this happens, the rash often follows the exact area of contact, which can be an important clue.

Hair Dyes & Nail Products

Hair dyes and nail cosmetics are frequent but sometimes overlooked triggers. Reactions to hair products may affect the scalp, hairline, face, or neck. Nail products can cause dermatitis on the fingers, but also on the eyelids or face because hands touch those areas throughout the day. Acrylates used in gel and acrylic nail products are a recognized cause of allergy.

Water & Repeated Irritation

Even plain water can contribute to irritant contact dermatitis when exposure is frequent enough. This is especially common in people who wash their hands often or work in healthcare, childcare, food service, cleaning, or hair care. People with eczema may be more prone to this type of irritation because their skin barrier is already more vulnerable.

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in St. Louis, Missouri

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Girl with allergic contact dermatitis rash near neck

Less Common & Commonly Overlooked Causes of Contact Dermatitis

Some triggers are not as obvious. Patients may continue to use the same “gentle” or “medicated” product without realizing it is part of the problem.

Topical Antibiotics

Ingredients in over-the-counter antibiotic ointments, such as bacitracin or neomycin, can cause allergic contact dermatitis in some people. A rash that seems to worsen with repeated use of a topical antibiotic can sometimes point in this direction.

Topical Medications, Including Steroid Creams

Although steroid creams are often used to calm inflammation, some patients can react to ingredients in medicated creams or ointments, including the medication itself or other components in the product. If a rash keeps recurring despite treatment, this may need to be considered.

Leather Dyes, Textile Dyes, & Clothing Finishes

Some people react to dyes, finishes, or chemicals in clothing, shoes, or leather products. When the rash appears in areas where clothing or footwear repeatedly rubs the skin, these exposures may be relevant.

Work-Related Chemicals

Occupational exposures are another important but sometimes missed cause. Depending on the job, triggers may include disinfectants, solvents, cement, oils, dusts, or repeated wet work. This is especially important to consider when the rash improves away from work or worsens during the workweek.

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in St. Louis, Missouri

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Zoomed in picture of contact dermatitis rash on the skin

What Contact Dermatitis Looks Like

Symptoms vary from person to person, but common signs include itchy skin, redness or discoloration, dryness, scaling, cracking, burning, tenderness, and sometimes blisters. The rash often appears where the skin came into contact with the trigger, although allergic contact dermatitis may spread beyond the original area.

When Allergy Testing May Help

If a rash keeps coming back, does not improve as expected, or the trigger is unclear, specialist evaluation may help. Patch testing is used to look for allergic contact dermatitis by checking the skin for reactions to specific substances such as fragrance ingredients, metals, preservatives, rubber chemicals, and other common allergens. Patch testing does not evaluate food allergy.

When to See an Allergy Specialist

You may benefit from evaluation if:

The rash is recurrent
The cause is unclear
Treatment only helps temporarily
The rash may be related to products, work exposures, or personal care items
Eczema seems to be worsening without an obvious reason

The most common causes of contact dermatitis include soaps and detergents, fragrances, nickel, preservatives, plants such as poison ivy, rubber or adhesives, and repeated exposure to water or irritants. Less obvious causes can include topical antibiotics, medicated creams, nail products, dyes, and workplace chemicals. When the trigger is not clear, patch testing can help identify allergic causes and guide avoidance.

See a Skin Allergy Doctor

in St. Louis, Missouri

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References

[1] American College of Allergy, Asthma & Immunology: https://acaai.org/
[2] Asthma and Allergy Foundation of America: https://www.aafa.org/

More Specialties

Asthma

Drug Allergies

Eye Allergies

Food Allergies

Nasal Allergies

Skin Allergies

Allergy Shots

Allergy Testing

Biologic Therapy

Visit Allergist Dr. Sonia Cajigal of St. Louis Family Allergy in St. Louis, Missouri

Skin Allergy Doctor
Dr. Sonia Cajigal

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"Dr. Cajigal was friendly, professional, and informative. She took the time to explain the tests and what was going on with my allergies. She is so knowledgeable and really cared about how I was feeling. I would highly recommend this practice if you suffer from allergies and asthma."

- Sue D, July 2020

“Dr Cajigal is a great listener. She trusts her patients instead of treating them as if they are not the experts of their own bodies. I really appreciate that (many doctors do not have that quality). She also immediately treats the symptoms instead of waiting to see if things clear. I use her for my children and myself. We have never left her office feeling as if it was a waste of time.”

– Stephanie, August 2020

"Great Allergist!"

- Ann H, December 2018

"She is the best."

- Stephen W, June 2020

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See a Contact Dermatitis Specialist in St. Louis, Missouri

About Contact Dermatitis