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Itchy rash could be contact dermatitis


So many things that touch our skin can irritate it or cause an allergic reaction, leading to an itchy and sometimes painful rash. When this happens, you have contact dermatitis.

If you can find and avoid the cause, you can get rid of this rash. Easy as that sounds, discovering the cause can be difficult – but not always. By taking time to think about what touches your skin, you may find the cause on your own. When this is not successful, a dermatologist can help identify the cause.

This dermatologist insight tells you what to look for — and the first question you need to ask yourself.

Where does the rash appear?

The answer to this question often provides your biggest clue. Here are some likely causes, sorted out by where the rash appears.

Around your eyes

Skin around the eyes is thin and delicate, which makes it easier for contact dermatitis to develop there.

Clues to look for: Everything from skin care products that remain on the skin for hours, like an anti-aging cream, to something that touches your skin for seconds, think tweezers and facial cleanser, can cause contact dermatitis in this area.

Here are some possible causes of contact dermatitis in this area:

  • Skin care product, makeup, makeup sponge, or makeup remover: Have you started using a new product? If this product touches the skin around your eyes, your skin may be reacting to a fragrance or other ingredient.

    If you think one of these could be causing your rash, stop using the product that you think is causing the rash. If your rash clears, you’ve likely found the cause. Switching to a hypoallergenic product may prevent a new rash.

  • Tweezers, eyelash curler, doorknob, or keys: These items usually contain metal, which can cause an allergic skin reaction. The metal in a doorknob or keys can cause a reaction without directly touching the skin around your eyes. If you grab a doorknob or keys and then rub your eyes, you can transfer metal particles too small to see from your hand to the skin around your eyes.

    To find out if metal is causing your rash, stop using metal products like tweezers around your eyes. Stop rubbing your eyes. If the rash goes away, you may have a metal allergy.

  • Nail polish or artificial nails: If you wear nail polish or artificial nails, try to stop touching the skin around your eyes. If the rash clears, you likely have an allergy to an ingredient in one of these nail products.

An itchy rash around your eyes could be contact dermatitis

If you have contact dermatitis in this area, you may have an allergy to fragrance or nickel.

Woman rubbing eye

Side of your face

If you have a rash on the side of your face, you may have developed an allergic reaction to something in your cell phone, shampoo, or one of many other products.

Clues to look for: Think about everything that touches the side of your face, from cell phones to shampoo that briefly runs down it. Then try the following to see if the rash clears when you avoid what you think is causing the rash.

Here are top tips that dermatologists give their patients:

  • Cell phone: Stop holding the phone against your face. Use the speakerphone or headphones that have a microphone. If the rash starts to clear, you may be hypersensitive to nickel or cobalt.

  • Shampoo or conditioner: When rinsing off shampoo and conditioner, make sure they don’t run down your face or other area of your body. If the rash starts to clear, you may have an allergy to an ingredient, such as fragrance. To avoid another flare-up, try using hypoallergenic hair care products.

  • Hair color or perming solution: Wear your hair away from your face. If the rash starts to clear, you may have an allergy to an ingredient in the dye or perming solution.

Cell phones are a common cause of contact dermatitis

Some cell phones contain nickel, which can cause an allergic reaction on your skin.

Mechanic talking on cell phone

Lips

An itchy and painful rash on (or around) your lips, along with uncomfortably dry and flaky lips that sometimes split, are signs of contact dermatitis.

Clues to look for: Anything that touches your lips can cause contact dermatitis. The list of possible causes includes musical instruments that touch your lips, lipstick, lip balm, and lip gloss. Here’s how to spot one of these causes:

  • Musical instrument: If you play a wind instrument, stop playing it until your rash clears. When that’s not possible, switch to a plastic mouthpiece or try a different reed.

  • Lip products: Stop applying everything to your lips. If the rash clears, start adding one product a week. If you develop a rash within 7 days of using that product, you’ve likely found the cause.

Musical instruments are a common cause of contact dermatitis

Many musicians who play a wind instrument develop an allergy to metal in the mouthpiece.

Musician playing trumpet

Lips and one hand

Clue to look for: The best way to figure out if contact dermatitis is causing this rash is to stop using e-cigarettes. If the rash clears, you’ve likely found the cause.

E-cigarettes often contain nickel, which can cause contact dermatitis

If you have a rash on your lips and the hand that you hold your e-cigarette with, you may have contact dermatitis.

Man smoking e-cigarette

Skin beneath jewelry or glasses

Jewelry and eyeglass frames can contain metals known to cause an allergic skin reaction. Even plastic frames on eyeglasses or sunglasses can cause a reaction.

Clues to look for: If you have an itchy or painful rash beneath a piece of jewelry or where glasses touch your skin, dermatologists recommend the following:

  • Jewelry: When a rash develops beneath a ring, necklace, watch, or other piece of jewelry, stop wearing the jewelry. If the rash clears, start wearing that piece again. If the rash returns, you may have an allergy to a metal like nickel, brass, palladium, gold, or silver.

  • Eyeglasses or sunglasses: If you wear eyeglasses or sunglasses and develop a rash near or around your ears, you may have developed an allergy to a metal in the frames. A frame that contains nickel, palladium, or titanium can cause an allergic reaction.

    Some people’s skin reacts to a plasticizer, UV stabilizer, or varnish used to make the glasses. If you can, wear contact lenses instead of glasses for a while. If the rash clears, it may be time to switch frames. Some frames are hypoallergenic.

Tip dermatologists give their patients: If you have a rash beneath a ring, soap and water may be irritating the skin beneath. You may be able to get rid of the rash by removing your ring before you wash your hands. Before putting your ring back on, dry your hands thoroughly.

Jewelry is a common cause of contact dermatitis

A rash can develop beneath a new piece of jewelry or one you’ve worn for 20 years.

Woman pumping soap onto hand

Legs

If you have a rash on one or both legs, you may have developed an allergic reaction to clothing dye, fragrance in your moisturizer, or poison ivy.

Clues to look for: Try to avoid what you think is causing the rash.

  • Clothing: Dyes, metals, and fabrics can cause contact dermatitis anywhere on your body, including your legs. Some people wear certain clothing for years before it causes a problem. For example, if you’ve been wearing black pants for years but start having a rash on your legs, switch to a light color. Skip black and red pants. If the rash diminishes or clears, you may have found the cause – the dye.

    If you have a rash on your legs, you also want to avoid rough-feeling fabrics like wool and synthetics like polyester and rayon. These can irritate sensitive skin. Some people develop an allergy to the formaldehyde used in some synthetic fabrics.

    If you’ve had contact dermatitis in the past, wash new clothes before wearing them to avoid irritation.

  • Fragrance: This is one of the most common causes of contact dermatitis. A fragrance in skin care products, foods, and elsewhere can cause everything from a painful itchy rash to hives. If a product you apply to your skin contains fragrance, switch to a product labeled “fragrance free.”

  • Plant: If your skin brushes up against certain plants, you can develop a rash. You’ll find a list of plants that can make you itch, along with a map that shows you where they grow in the United States and tips to avoid a rash, at Plants that make you itch.

Tip dermatologists give their patients: To avoid fragrance, use products labeled “fragrance free.” If you see “unscented” on the label, it means the fragrance in a product has been covered up. A fragrance that’s been covered up can still cause an allergic reaction.

Many people develop a rash when their skin touches poison ivy, oak, or sumac

These plants are a common cause of contact dermatitis.

Girl stopping hike to scratch itchy leg

Feet

On the feet, shoes and socks have become a common cause of contact dermatitis. It’s so common that there’s a medical term to describe it — footwear dermatitis.

Clues to look for: If you think that something which touches your feet is causing a reaction, here’s what may be happening.

  • Shoes or socks: Materials used to make these include leather, rubber, plastic, fabrics, dyes, metal, and glue. If you develop a hypersensitivity to any of these, you can develop an itchy rash. This rash can develop when you wear a new pair of shoes or put on clean socks that you’ve worn before. If you can, stop wearing the shoes and socks that you had on when you noticed the rash. If the rash disappears, you may have found the cause.

  • Foot cream, scrubs, nail polish: Many ingredients in these products, including fragrance, can cause a hypersensitivity. If you’re using one of these products, stop using it and see if the rash clears. When using two or more of these products, stop using all of them. Then, add the products back into your routine one at a time. Use one product for a week before adding the next one. This can help you see what’s causing the rash.

  • Medications, powders, and deodorants you apply to your feet: Some people develop an allergy to an antibiotic that they apply to their skin like neomycin. A fragrance in a foot powder or deodorant can also trigger contact dermatitis. If you’re using a prescription medication, tell the doctor who prescribed it what’s happening.

Itchy feet can be a symptom of contact dermatitis

Unlike itchy athlete’s foot, contact dermatitis often affects only on the tops of the feet.

Using one foot to scratch the other foot

When to see a dermatologist

If you cannot get rid of the itchy rash or it returns, it’s time to see a board-certified dermatologist. With more than 15,000 allergens, it can be difficult to find what’s causing a rash.

There are tests that can help a dermatologist find out what is causing your rash. It’s also possible that you have another skin condition. To effectively treat your skin, you need to know what’s causing your rash.

Related AAD resources


Images
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References
Ahlström MG, Thyssen JP, et al. “Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment.” Contact Dermatitis. 2019 Oct;81(4):227-41.

Cheng J and Zug KA. “Fragrance allergic contact dermatitis.” Dermatitis. 2014 Sep-Oct;25(5):232-45.

Gehrig KA and Warshaw EM. “Allergic contact dermatitis to topical antibiotics: Epidemiology, responsible allergens, and management.” J Am Acad Dermatol 2008;58:1-21.

Kraft M, Schubert S, et al. “Contact dermatitis and sensitization in professional musicians.” Contact Dermatitis. 2019;80(5):273-8.

Lazzarini R, Mendonça RF, et al. “Allergic contact dermatitis to shoes: Contribution of a specific series to the diagnosis.” An Bras Dermatol. 2018;93(5):696-700.

Nguyen HL and Yiannias JA. “Contact dermatitis to medications and skin products.” Clin Rev Allergy Immunol. 2019 Feb;56(1):41-59.

Situm M, Lugovic-Mihic L, et al. “Dermatological aspects of contact dermatitis from eyeglass frames and optical materials.” Coll Antropol. 2013 Apr;37 Suppl 1:19-24.

Uter W, Werfel T, et al. Contact allergy: Emerging allergens and public health impact.” Int J Environ Res Public Health. 2020;17(7):2404. Published 2020 Apr 1.

Zirwas MJ, “Contact dermatitis to cosmetics.” Clin Rev Allergy Immunol. 2019 Feb;56(1):119-28.


Written by:
Paula Ludmann, MS

Reviewed by:
Bassel Hamdy Mahmoud, MD, PhD, FAAD
Elena Hawryluk, MD, PhD, FAAD
Stephen Stone, MD, FAAD

Last updated: 12/15/20

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