Contact Dermatitis

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Duke dermatologists diagnose and treat contact dermatitis -- a skin inflammation, irritation, or allergic reaction that occurs following exposure to a specific substance. The reaction can result from contact with everyday items like shampoo, clothing, cosmetics, jewelry, and gloves, or it can result from substances you're exposed to in your workplace. We use the latest techniques to identify the cause of your allergic reaction so we can relieve your symptoms and help prevent future outbreaks.

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Determining the Cause of Your Contact Dermatitis

If your doctor cannot identify the cause of your skin problem and suspects contact dermatitis, you may be referred to our dermatologists, who have special expertise in skin patch testing.

Physical Exam and Medical History

We will examine your skin and conduct a thorough evaluation of your potential exposure to irritants or allergens in your home, at work, or in other environments you visit frequently.

Skin Patch Testing

This test identifies the source of your allergic skin reaction, especially if you experience repeated and long-lasting occurrences of contact dermatitis. Small amounts of potential allergens are applied to adhesive patches, which are typically placed on your back. Your skin’s reaction to the substances is examined for possible allergies over several days.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Preparing for Your Skin Patch Test

Three Required Appointments

The week-long patch test process typically involves three visits to our office. You will also receive a questionnaire to complete and send in before your first visit.

Visit 1: You and your doctor discuss your skin problems, and they decide which substances to test as possible allergies. The substances are then applied to your back and held in place with special tape.
Visit 2: Two days after the substances are applied, you’ll return for patch test removal.
Visit 3: Two to three days after the patches are removed, your doctor will interpret the test, explain the results to you, and make a plan for next steps.

What to Bring to Your Appointment

You should bring the products you use in their original containers to your first appointment so they can be incorporated in your skin patch test. If this is not possible, come with an ingredient list for products you use regularly. Some products are tested directly, while others are reviewed for their ingredients. Some common product categories include:

Hair products
Soaps and cleansers
Moisturizers
Sunscreen
Makeup
Nail products
Jewelry you normally wear
Any other items you suspect may be causing a problem

In addition, if you have a skin problem on a specific area of your body, bring products that routinely touch or are applied to that area. For example, if you have a rash on your hands, bring gloves, soap, and hand sanitizer that you use at work and home, or labels from these products.

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Treatments for Contact Dermatitis

Once your doctor identifies the cause of your contact dermatitis, they can decide on the best treatment for you.

Prevention

The most effective treatment for contact dermatitis is to avoid the substances that trigger your skin reaction. Our doctors will talk to you about the substances that irritate your skin or cause an allergic reaction and help you determine the best steps for avoiding them. If you have a contact allergy, we will provide a detailed “safe list” of products you can use.

Topical and Systemic Relief

Inflammation resulting from contact dermatitis may be treated with:

Anti-itch medicines and moisturizers to relieve the itching and allow your skin to heal
Prescription cortisone creams, which alleviate rashes
Immunosuppressants, which decrease your allergic response

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 10 pediatric specialties by U.S. News & World Report for 2024–2025.

Why Choose Duke

Advanced Expertise in Diagnosis and Management of Contact Dermatitis
Our dermatologists are among a small number in the U.S. with advanced experience in contact dermatitis and patch testing.

Wide Range of Allergen Testing
We use skin patch testing to identify the source of your allergic reaction and test for a wider range of substances than most medical centers. Our patch tests include cosmetic additives, fragrances, preservatives, metals, and other unusual allergens. We personalize the patch test to fit your lifestyle by tailoring allergen panels to your exposures and testing products you are regularly exposed to at home, at work, and in other environments you visit frequently. We perform standard comprehensive, pediatric, and implant tests, as well as photo-patch testing to assess allergic reactions that occur only in the presence of sunlight.

This page was medically reviewed on 06/15/2023 by

Rabina Kochar Walsh, MD | Dermatologist