Contact dermatitis treatments: 5 skin soothing ingredients

Here we get into the nitty gritty of what is contact dermatitis and explore if there are any skin-soothing saviours that can help get rid of that itch. Are you wondering if an allergy is causing the itchy patches on your skin? Could excessive hand washing be the cause of dermatitis on your hands? Or maybe it’s a fragrance in your washing detergent causing patches of dermatitis on your legs. Here, we answer the question: What is contact dermatitis? We'll then explore what’s happening to your skin to cause contact dermatitis to break out. Finally, we ask a Holland & Barrett expert to share some skin-soothing super ingredients and other ideas on how to keep the itching at bay.

An introduction to contact dermatitis

First of all, it’s difficult to say anything conclusive about what causes contact dermatitis. This is because triggers vary significantly, which makes pinpointing the primary cause troublesome. “Contact dermatitis usually flares up following an interaction with a particular substance that causes your skin to react,” says Holland & Barrett nutritionist, Emily Rollason. “As a result, taking away the trigger will often provide the most benefit for this form of dermatitis. But the difficult part is identifying what causes the allergic response in the first place. And then identifying all of the sources. It can often be obscure and hidden ingredients that cause a reaction.” For example, one common trigger is the sodium lauryl sulphate (or SLS) that creates the soap and bubbles in many shampoos, soaps and shower gels. But it could also be a chemical preservative used in your fabric conditioner or baby wipes. Or contact with course fabrics or abrasive materials – they're also common causes of contact dermatitis. The bottom line is everyone is different. Simply because one person reacts to a certain ingredient, it doesn’t necessarily mean this will trigger someone else’s reaction too. “The great news is, there are lots of ways to reduce the discomfort caused by this type of eczema,” Emily adds. “There are various soothing creams and emollients available over-the-counter, and plenty of natural alternatives. It’s definitely advisable to talk to your GP if your skin is particularly troublesome. But, there are also small things you can do at home to work alongside eczema treatments.” In this post, we'll delve into what makes dermatitis creams effective and provide some ideas that can help you prevent it. But first, let's understand what’s happening to cause contact dermatitis.

What is dermatitis?

Dermatitis is a medical term to describe irritated or inflamed skin. It’s also often called eczema. There are several types of dermatitis, but they are generally grouped into two main categories:

1. Dermatitis that’s caused by contact with something outside of the body.Patches of inflammation form on areas of skin that come into contact with a substance.
2. Dermatitis is caused by a problem originating within the body.For example, you might be born with a tendency for your skin to flare up with inflammation from time to time (e.g. atopic eczema.)

The cause of contact dermatitis is exposure to a particular substance. For this reason, it falls under category one.

How do I know if I have contact dermatitis?

What does contact dermatitis look like? The appearance of contact dermatitis varies depending on severity and also the stage in the flare up. As a result, it can present as anything from a small, itchy red mark on the skin, to more extensive patches of cracked, crusting and itchy skin. Symptoms of contact dermatitis can sometimes appear immediately after exposure to a substance, but it can take several days with mild irritants. In most cases, you’ll notice a reaction within 48 hours. Symptoms of contact dermatitis^1,2

• Inflamed skin that's sometimes blistered, dry, thickened and cracked.
• Skin pigmentation can change, with darker skin becoming dark brown, purple or grey, and lighter skin becoming red.
• The hands are most commonly affected, but it can appear in other areas too, including arms, neck and face.

What causes contact dermatitis?

Contact dermatitis is caused by an interaction with a particular substance.^3,4 This could be one of two things. An irritant causing damage to the outer layer of skin. Or alternatively, an allergen prompting your immune system to react, causing inflammation to an area of skin. Now, let’s consider what’s behind these two types of contact dermatitis.

Irritant contact dermatitis

With irritant contact dermatitis, direct contact with a substance causes irritation to the skin. This can happen instantly. On the other hand, with milder irritants, it can take repeated exposure to trigger a reaction. Many irritants are common in everyday life – detergents, solvents and acids. But mild substances can sometimes cause irritation in individuals. This is usually if they're used in a high concentration or due to long or repeated interactions. For example, if you wash your hands often with soap and water, or work with water. In these cases, prolonged exposure to water and detergents can strip the skin of the natural oils that help create the skin’s barrier. This can cause a flare up of contact dermatitis.

Allergic contact dermatitis

This form of dermatitis happens when an individual develops an allergy to a specific chemical. When your immune system reacts to a substance, it becomes an allergen. For some people, even the most fleeting contact with an allergen can cause a contact dermatitis rash. This isn’t something you’re born with. An allergy develops after repeated interactions with a chemical over a period of time. As your body’s defence mechanisms begin to recognise this chemical, they can become sensitised to it. In response, you can cultivate an individual reaction, which is ‘remembered’ by the body. This reaction is what causes allergic contact dermatitis. Allergens are everywhere, from your jewellery box and bathroom cabinet to the borders in your garden. Common examples include nickel, cobalt, chromate, preservatives and certain plants.

How to aid contact dermatitis

The most effective aid for contact dermatitis is to avoid the substance causing the irritation or reaction. This helps you to regain control of an existing break out and can also prevent it happening again.

How to prevent contact dermatitis

• Identify the substance causing the reaction.
• Find out everywhere it’s likely to appear. This involves looking at product labels for ingredients.
• Avoid content with this substance.
• Minimise contact by wearing gloves or protective clothing.

4 common ingredients that cause dermatitis (or make it worse)

Ever noticed your dermatitis flares up after you’ve done more than your fair share of dish washing? Or maybe after changing your brand of shampoo or fabric conditioner? This could be down to one of these three culprits.

• Sodium lauryl sulphate (or SLS)
• Methylchloroisothiazolinone
• Methylisothiazolinone
• Fragrance

Sodium lauryl sulphate (or SLS) If you like your shower gels and shampoos to produce bountiful bubbles, check the ingredients for sodium lauryl sulphate. SLS might be a top-ranking bubble-creator, but it’s also widely thought to disrupt your skin’s natural oils. This can irritate your skin and reduce your epidermis’ ability to perform a vital function – to keep out allergens and irritants. As a result, SLS can trigger reactions such as contact dermatitis. “As we’ve learnt more about the harmful effects of SLS on the skin, more and more skincare manufacturers and retailers – including Holland & Barrett – have chosen to no longer sell products containing SLS,” says Holland & Barrett nutritionist, Emily Rollason. “So, if you’re prone to even mild dermatitis, be mindful about the products you choose – there are plenty of gentler alternatives to SLS now available.” Methylchloroisothiazolinone and Methylisothiazolinone Methylisothiazolinone, or MI, is a synthetic preservative. Methylchloroisothiazolinone, or MCI, is a preservative commonly used alongside MI in a blend. This duo of chemical preservatives is used in some water-based products to prevent the growth of mould and bacteria. For example, look out for them in toiletries, cosmetics, baby wipes, and household products, such as lotions or gels. “When skin is itchy, dry and cracked, it’s more prone to infection and more likely to react to certain chemicals,” says Emily. “So, I'd definitely suggest checking the label for these common irritants.” Fragrance Many people choose their cosmetic and skincare products for their pleasant aroma. But this fragrance can cause contact dermatitis and other negative skin reactions.⁵ Between 1 and 3% of the European population show some level of allergy to fragrance ingredients.⁶ So, look out for known perfume allergens such as eugenol, limonene and linalool. These are often potential irritants, particularly for those prone to contact dermatitis. The 26 fragrance allergens to look out for Manufacturers have to declare fragrance allergens used in cosmetic products. This is a European Union (EU) regulation.⁷ For example, the EU uses a list of 26 most-known allergenic fragrance substances. If they reach certain concentrations in a formulation, these ingredients must appear on the product label.⁸

Alpha isomethylionone	Coumarin
Amyl cinnamal	Eugenol
Amylcinnamyl alcohol	Farnesol
Anisyl alcohol	Geraniol
Benzyl alcohol	Hexyl cinnamal
Benzyl benzoate	Hydroxycitronellal
Benzyl cinnamate	Hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral)
Benzyl salicylate	Isoeugenol
Butylphenyl methylpropional (Lilial)	Limonene
Cinnamal	Linalool
Cinnamyl alcohol	Methyl 2-octynoate
Citral	Evernia furfuracea (Treemoss) extract
Citronellol	Evernia prunastri (Oakmoss) extract

What to look out for in dermatitis creams

Every now and again you may come into contact with an irritant or allergen hidden in an unlikely substance. And when this happens, you’ll be looking for an emollient or moisturising cream to apply to the affected skin. These formulations calm redness and reduce irritation and dryness. This provides some relief against the urge to itch. “It can take some trial and error to find the right solution for your skin,” says Emily. “The levels of hydration offered by skincare products vary considerably. For example, ointments are great for very dry skin. But a lotion or cream could be better for skin that’s less affected. There are also emollients that can work as a substitute for soap. What works for you will depend on what’s triggering your dermatitis.” So, with so much on offer, where do you start? First, look beyond the big claims and take a look at the ingredients of your skincare products. We’ve talked about key chemicals to avoid if you have dermatitis-prone skin, but what ingredients could help de-sensitise skin during a breakout? “There are a special group of skin-soothing skincare ingredients that are known to calm signs of irritation or sensitivity when applied to irritated skin,” Emily adds. “They’re often derived from plants so they are a great solution if you’re looking for natural skincare.”

5 natural skin-soothing skincare ingredients

There are lots of soothing ingredients widely available in products. Far too many to cover in this post. So, we asked Emily to pick her top five to look out for when choosing skincare and creams for dermatitis:⁹ #1 Chamomile Chamomile is a plant-based ingredient that’s well known for its soothing qualities. The oil extracted from the flowers contains compounds such as azulene, allantoin and bisabolol. These all give chamomile potent anti-inflammatory properties when applied topically. This aids with soothing irritated skin and reducing redness. #2 Turmeric A compound contained in turmeric, called curcumin, makes the spice a great skin-soothing ingredient. With natural anti-inflammatory and antioxidant properties, curcumin helps calm irritation. It may even play a role in reducing redness and restoring healthy skin. #3 Oat Colloidal oatmeal is a common ingredient in many skin-soothing creams. It can aid the repair of skin damage caused by dryness, by boosting moisture and plumping the skin. For clarity, this is not the same oats as you use to make porridge. This is a finely ground oat powder, that as well as being in creams, can also dissolve into a warm bath. An oatmeal bath can offer relief to all kinds of skin conditions. #4 Liquorice Liquorice is a great multi-tasking herb with wide-ranging wellness benefits. This includes skin-soothing benefits. One of its components, called glabridin, stands out as a powerful antioxidant. Applied topically, liquorice can provide relief from the itching and redness caused by contact dermatitis. #5 Fatty acids Fatty acids are important ingredients in any natural skincare diet. Fats, such as chia seed oil, safflower oil and evening primrose oil, can help reinforce the skin's natural oil barrier. This makes them great for plumping and hydrating dry, dermatitis-prone skin.

Contact dermatitis and work

Eczema and contact dermatitis is the cause of  84-90% of occupational skin disease.¹⁰ Is working with irritants part of your day job? Or does your role involve having your hands in and out of water and using lots of soap or cleaning materials? If so, you may become more prone to contact dermatitis. And if you already have a pre-existing skin condition, it could get worse. When there’s a clear connection between an allergy and your work habits, the condition can be called ‘occupational dermatitis’. It’s particularly common amongst hairdressers, beauticians, health workers, chemical workers, construction workers and cleaners.

5 things you can do to prevent contact dermatitis on your hands

Hands are the most common area for contact dermatitis to develop. Water and liquid soap have a drying effect and with frequent exposure can cause contact dermatitis on the hands. Changing your handwashing habits to use the right products could reduce irritation. Here's how:¹¹

1. Apply soap to wet hands (rather than dry)
2. Rinse and dry hands well after washing
3. Consider using an emollient for non-critical, routine hygiene washes. They don’t strip away the natural oils and can be gentler to the skin
4. Use emollient to improve the condition of your hands if dermatitis develops
5. Don’t wear rings. Irritants can collect under rings causing dermatitis between fingers

Summary: What is contact dermatitis? And are there any skin-soothing super ingredients that can help?

Contact dermatitis is a form of eczema that flares up following direct contact between your skin and a substance. Whether this substance is an 'irritant' or an 'allergen', the result is patches of redness, dryness, and cracked skin. It's usually intensely itchy. The best cure of contact dermatitis is to prevent (or limit) interaction with the offending substance. This means understanding the sources and checking ingredients labels thoroughly. Be aware, it may pop up in places you don’t expect. But, if you unwittingly come into contact with an allergen or irritant, help is available. Emollients and eczema creams can provide relief and help minimise the length of a breakout. Last updated: 9 July 2020 Sources 1 https://www.nhs.uk/conditions/contact-dermatitis/symptoms/ 2 https://www.britishskinfoundation.org.uk/contact-dermatitis 3 https://patient.info/skin-conditions/contact-dermatitis 4 https://eczema.org/wp-content/uploads/All-about-Contact-Dermatitis-booklet-2019-1.pdf 5 https://www.paulaschoice.com/expert-advice/skincare-advice/sensitive-skin/why-fragrance-free-products-are-best-for-everyone.html 6 https://ec.europa.eu/health/sites/health/files/scientific_committees/docs/citizens_fragrances_allergens_en.pdf 7 https://ec.europa.eu/health/sites/health/files/endocrine_disruptors/docs/cosmetic_1223_2009_regulation_en.pdf  8 https://www.ecomundo.eu/en/blog/cosmetics-allergens-europe-compliance 9 https://www.paulaschoice.com/expert-advice/skincare-advice/sensitive-skin/skin-soothing-ingredients.html 10 https://eczema.org/information-and-advice/our-skin-and-eczema/ 11 https://www.nes.scot.nhs.uk/media/3156379/hand_dermatitis_pocket_guide.pdf