Many substances can cause eczema

Eczema is a term for “inflammation of the skin.” Inflamed skin is itchy, red, swollen and flakey. In extreme cases it can even crack, weep and blister. Dermatitis is another name for eczema. Eczema and dermatitis are synonyms and used interchangeably.

Dermatitis can have many causes. These include allergic reactions, irritation, prolonged exposure to heat and moisture, prolonged exposure to dryness (winter), and genetic factors. For now, we will focus on rashes caused by allergic reactions.

eczema skin

Allergic contact dermatitis

The intense itching and blistering of allergic contact dermatitis can occur after contact with a substance that causes an allergic reaction. This substance is referred to as an “allergen.” These reactions typically appear within a few days of exposure. The reacting person must be exposed on a prior occasion for the reaction to occur.

Common allergens include: nickel, rubber, antibiotics, poison ivy, hair dyes, preservatives, chemicals used in clothing manufacturing, natural oils, ingredients in skin care products, and many others. Last week we looked at allergic rashes caused by exposure to nickel and rubber products. This week we will review other causes of allergic skin dermatitis.


Hair and clothing dyes

Most people can dye their hair without any problem. Paraphenylene-diamine (PPD) is a common ingredient in many permanent hair colors that acts as a potent allergen. PPD is commonly mixed with peroxide to activate.

Be sure to always do a small spot test with any permanent dye to make sure that you are not allergic. Most temporary colorants can be tolerated, but they still need a pre-test. Some people may also react to dyes found in some clothing.

Also, a distant relative to PPD is the anesthetic PPD. About 20 percent of people allergic to PPD have allergy problems with anesthetics like benzocaine. Henna tattoos may also now contain PPD and cause allergy problems.


Antibiotic ointments

Triple antibiotic ointment contains bacitracin, neomycin and Polymyxin B. All of these can cause allergic reactions, but most commonly either bacitracin or neomycin. The longer one uses these antibiotics, the more likely one is to develop an allergy to them. Consult with your dermatologist before using any over-the-counter topical antibiotic, especially long term.


Skin care products

Perfumes, fragrances, creams, lotions, and cosmetic products may cause allergic contact dermatitis. Some allergies are a result of the chemical used to fragrance a product; others may be from the ingredients used as preservatives in the product. Although many products will proclaim that they are “fragrance free “or “unscented,” they rarely are.

It is easy to determine if you can tolerate such products: Put a small amount, twice daily, on your forearm for 3-5 days and if no rash forms, it is a good indicator the product is safe for you to use without an allergic reaction. More extensive allergic contact testing can be done by your dermatologist.



Chromates contain chromium and are common sources of allergic contact dermatitis. Chromates are found in cement, match tips, leather tanning, some paints, and products that combat rust. Because chromates are found in so many products, many occupations can experience chromate allergies.


Tattoo inks

There are now hundreds of pigments used in the tattoo industry, but some of the common color pigments in tattoo ink that cause allergies are:

  • Red: Cinnabar
  • Yellow: Cadmium
  • Blue: Cobalt
  • Green: Chromic oxide
  • Purple: Manganese
  • White: Titanium and Zinc Oxide


Poison ivy and its relatives

Every year 30 million U.S. citizens experience dermatitis from poison ivy. Poison ivy, poison oak, and poison sumac are three related American plants of the rhus family. They contain an oil (urushiol) which is the allergen and cause of allergic contact dermatitis. A diagnostic pearl is that often the very itchy rash is composed of linear blisters, marking the area where the plant brushed up against the skin.

Allergies to these three plants may make people sensitive to certain tree oils, mango husks, pistachios and cashew shells from overseas. The skin has enzymes that naturally break down the oils over four to six hours after exposure. After that, you can’t spread the dermatitis by rubbing it or breaking blisters. The only exception is if it gets on animal fur or clothing that does not contain the enzyme to break it down, it can be touched later and cause the reaction.



People with allergic contact dermatitis should:

  • Avoid the allergen that causes the reaction and chemicals that cross-react with it. Your dermatologist can help you identify items to avoid.
  • Substitute products that do not cause allergic reactions. Your dermatologist can provide you with a comprehensive list of suggested alternatives.
  • Treatment is directed to relieve symptoms. Topical or oral steroids, cool compresses, and other non-steroidal anti-itch medicines will be recommended by your dermatologist.
  • Next it is important to investigate (contact allergy ‘Patch’ test) and identify and remove/avoid the cause of the allergic skin reaction. This information can be employed to avoid future skin reactions.
  • Most allergic reactions need to be treated for three weeks.

If you suspect an allergic contact dermatitis, see your dermatologist for the appropriate evaluation and treatment.

Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians,

Best Inexpensive Dry Skin Care Products You Can Buy – Dr. Crutchfield on ABC Channel 5

Well John, with winter weather here- so is that dry skin. So are you itching to find out how to prevent it? Dermatologist Dr. Charles Crutchfield joins us this morning. Thank you so much for being here. Thanks for having me. We appreciate it

If we don’t deal with this dry skin right away, it can lead to some very serious problems?

Dry Skin Winter 2014- 2015Absolutely, dry skin, the nice thing about Winter in Minnesota is they’re are good treatments that are inexpensive that you can really have nice skin throughout the Winter.

You’re right. Without proper skin protection and care you can have some problems. Let’s talk about some of these things here these aren’t the high priced items right?

That’s the key. You can have a good quality healthy skin in the winter without having to pay expensive prices.

There are four principles I look at: 1 gentle cleansing, 2 moisturization, 3 protection, and 4 correction. That means a gentle cleanser like Vanicream, Cetaphyl, or Dove. Good moisturizers like Saravay or Aveeno

You can also protect with good sunscreens SkinCeuticals, Neutrogena things like that. And then you can correct with the new anti-oxidants

Aveeno has that, and so does Eucerin.

Basically when you are looking through all of these, you recommend these Aveeno we get at the drug store.

Yeah absolutely. Once again, you don’t have to pay a high price to have good quality skin care products.

What’s your other advice? We have some pictures too of some more severe examples of what can happen to dry skin if you don’t a correct things.

Yes. Now this is a condition called Eczema and this comes from having just dry skin on the legs are not moisturized. When it gets to this point you probably need the help of a board-certified dermatologist

Okay, and your website is you have a lot of other tips for people?

Yes. Lots of other tips, and we have a full list of all the products and also some other helpful information the last picture on there’s the Minnesota Winter foot and we have advice on how to take care that that’s a problem I see my office all the time

Yeah that is common. All right! Thank you so much Dr. Crutchfield we appreciate it

It’s nice to know that we don’t have to spend too much money.