Contact Dermatitis in Babies

If you notice patchy and scaly blisters on your child’s skin, don’t hesitate to seek a paediatrician as it may be a sign of Contact Dermatitis in babies, a skin disease that develops due to surrounding environment.

Irritant contact dermatitis is usually common in infants

In general, dermatitis is referred to as inflammation of skin and contact dermatitis is inflammation of skin caused due to contact or sensitivity towards foreign object. The skin disease has two forms, Irritant Contact Dermatitis and Allergic Contact Dermatitis.

Allergic contact dermatitis is slow to show reaction as the antibodies take time to produce. It takes place when theimmune system is sensitive towards certain substance, including food. Irritant contact dermatitis can by direct contactwith chemical substances such as soaps, fabric softeners, detergents or body lotions (that’s applied by the mothers). The reactions can be burning and irritating.

Contact dermatitis is also called as Contact Eczema.  Some infants suffer from both types simultaneously.

Contact Dermatitis in Babies

Irritant Contact Dermatitis

Irritant Contact Dermatitis (ICD) happens when the baby has direct contact with substances that produce rashes and irritation. In this case symptoms usually appear within 2 days from contact. Babies who wear diapers are prone to this type of dermatitis. Here the diaper skin is affected and the reaction is prolonged due to contact with urine and stool.

Other reasons why babies may develop this skin problem include:

  • Baby food
  • Drools
  • Soap
  • Detergent
  • Bleach
  • House cleaning products
  • Perfume and cosmetics applied by mothers
  • Cold wind
  • Raw food
  • Toiletries
  • Metals such as nickel used in cheap jewelleries
  • Latex found in rubber toys, nipples and pacifiers
  • Plants like poison ivy, oak, sumac

Any child can develop ICD; however, children who already have atopic dermatitis (Eczema) are at a higher risk for developing contact dermatitis. The substances remove skin oils and moisture present in the skin, making the area dry, scaly and peeling.

Allergic Contact Dermatitis

Allergic Contact Dermatitis (ACD) occurs when the body’s immune system reacts to a chemical or allergic producing substance. Again, the skin reaction will be visible only in the area that came in contact with the allergen.

How it is different from ICD? When the baby’s skin comes in contact with the allergic producing substance for the first time, the body becomes sensitised towards it and the immune system starts reacting. Its only when the skin comes in contact with the same substance again, an itchy red rash appears on the skin.

Your body will remember the allergy for many years. However, unlike ICD, ACD sensitization takes sometime to build up. Allergic Contact Dermatitis is less common in babies and toddlers.

Allergic Contact Dermatitis can cause due to

  • Perfumes
  • Preservatives found in toiletries
  • Plants such as Christmas pine, ivy etc.
  • Topical medicines in the form of creams such as hydrocortisone and antibiotics
  • Paraphenylenediamine found in hair dyes
  • Cosmetics
  • Rubber and latex in toys
  • Cheap jewellery made out of nickel
  • Non children friendly glues like Epoxy resins

Symptoms of Contact Dermatitis

Symptoms vary in each child.The common body parts that are affected by contact dermatitis include

  1. Hands, between fingers and back of the hand
  2. Face, especially the mouth area as babies tend to put everything inside mouth
  3. Body, due to friction from clothes

Some of the signs and symptoms of Contact Dermatitis in Babies are;

  • Painful rashes
  • Red marks, almost like small pimples
  • Sheets of skins
  • Swollen hands or body part
  • Itchy skin
  • Bleeding rashes (especially if its chronic)
  • Peeling skin
  • Hardened and scaly skin
  • Dry and cracked skin
  • Blisters

Diagnosing and Treating Contact Dermatitis in Babies

ICD – Doctors will examine the rash and go through the child’s diet and family history. He may ask to change certain things in the home environment and habits on the basis of the examination and questions asked.

In case the ICD recurs quite often, the doctor may suggest for patch test by an allergist to find out if it’s ACD.

ACD –The allergist, who is specialised in treating allergies, will test a particular portion of body by placing small pieces of paper tapes infused in chemicals. After 48 hours, the tape will be removed to see the chemical reaction on the skin.

***ACD test can be performed only on children above 5 years of age.

The rashes usually disappear within one to four weeks. The doctor may prescribe 1% diluted hydrocortisone ointment for mild cases and oral steroids for severe cases affecting larger skin area.


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