Clinical Reviews in Allergy & Immunology

, Volume 56, Issue 1, pp 99–109 | Cite as

Irritant Contact Dermatitis

  • Sonia N. BainsEmail author
  • Pembroke Nash
  • Luz Fonacier


Contact dermatitis accounts for 95% of occupational skin disorders. Irritant contact dermatitis (ICD) is often caused by cumulative exposure to weak irritants, accounting for 80% of all cases of contact dermatitis. ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with AD and ACD may have a lower inflammatory threshold for developing ICD. Therefore, it needs to be distinguished from lesions of AD and ACD. ICD Patients report stinging and burning in excess of pruritus. Pruritus is classically reported by patients with AD and ACD. ICD lesions are typically well-demarcated unlike AD and ACD. ICD is diagnosed by exclusion. Patients undergo testing to rule out type I and type IV hypersensitivity. Negative results suggest a diagnosis of ICD. Management consists of irritant identification and avoidance with regular emollient use. Although ICD is more common in certain occupations, genetics and environment play significant roles in its development.


Irritant contact dermatitis (ICD) Allergic contact dermatitis (ACD) Contact dermatitis Patch testing Occupational skin disease 


Compliance with Ethical Standards

Conflict of Interest

Sonia Bains is currently a Speaker for Pfizer 090117. Luz Fonacier received research and educational grants from Winthrop University Hospital, Genentech, Baxter, Pfizer, and Regeneron. She is also a Treasurer of the American College of Allergy, Asthma & Immunology (2015–2018) and a member of the American Board of Allergy and Immunology (ABAI) (2016–present). Pembroke Nash declares no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Seyfarth F, Schliemann S, Antonov D, Elsner P (2011) Dry skin, barrier function, and irritant contact dermatitis in the elderly. Clin Dermatol 29(1):31–36CrossRefGoogle Scholar
  2. 2.
    Diepgen TL, Coenraads PJ (1999) The epidemiology of occupational contact dermatitis. Int Arch Occup Environ Health 72(8):496–506CrossRefGoogle Scholar
  3. 3.
    Fartasch M, Schnetz E, Diepgen TL (1998) Characterization of detergent-induced barrier alterations -- effect of barrier cream on irritation. J Invest Dermatol Symp Proc 3(2):121–127CrossRefGoogle Scholar
  4. 4.
    Yang L, Mao-Qiang M, Taljebini M, Elias PM, Feingold KR (1995) Topical stratum corneum lipids accelerate barrier repair after tape stripping, solvent treatment and some but not all types of detergent treatment. Br J Dermatol 133(5):679–685CrossRefGoogle Scholar
  5. 5.
    Smith HR, Basketter DA, McFadden JP (2002) Irritant dermatitis, irritancy and its role in allergic contact dermatitis. Clin Exp Dermatol 27(2):138–146CrossRefGoogle Scholar
  6. 6.
    Nosbaum A, Vocanson M, Rozieres A, Hennino A, Nicolas JF (2009) Allergic and irritant contact dermatitis. Eur J Dermatol: EJD 19(4):325–332Google Scholar
  7. 7.
    Gittler JK, Krueger JG, Guttman-Yassky E (2013) Atopic dermatitis results in intrinsic barrier and immune abnormalities: implications for contact dermatitis. J Allergy Clin Immunol 131(2):300–313CrossRefGoogle Scholar
  8. 8.
    Suarez-Farinas M, Tintle SJ, Shemer A, et al. (2011) Nonlesional atopic dermatitis skin is characterized by broad terminal differentiation defects and variable immune abnormalities. The Journal of allergy and clinical immunology 127(4):954–964.e951–954Google Scholar
  9. 9.
    Palmer CN, Irvine AD, Terron-Kwiatkowski A et al (2006) Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet 38(4):441–446CrossRefGoogle Scholar
  10. 10.
    Proksch E, Brasch J (1997) Influence of epidermal permeability barrier disruption and Langerhans' cell density on allergic contact dermatitis. Acta Derm Venereol 77(2):102–104Google Scholar
  11. 11.
    Shimada S, Caughman SW, Sharrow SO, Stephany D, Katz SI (1987) Enhanced antigen-presenting capacity of cultured Langerhans' cells is associated with markedly increased expression of Ia antigen. J Immunol (Baltimore, Md : 1950) 139(8):2551–2555Google Scholar
  12. 12.
    Onoue A, Kabashima K, Kobayashi M, Mori T, Tokura Y (2009) Induction of eosinophil- and Th2-attracting epidermal chemokines and cutaneous late-phase reaction in tape-stripped skin. Exp Dermatol 18(12):1036–1043CrossRefGoogle Scholar
  13. 13.
    Mori T, Kabashima K, Yoshiki R, Sugita K, Shiraishi N, Onoue A, Kuroda E, Kobayashi M, Yamashita U, Tokura Y (2008) Cutaneous hypersensitivities to hapten are controlled by IFN-gamma-upregulated keratinocyte Th1 chemokines and IFN-gamma-downregulated Langerhans cell Th2 chemokines. J Investig Dermatol 128(7):1719–1727CrossRefGoogle Scholar
  14. 14.
    Thyssen JP, Skare L, Lundgren L, Menné T, Johansen JD, Maibach HI, Lidén C (2010) Sensitivity and specificity of the nickel spot (dimethylglyoxime) test. Contact Dermatitis 62(5):279–288CrossRefGoogle Scholar
  15. 15.
    Clark SC, Zirwas MJ (2009) Management of occupational dermatitis. Dermatol Clin 27(3):365–383 vii-viiiCrossRefGoogle Scholar
  16. 16.
    Rougier A, Dupuis D, Lotte C, Roguet R, Wester RC, Maibach HI (1986) Regional variation in percutaneous absorption in man: measurement by the stripping method. Arch Dermatol Res 278(6):465–469CrossRefGoogle Scholar
  17. 17.
    Scharschmidt TC, Man MQ, Hatano Y, et al. (2009) Filaggrin deficiency confers a paracellular barrier abnormality that reduces inflammatory thresholds to irritants and haptens. J Allergy Clin Immunol;124(3):496–506, 506.e491–496Google Scholar
  18. 18.
    Klas PA, Corey G, Storrs FJ, Chan SC, Hanifin JM (1996) Allergic and irritant patch test reactions and atopic disease. Contact Dermatitis 34(2):121–124CrossRefGoogle Scholar
  19. 19.
    Lerbaek A, Kyvik KO, Mortensen J, Bryld LE, Menne T, Agner T (2007) Heritability of hand eczema is not explained by comorbidity with atopic dermatitis. J Investig Dermatol 127(7):1632–1640CrossRefGoogle Scholar
  20. 20.
    Zhai H, Maibach HI (2001) Skin occlusion and irritant and allergic contact dermatitis: an overview. Contact Dermatitis 44(4):201–206CrossRefGoogle Scholar
  21. 21.
    Uter W, Gefeller O, Schwanitz HJ (1998) An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands. Br J Dermatol 138(2):266–272CrossRefGoogle Scholar
  22. 22.
    Fluhr JW, Akengin A, Bornkessel A, Fuchs S, Praessler J, Norgauer J, Grieshaber R, Kleesz P, Elsner P (2005) Additive impairment of the barrier function by mechanical irritation, occlusion and sodium lauryl sulphate in vivo. Br J Dermatol 153(1):125–131CrossRefGoogle Scholar
  23. 23.
    Bock M, Schmidt A, Bruckner T, Diepgen TL (2003) Occupational skin disease in the construction industry. Br J Dermatol 149(6):1165–1171CrossRefGoogle Scholar
  24. 24.
    Menne T, Johansen JD, Sommerlund M, Veien NK (2011) Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema. Contact Dermatitis 65(1):3–12CrossRefGoogle Scholar
  25. 25.
    Lodde B, Paul M, Roguedas-Contios AM, Eniafe-Eveillard MO, Misery L, Dewitte JD (2012) Occupational dermatitis in workers exposed to detergents, disinfectants, and antiseptics. Skinmed 10(3):144–150Google Scholar
  26. 26.
    Oiso N, Fukai K, Ishii M (2005) Irritant contact dermatitis from benzalkonium chloride in shampoo. Contact Dermatitis 52(1):54CrossRefGoogle Scholar
  27. 27.
    Loden M, Wessman C (2002) Mascaras may cause irritant contact dermatitis. Int J Cosmet Sci 24(5):281–285CrossRefGoogle Scholar
  28. 28.
    Bordel-Gomez MT, Miranda-Romero A (2008) Fibreglass dermatitis: a report of 2 cases. Contact Dermatitis 59(2):120–122CrossRefGoogle Scholar
  29. 29.
    Modi GM, Doherty CB, Katta R, Orengo IF (2009) Irritant contact dermatitis from plants. Dermatitis: contact, atopic, occupational, drug 20(2):63–78Google Scholar
  30. 30.
    Morris-Jones R, Robertson SJ, Ross JS, White IR, McFadden JP, Rycroft RJ (2002) Dermatitis caused by physical irritants. Br J Dermatol 147(2):270–275CrossRefGoogle Scholar
  31. 31.
    Gibson WB (1963) Sweaty sock dermatitis. Clin Pediatr 2:175–177CrossRefGoogle Scholar
  32. 32.
    Friis UF, Menne T, Schwensen JF, Flyvholm MA, Bonde JP, Johansen JD (2014) Occupational irritant contact dermatitis diagnosed by analysis of contact irritants and allergens in the work environment. Contact Dermatitis 71(6):364–370CrossRefGoogle Scholar
  33. 33.
    Fonacier LS, Dreskin SC, Leung DY (2010) Allergic skin diseases. J Allergy Clin Immunol 125(2 Suppl 2):S138–S149CrossRefGoogle Scholar
  34. 34.
    Simpson EL, Thompson MM, Hanifin JM (2006) Prevalence and morphology of hand eczema in patients with atopic dermatitis. Dermatitis: contact, atopic, occupational, drug 17(3):123–127CrossRefGoogle Scholar
  35. 35.
    Roberts RO, Jacobsen SJ, Reilly WT, Pemberton JH, Lieber MM, Talley NJ (1999) Prevalence of combined fecal and urinary incontinence: a community-based study. J Am Geriatr Soc 47(7):837–841CrossRefGoogle Scholar
  36. 36.
    Fisher AA (1980) Cosmetic dermatitis. Part II. Reactions to some commonly used preservatives. Cutis 26(2):136–137 141–132, 147–138Google Scholar
  37. 37.
    Medenica M, Rostenberg A Jr (1971) A comparative light and electron microscopic study of primary irritant contact dermatitis and allergic contact dermatitis. J Investig Dermatol 56(4):259–271CrossRefGoogle Scholar
  38. 38.
    Suarez-Farinas M, Gittler JK, Shemer A, Cardinale I, Krueger JG, Guttman-Yassky E (2013) Residual genomic signature of atopic dermatitis despite clinical resolution with narrow-band UVB. J Allergy Clin Immunol 131(2):577–579CrossRefGoogle Scholar
  39. 39.
    Chew AL, Maibach HI (2003) Occupational issues of irritant contact dermatitis. Int Arch Occup Environ Health 76(5):339–346CrossRefGoogle Scholar
  40. 40.
    Brancaccio RR, Alvarez MS (2004) Contact allergy to food. Dermatol Ther 17(4):302–313CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Allergy Partners of RaleighRaleighUSA
  2. 2.State University of New YorkStony BrookUSA
  3. 3.NYU Winthrop HospitalMineolaUSA

Personalised recommendations