There are two types of dermatitis caused by substances coming in contact with the skin: primary irritant dermatitis and allergic contact dermatitis.
The primary irritant dermatitis is due to a non-allergic reaction of
the skin resulting from exposure to an irritating substance. Allergic
contact dermatitis is the allergic sensitization to various substances.
Primary irritant Dermatitis
People who work in areas where their feet are exposed to repeated or
prolonged contact to chemicals, oils, or wet cement can develop primary
irritant dermatitis. There are certain solutions that people soak their
feet in as home remedies. Some of these solutions are safe if used
properly, but their improper use can cause a significant contact
dermatitis. This can result in skin break down and infection. This is
particularly dangerous in people with diabetes; the result can be
devastating and limb threatening. A common misconception is the value of soaking in hot water.
Some people believe that the hotter the water the better. Quite to the
contrary, hot water can cause damage to the skin and result in first or
second-degree burns. People will soak their feet in all sorts of
solutions. Common solutions are bleach, vinegar, salt water and
iodine-based solutions such as betadine. If used properly and under the
guidance of a doctor, these solutions can be beneficial. A common
mistake that is made is to create solutions that are too strong. Should
this occur, irritation to the skin and the development of a rash can develop. The dermatitis that results can also become secondarily infected.
Allergic contact Dermatitis
Allergic contact dermatitis is the result of exposure to substances
that sensitize the skin, so that each time one becomes exposed to it
again, an inflammatory reaction will occur. Some people are allergic to
the substances in the dyes of socks or the materials used to make shoes.
The rash
that develops is in a pattern that reflects the exposure to the
substance. Adhesive tapes can cause an allergic reaction with blisters
or a rash
developing beneath the tape. Not all blistering or rashes from tape on
the feet however are an allergic reaction. Because of the heat and the
accumulation of moisture beneath the tape an acute athlete’s foot
infection may occur.
Treatment
Treatment should be directed at the cause of the dermatitis. Burns
should not be treated with ointments because ointments are too occlusive
and can trap the heat in the burned tissues resulting in further tissue
damage. Cool compresses are soothing and can limit the damage caused by
the burn. The dermatitis caused by the soaking of the feet in
concentrated solutions act like chemical burns and cool compresses are
also useful in this instance. Dermatitis caused by an allergic reaction
will respond well to topical steroid compounds like hydrocortisone
cream. Steroid creams should not be used unless you are certain that the
condition is caused by an allergy. Cortisone creams will mask infection
and allow infections to get worse while reducing the normal
inflammatory reaction associated with infections. Anti-fungal creams are
useful in the treatment of athlete’s foot that may be caused by
occlusion under adhesive tape.
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