Contact dermatitis
Introduction
Contacteczema is an inflammatory reaction of the skin that develops after contact with certain substances. The skin can become reddish, itchy, dry or scaly. If a stronger or acute reaction occurs, swelling, vesicles and wet spots may also occur. If contacteczema lasts longer, the skin can be thicker, rougher and cracked.
There are two main forms: irritating contact eczema and allergic contact eczema. In case of irritating contact eczema, the skin is directly damaged by irritating substances or repeated stress. In case of allergic contact eczema, the immune system reacts to a substance for which someone has become sensitive.
Recognizing and, where possible, avoiding the causing substance is an important part of the treatment. Acupuncture and Chinese herbal medicine can also be tailored to the characteristics and phase of the eczema and the underlying TCM pattern.
Common symptoms
Contact eczema usually occurs in areas where the skin has come into contact with the substance causing it. Depending on its severity and duration, the following symptoms may occur:
- itching, burning or irritating sensation;
- redness;
- swelling;
- small bumps or blisters;
- wet skin abnormalities;
- crust formation;
- dryness and scaling;
- cavities;
- thickening and roughening of the skin in case of prolonged complaints.
In an acute reaction, redness, swelling, vesicles and moisture are more common in the foreground. Chronic contact eczema is usually drier and may be associated with scaling, thickening and painful gorges.
Irritative and allergic contact eczema
Irritative contact eczema
In case of irritating contact eczema, a substance or other load directly damages the skin barrier. No allergy need be present for this.
The reaction may occur after one-off strong exposure, but more often it is caused by repeated contact with relatively mild irritating factors. Examples include frequent contact with water, soap, cleaning agents, solvents, chemicals and friction.
This makes it easier for people who often wash their hands or work with water and irritants to develop complaints.
Allergic contact eczema
Allergic contact eczema has an allergic reaction to a particular substance. First, sensitisation occurs: the immune system becomes sensitive to the substance. A subsequent exposure may result in eczema.
Possible allergens include metals such as nickel, fragrances, preservatives, cosmetics, hair dye, rubber components and certain plants.
The skin reaction usually occurs at the point of contact, but can also spread outside with a strong reaction.
Possible causes and triggering factors
Which substances cause contact eczema varies greatly per person and is also dependent on work, hobbies and products that are used regularly.
Common exposures are, for example:
- water and frequent hand washing;
- soap and cleaning agents;
- cleaning products;
- solvents and chemicals;
- cosmetics and skin care products;
- perfumes and fragrances;
- metals;
- rubber and adhesive;
- hair dye;
- plants and garden products.
With chronic exposure, the skin barrier may become increasingly damaged. As a result, the skin can become more sensitive to substances that have previously caused little problems.
If allergic contact eczema is suspected, a dermatologist may use adhesive tests (epicuntaneous allergy tests) to investigate for which substances a person may be allergic.
How can acupuncture help with contact dermatitis?
In the case of contact eczema, avoiding or limiting the substance causing it remains the main point of departure. Acupuncture does not alter a contact allergy and cannot compensate for continuous exposure to an irritating substance.
The treatment is tailored to the way in which the eczema appears and may be aimed at:
- reduce itching and skin irritation;
- reduce redness and heat;
- help to reduce swelling;
- reduce vesicles and wetness of skin;
- support dry, scaly or cracked skin;
- support the recovery of the skin after reducing the stimulating effect.
An acute, red and wetting reaction in Chinese medicine requires a different approach than chronic contact eczema with dry, thickened and cracked skin.
How can Chinese herbal medicine help with contact dermatitis?
Chinese herbal medicine is also adapted to the phase and appearance of the contact eczema. In addition to the local skin reaction, it also looks at other complaints and the total TCM pattern.
Depending on the skin image, treatment may be directed at:
- reduce itching and irritation;
- soothe redness and heat;
- reduce moist, wet or blistering skin discomfort;
- reduce dryness and scaling;
- support damaged or cracked skin;
- treat long-term skin problems if they persist after repeated exposure.
Herbs can be used daily between treatments. In the Chinese dermatology, external herbal treatments are also applied to contact eczema. Which application is suitable depends, among other things, on the condition of the skin.
TCM vision on contact eczema
In traditional Chinese Medicine, contact eczema is also assessed on the basis of the phase and appearance of the skin. The external stimulus is important, but people may react differently to the same exposure according to the TCM.
With an acute reaction with clear redness, swelling, vesicles and moisture, the main focus is Heat and Dampness. If the itching is strong, Wind can also play a role.
If contact eczema remains present for a long time, the skin image can change. The skin is more often dry, scaly, rough and thickened. Within the TCM such chronic images are previously associated with insufficient nutrition and moistening of the skin by Blood and Yin .
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns in contact eczema
Damp-Heat
Brief explanation
This is mostly an acute and active skin image. Dampness is connected to vesicles, moisture and wetting skin defects within the TCM, while Heat is mainly found in redness, heat and inflammation.
Common symptoms
- clear redness;
- swelling;
- severe itching;
- a warm or burning sensation;
- bumps and blisters;
- wet skin abnormalities;
- crust formation.
Wind-Heat
Brief explanation
With Wind-Heat, itchyness, redness and a relatively sudden skin reaction are mainly present in the foreground. The skin image is usually less moist than with pronounced Dampness-Heat.
Common symptoms
- sudden redness;
- strong itching;
- a warm feeling of skin;
- red bumps;
- limited or no moisture formation;
- sometimes enlargement of the skin rash.
Blood-Heat with Wind
Brief explanation
With this pattern the skin is clear red and the itching is often strong. Wind contributes to the itching according to the TCM, while Blood Heat is associated with an intense and more persistent redness.
Common symptoms
- red or dark red skin;
- strong itching;
- a warm or burning sensation;
- dry or slightly scaly skin abnormalities;
- scratch marks;
- low wet moisture.
Blood-Dryness with Wind
Brief explanation
This pattern is especially seen when contact eczema exists for a long time. According to the TCM, the skin is not sufficiently nourished and moistened, resulting in dryness. Wind contributes to the persistent itching.
Common symptoms
- dry skin;
- scaling;
- itching;
- raw or thickened skin;
- cavities;
- scratch marks;
- low redness and virtually no moisture formation.
What can you do for yourself?
The detection and avoidance of the causing substance is particularly important in contact eczema. If exposure persists, the eczema can be stimulated over and over again despite treatment.
In addition, try to limit excessive contact with water, soap and cleaning agents when irritating the skin. Protective gloves may be useful in certain activities, but the type of glove should fit the substance you work with and wear for a long time due to heat and sweating can sometimes cause irritation.
A suitable fatty cream or ointment can help to support the skin barrier. If a contact allergy is suspected, research by a general practitioner or dermatologist may help to identify the substance in question.
Outlook
The prognosis is strongly related to the cause and ability to prevent further exposure. An acute reaction may unwind relatively quickly when the causing stimulus is removed. In case of prolonged or repeated exposure, contact eczema can become chronic and the skin can remain dry, thickened and cracked.
In case of allergic contact eczema, sensitivity to the relevant allergen usually persists. It is therefore important to recognise and avoid it in order to prevent new reactions.
As a directive, acupuncture can be used once a week in the initial phase. When complaints are reduced and stable, the frequency can be reduced. Chinese herbs can be used daily between treatments when appropriate.
Medical safety
Allow persistent or regular contact eczema to be assessed when the cause is not clear. In case of suspicion of allergic contact eczema, reference for adhesive testing may be useful.
Contact your doctor if you experience rapid redness, pain, pus, extensive yellow crust formation, fever or feeling sick, as this may indicate skin infection.
If contact with a substance leads to complaints outside the skin, such as swelling of mouth or throat or breathing problems, immediate medical assessment is necessary.
Use prescribed medication and ointments according to appointments with doctor or dermatologist and do not change them independently.
Contact
Do you suffer from contact eczema and do you want to know if acupuncture and/or Chinese herbal medicine can match your symptoms? During a first consultation we discuss skin complaints, when and where they occur, possible exposure to irritating or allergenic substances and other relevant symptoms.
On the basis of the overall complaint picture, it is considered which TCM pattern is likely to be at the forefront and which treatment fits in with it.