In less than a month, three patients walked into the dermatology office of Lisa A. Garner, MD, complaining of red, irritated skin that later developed brown streaks. Garner quickly figured out the cause. After accidentally spilling lime juice on themselves — “Margaritas, anyone?” — each patient developed a case of sun-induced dermatitis after going outdoors.
Many of us know that harsh cleaning products are common skin irritants around our homes. But what about the odd culprits—not just lime juice, but tulip bulbs, hand sanitizers, antibiotic ointments, and even metal zippers or snaps?
If your skin flares up after touching something, the resulting contact dermatitis takes one of two forms, says Garner, a clinical professor of dermatology at the University of Texas Southwestern Medical Center and a fellow of the American Academy of Dermatology.
First, in a true allergic reaction, your immune system responds to an offending substance and your skin may turn red and itchy. Second, you might not have an allergy at all, but rather, irritation, which typically causes pain, stinging or burning.
A wide range of substances can cause contact dermatitis, but not in everyone. “Irritation is an interesting concept,” Garner says. “It’s exceedingly variable from person to person and really has to do with a threshold response to some particular ingredient.”
Some surprising offenders:
Hand sanitizers: When swine flu fears were in full swing, Garner saw lots of patients with irritant hand dermatitis after rubbing on way too much hand sanitizer.
“Everyone’s afraid of germs, but our skin can’t tolerate [hand sanitizer] as much as some people are using it,” she says.
In most cases, the active ingredient, ethyl alcohol, is probably causing the irritation, but it’s possible that some people are sensitive to other ingredients in the product, she says.
“Hair removal products can be very irritating. It’s truly an individual thing, and it depends on what part of the skin you’re doing,” she says. “If you do hair removal on your face or bikini line, you’re much more likely to have irritation than if you do your legs.”
The underarms pose another sensitive zone for some people who use antiperspirants. “Their job is to actually clog your sweat glands—that’s how they work,” Garner says. “It’s an area that’s warm and sweaty. You’ve got skin on skin, which always increases your risk of irritation.”
Furthermore, Garner has lost count of patients with inflamed eyelids from using too many products. “Not a week goes by that I do not have someone in my office with eyelid dermatitis. The majority of time, this is going to be an irritation reaction.”
It’s often tough to figure out the exact source because many women use multiple eye cosmetics, as well as eye makeup remover and eye creams, Garner says. Patients can get into a vicious cycle. “They start getting a skin rash—usually a very itchy rash—and then people keep putting their cosmetics on to hide it, which actually keeps the rash going.” The best thing is to take a break from all eye products and let the skin heal, she says.
Antibiotic ointments: “Big problems through real allergies,” Garner says of these over-the-counter products. Many households treat cuts and scrapes with triple antibiotic ointments that contain neomycin, bacitracin and polymixin B.
But neomycin and bacitracin are common allergens, according to Garner. “It’s especially a problem because you’re putting that on injured skin. Whenever you put anything on injured skin, you’re more likely to react to it.”
Bandages: When some people apply bandages to the same patch of skin, they can develop irritation after a while, according to Garner. “They’ll end up with sensitivity to the bandage adhesives.”
Nickel: Many people notice an itchy, prickly rash on their finger after wearing a ring. Or certain earrings will irritate their earlobes. Most likely, they’re reacting to nickel, which shows up in jewelry and many other metal items.
But most people don’t know that skin can also react to nickel in zippers, buttons, clothing snaps and belt buckles. Garner has even seen a flute player whose lips developed a reaction after coming into contact with nickel in the instrument.
Plants: Many plants can cause irritant reactions or true allergic reactions, Garner says. Of course, poison ivy is a well-known villain, causing a rash and blisters through a plant oil called urushiol.
But seemingly ordinary plant matter, including tulip bulbs, garlic, and mango rinds can also cause skin reactions in certain people.
Rubber: Rubber products, which can be found throughout the home, can provoke allergic contact dermatitis marked by itching, burning or hives. “You can be allergic to the mouse pad, to swim goggles, your shoes—your tennis shoes have rubber insoles,” Garner says.
How can you tell what’s causing your contact dermatitis?
If you can figure out what’s causing your skin irritation or allergy, you can avoid contact with the substance and let your skin heal.
But it’s not always easy to pinpoint the source on your own--just ask the lime juice patients. “These types of skin problems can be difficult to tease out,” Garner says.
If your skin doesn’t heal in a couple of weeks or it’s getting worse, see a dermatologist, Garner says. Don’t let dermatitis go on too long, she says. Some of her patients have spent several months futilely trying to hide irritated eyelids with makeup before they seek medical help.
If skin is red and swollen or weeping, “You really need to see somebody right away,” Garner says. “It could be an allergy, like poison ivy, but it could be an infection.”
One last bit of startling advice: “You should never use a household cleaning product on your skin,” Garner says. In the movie, My Big, Fat Greek Wedding, the bride’s father used glass cleaner as an all-purpose skin remedy—and yes, Garner has seen patients do the same.
“You’d be surprised how many people do that,” she says. Some of her patients have also attempted to heal various skin problems by dabbing on gasoline. “It’s making it worse, without a doubt,” Garner says.