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 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.