Occupational dermatitis is not one
specific type of eczema. It is any type of eczema caused by a
person’s workplace. This distinct classification came about because
occupational dermatitis has unique causes and a large number of
people develop eczema on the job.
develop occupational dermatitis on their hands. This chef
frequently handles garlic and now has allergic contact
dermatitis caused by an allergy to diallyl disulfide, a
compound found in garlic.
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Signs and Symptoms
According to estimates, 5% of men and 10% of women in the
workforce develop eczema on their hands from workplace exposure.
Most often this occurs when something that touches the skin causes
irritation (irritant contact dermatitis) or an allergic reaction
(allergic contact dermatitis). Occupational dermatitis also
frequently develops on the forearms and face. Signs and symptoms
of occupational dermatitis include:
Dry, chapped skin (mild case)
Raw and irritated-looking skin (more
Redness, swelling, scaly skin,
wearing away of the top layers of skin, cracks, blisters, and skin
ulcers (more severe)
Itching, burning, and/or stinging of
the affected skin
If the condition persists for some
time, the skin may thicken
Anyone who has frequent exposure to substances that can
irritate the skin or who uses strong chemicals on the job can
develop occupational dermatitis. With frequent use, even
substances as mild as water and detergent can irritate the skin
and cause eczema.
The causes of occupational dermatitis are many and
dermatologists often find that more than one cause plays some
role. Leading causes include:
Repeat exposure to substances that
over time irritate the skin.
Long-term exposure to a substance
that over time becomes an allergen (substance to which the person
Airborne particles that become
trapped against the skin, such as under the collar or beneath the
Harsh chemical(s) touches the hands
or saturates the clothes, causing eczema.
Working with chemicals that become
toxic when exposed to sunlight. Most common amongst roofers and
Occupation. People in certain
occupations have a higher risk.
A study of 42,839 patients with contact dermatitis found that
about 27% of these people developed eczema from on-the-job
exposure. Five occupations — housekeeper, bricklayer, worker in
the metallurgic or mechanical industry, hairdresser, and
health-care worker — were responsible for more than 60% of these
Studies in the United States, Canada, and Europe conclude that
other occupations with a higher-than-average risk include janitors
and maids, florists, bakers, bartenders, caterers, cooks, and
Industry. Working in some
industries, especially agriculture and manufacturing, increases
Age. Several studies suggest
that susceptibility decreases with age.
Gender. Women seem to have an
increased risk and more intense reactions.
Atopic condition. Persons who
have a history of atopic dermatitis, a type of eczema, have an
increased risk of developing hand dermatitis, especially if they
frequently immerse their hands in water while at work.
wetting and drying the hands damages the skin’s protective
barrier, making it easier for irritants and allergens to penetrate
the skin. By contrast, a low-humidity environment also can damage
the skin’s protective barrier, making it more susceptible to
irritants and allergens.
Occupational dermatitis can become
chronic (long-lasting) if the irritants or allergens continue to
contact the skin and the condition is not effectively treated.
Even the slightest exposure can
trigger a flare-up once the skin clears.
Diagnosis of an occupational skin disease often requires some
detective work by both the patient and the dermatologist. A
Take a complete medical history and
thoroughly examine the patient’s skin.
Ask questions about when the
condition first appeared, when it worsens, and when it gets
Order patch testing if allergic
contact dermatitis, a common type of eczema, is suspected. Patch
testing is a safe and effective way to identify allergens
(substances to which a person is allergic).
During a patch test, strips of tape that contain small amounts of
several possible allergens, usually 25 to 150, are applied to the
patient’s back. The amounts are too small to cause a reaction
unless the person is allergic. After 2 days, the patient returns,
and the tape is removed. If a small red spot appears, the person
is considered allergic to the substance. After 96 hours, the
patient is checked again to see if any delayed reactions occur.
Since allergic contact dermatitis occurs so often in some
occupations, testing may include a series of potential allergens
unique to a profession or industry. Special series of allergens
were developed for bakers, hairdressers, as well as people who
work with cooling oils, glues, metals, plastics, and rubber.
The sooner occupational dermatitis is diagnosed and treated, the
better the prognosis. Chronic (long-term) occupational dermatitis
can be difficult to treat. Treatment for occupational dermatitis
Avoiding the substance(s) causing
the irritation or allergy. The patient must avoid the cause.
Avoiding all substances that can trigger a flare-up can be
difficult — if not impossible — when the person encounters these
substances at work. Dermatologists can help their patients develop
an effective “avoidance” strategy. This may include using a
barrier cream and wearing gloves or doing some tasks differently.
Sometimes changes also are needed at home. The condition can be
worsened by direct exposure to things around the home, such as
soaps and detergents.
Treatment to help clear the skin.
Treatment may include applying emollients and moisturizers
frequently throughout the day, using a topical anti-itch product,
taking an oral antihistamine to help stop the itch, and applying a
topical corticosteroid or calcineurin inhibitor to reduce
inflammation. In more severe cases, phototherapy treatments may be
used to suppress the person’s overactive immune response. If an
infection develops, antibiotics are necessary.
If contact dermatitis persists despite treatment, oral or
injectable corticosteroids can be used for a short time to get the
inflammation under control.
Following a skin care program.
The dermatologist may recommend a skin care program. Following
this program can help prevent the condition from getting worse and
prevent future outbreaks.
Belsito DV. “Occupational contact dermatitis: Etiology,
prevalence, and resultant impairment/disability.” Journal of the
American Academy of Dermatology. 2005. August;53(2)303-313.
Belsito DV et al. “Pimecrolimus Cream 1%: A Potential New Treatment
for Chronic Hand Dermatitis.” Cutis. 2004.
Cvetkovski RS et al. “Prognosis of Occupational Hand Eczema.”
Archives of Dermatology. 2006. March;142(3):305-311.
Fowler JF et al. “Contact Dermatitis.” Presented as a forum at: The
64th Annual Meeting of the American Academy of
Dermatology. March 2006; San Francisco.
The Lewin Group (prepared for the Society for Investigative
Dermatology and the American Academy of Dermatology Association).
“The Burden of Skin Diseases.” 2004.p. 37-40.
Sertoli A et al. “Epidemiological survey of contact dermatitis in
Italy (1984-1993) by GIRDCA.” American Journal of Contact
Dermatitis. 1999. March;10(1):18-30.
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developed by the American Academy of Dermatology
Studies show that, in
general, people who develop eczema as a result of their
jobs do not need to change jobs.