Contact Dermatitis Patch Testing

A few months ago I developed under eye swelling and facial rash that started out slowly, but worsened over time. At first it would last 3 days from first symptom to clearing, and would happen again a week or two later until I got to the point where my face was so swollen and covered with a rash, that I went to the dermatologist. I had been seen by an allergist that said it was contact dermatitis, and the best way to figure out what was causing it was to do a patch test. While I had not changed any facial products, cleaning items or detergents, he said I could develop an allergy to something I have been using forever. As the face is so sensitive, all it would take is for me to touch something I was allergic to and then touch my face to have a reaction. As I do touch my face often without really realizing it, this made perfect sense.

The dermatologist was able to get my face back to almost normal with oral and topical steroids as well as some antibiotics in the event I had picked up staph at work. I changed my face soap, and only wear foundation and blush for work, dropping all eye make up. I am only using Vaseline on my lips instead of a Blistex product I have always used. I had been doing well for the last few weeks until the other day I had swelling again. I did use the Blistex lip moisturizer once or twice during Thanksgiving as it was sitting on the counter and I was too tired to walk up the stairs to get the Vaseline! Don’t know if that was the cause or not, but it is all I changed in the last few week.

I am scheduled to have the Patch Testing next week and hope something shows positive, if not, I am back to dropping products from use and seeing when I next wake up to swelling. For those that have had Patch Testing, were you able to find out what caused problems? I know the test is not 100% as of course they can not test for everything, just the most common allergens.

I am not looking for medical advice, just others experience with contact dermatitis and/or Patch Testing. I believe my doctors are working in my best interest to get to the bottom of the problem.

Just an anecdotal note – I’ve read nail polish can trigger dermatitis in the eye area, though I believe it is typically limited to the eyelid area.

Yes, that was the first thought of my allergist, and I went without polish for a few weeks with no change. I happen to have very soft nails, and without polish they peel and split. While I still keep them short, no polish would have left me with nubs to avoid catching on everything.

At least you’ve ruled out one possible cause, then!

I had the same issue with “contact dermatitis” - started near my eye, but also was on/in both ears! Hadn’t changed a thing about my habits, and wear no eye makeup. I needed prednisone for the initial swelling/rash, and was referred to an allergist. However, when I discovered that my insurance wouldn’t cover the patch testing (over $1,000), and that it may not be helpful I decided to hold off. I’ve been applying Cortizone cream daily to the small patch that remains near my eyebrow and one earlobe. Keep us posted on whether the patch testing is successful (I may do it after all).

FWIW, I am allergic to tree nuts, grass, mold, pollen, trees, and dust mites. I also have Oral Allergy Syndrome (can’t eat raw fruits and vegetables). It just dawned on me that I stopped taking (generic) Zyrtec months ago. I think I’ll start again and see if it does anything for my symptoms.

When I stop taking at least 1/2 to whole tablet generic Zyrtec daily, I tend to get off hives and rashes plus have trouble sleeping. It is one of my daily meds.

I have no other allergies, so this is what was so puzzling. It can on so quickly and would disappear and then come back a week or two later. The rash and swelling are only on my face, never anywhere else; not behind my ears, my hairline or neck. When I have an outbreak, it starts with what looks like a big blister under my eyes, and dryness around my lips, not on my lips.

I really think it is a food allergy, but all the doctors seem to think it is contact dermatitis or possibly eczema. The allergist is hoping not eczema as he says that would be a lifelong problem. If contact dermatitis, if we can find the culprit, if I can avoid it, I might not have issues anymore. There is a Mexican restaurant we eat at often, and I have had swelling within days of eating there. We had avoided it for weeks, but when the kids were home for Thanksgiving, we went Saturday night. I woke up to some swelling and a small rash in the same spot as usual on Monday morning. As I trial, we ate there last night to see if it happens again; nothing this morning so we will see what I look like tomorrow morning!

Interesting and timely thread for me. My 16 year old is just going for her first visit to an allergist tomorrow, where patch testing might be on the list.

Since toddlerhood she has had eczema, but it went away sometime in middle school. Her allergies were usually fairly seasonal, controlled with Claritin. Now, it is all back with a vengeance, in new places. It is ugly and raw looking.

She also has a patch of dandruff on her eyelid, which her primary care doctor has kept at bay with - of all things - baby shampoo on the affected eyelid. She normally takes Allegra morning and night, and Eucrisa topically when things get unbearable. The poor thing has been off everything for a week in anticipation of this appointment, and is really beside herself right now.

We have not noticed any allergies except to cats (we don’t have any). So I really do hope they do whatever they need to do, including testing, to figure this out.

She got a steroid shot from her primary care doctor and she was like a new woman in 24 hours and it was the happiest she has been in months. He refused to give her another one, however, instead referring her to a specialist.

A family member developed contact dermatitis to Neosporin, a product they had used for many years. OP - you can develop an allergy to a product at any time, and your suspicion about food may be correct. I’d avoid everything that is suspect. You may want to keep a daily written record of the products you’ve used and foods you’ve eaten. I would also get a new pillow and pillowcase. Hopefully your patch test gives some results.

Check to see if any of your cosmetic products contain natural ingredients, such as oak moss. Some of these things are highly allergenic. My mother did not develop her oak moss allergy until she was in her mid-50s. It took forever to diagnose.

I had the patch test that they attach to your back, it tests 80 or so different chemicals. I didn’t react to anything. I then went to an allergist and had blood tests. I was allergic to a few things but, although my blood showed I was having an allergic reaction, none of the specific allergens were that high. I hope you have better luck!

Is eyelid atopic dermatitis the same as eyelid dandruff? My kiddo was prescribed tacrolimus for treating (eyelid) atopic dermatitis.

@bearcatfan

Do you use eye drops, prescription or OTC? They contain preservatives and can cause reactions (though probably not around your lips).

Re the Mexican food. Rather than an allergy, you may be eating a food item with your fingers and then rubbing your eyes. This could trigger the reaction.

@Madison85 I"m not sure, but my daughter had a kind of buildup on her eyelid that was diagnosed as eyelid dandruff (it might have been called something different but that’s the layman’s term that was used).

She was first prescribed ammonium lactate cream to start sloughing off the buildup. Then, she was advised to use dandruff shampoo to keep it at bay. Later, a nurse practicioner suggested baby shampoo, which is much gentler and does the same thing. After she got tired of me reminding her, she is finally doing it on her own every other day or so and it hasn’t come back.

She still has the other skin issues. And I don’t know if it’s all related or not, but hopefully we find out today.

^^ That sounds like blepharitis.

I developed an allergic reaction to the antiperspirant I was using. I was buying large multi-packs at Costco and was on the last one in this particular pack, so it wasn’t that they had recently changed an ingredient. I had huge, red hives under both arms by the time I figured it out. So it is possible to develop an allergic reaction to a product you have used for a long time. Fortunately in my case, a hypoallergenic version of Dry Idea is working so far.

Funny timing on this thread - I’m going in for allergy testing later this week. I’ve had hay fever for years but in the past 6 months I’ve also developed some sort of new contact allergy, likely to something in Tide or some other detergent-like ingredient. It was really bad over the summer (I was so itchy all over my torso and backside). It had gotten a lot better with switching to gentler soaps and detergents. Then last week I put on my Christmas flannel shirt for the first time since last December and I broke out in hives on my chest within an hour! So after that I made the appointment for the testing. I saw my son have it done when he was little so I know how it works. Hopefully this test will cover whatever this thing is that I’m newly allergic to and not just the grass pollen, etc that I already was aware of.

I thought I’d come back and report on the patch testing on my 16 year old.

The results: She is allergic to dust mites, ragweed, cats, dogs, horses, six types of trees, three types of molds, and grass. Her grass test was the biggest reaction the nurse and doctor had ever seen, poor thing.

She got two prescriptions - one for a bedtime allergy pill as needed and one for a topical cream - and some OTC advice for a couple things. Take a Xyzal daily. Continue the Eucrisa as needed from the neck up, but the other cream was to be used on the crooks of her elbows as needed. We talked about allergy shots, but we all agreed to see how this worked first and come back in a month.

I wish I had done this sooner, but it was never this bad until now. She really had outgrown the eczema, but obviously other things were in play. We adopted her, so we have no family history to go by.

I’ve had patch testing done. I will warn you @snowball - it was extremely uncomfortable. I had so much tape on my back to make sure the patches stayed in contact that I was unable to stand up completely straight! Plus, I started reacting to things right away and it itched like mad.

That said, I am very glad that I had it done. Unlike most people that have patch testing done, I did not regularly suffer from contact dermatitis. Instead, I would get severe reactions that sometimes necessitated steroids. I thought I had identified what was the problem, and then I’d get a surprise reaction. The last time I dyed my hair (March) caused me an incredible amount of skin irritation and then I reacted to sunscreen on spring break and that was the last straw.

It turned out that it was the perfumes that were the biggest issue and since eliminating my allergens, my scalp has completely healed and my hair is getting thicker. I haven’t had a single incidence of hives since the testing in April. I’ve also had my medical chart flagged with my multiple metal allergies, as the only implants I can have are titanium. (I had stopped wearing earrings because my ears were constantly infected. I didn’t know that I was actually severely allergic to three metals.) Eliminating all the products hasn’t been easy, and there are certain things I really miss. But when I cheated and used my husband’s toothpaste, I developed several sores in my mouth, so I know using my kids toothpaste is the right thing to do for my health.

It’s not easy living with and managing allergies like this (I also have many environmental allergies) but I’d encourage you to get the testing and make the modifications because IMO, it is worth it.

@bearcatfan Sounds like your daughter had skin testing (pricks), not a patch test. Sorry your daughter has so many allergies, but it is helpful to know what she is allergic to. A patch test is actually applying the allergen on the back where it stays for 48 hours before the patch is removed. It requires several follow up appointments to check for reactions.

@My3Kiddos I know there is a chance the patch test will be uncomfortable. I don’t know how long ago it was when you were tested, but the patches are small enough now that hopefully it won’t be a problem. I know a women who has an allergic reaction to one brand of hair dye, but was able to find one she could use.