Primary Irritant Cosmetic Dermatitis

This rash on both palms concerned a 35-year-old hairdresser, who said she always wears vinyl gloves while working. She recalled using a new hair coloring product on a client a few days earlier. Within 24 hours of applying the substance, the rash began to erupt; it worsened over the course of 2 days.

Hair dyes are among the agents that most commonly cause primary irritant cosmetic dermatitis. Other culprits are lipstick, nail lacquer, antiperspirant, and sunscreen. The severity of rash, which varies from person to person, depends on the condition of the skin at the time of exposure, the strength of the irritant, and the duration and location of exposure. Local factors, such as occlusion and perspiration that facilitate the irritant’s absorption, can affect the condition.

Hairdressers are continually exposed to sensitizers—eg, hair dyes, ammonium persulfate, amphoteric surfactants, and glyceryl thioglycolate. Despite the use of gloves, reactions to these agents can develop.

Topical corticosteroids, antihistamines, and oral prednisone resolved this patient’s rash in 10 days. Mild outbreaks may respond to antihistamines alone.