Textile Contact Dermatitis

Textile contact dermatitis, also called clothing dermatitis, is a skin disorder caused by wearing certain clothing or having fabrics come in contact with the skin. This condition can arise from the fabric itself, as an individual reaction to textile fibres, or as a contact allergy to chemical additives used in fabric production, such as finishing agents or textile dyes.

Textile fibres can be natural, synthetic, or a combination of both. Wool, silk, cotton, and linen are classified as natural fibres. Nylon, rubber, fibreglass, and spandex are classified as synthetic or human-made fibres.

Allergic skin reactions to textiles are usually caused by formaldehyde finishing dyes, resins, glues, tanning agents, and chemical additives used in processing clothing or fabric. These substances are often used to make fabrics wrinkle-resistant. Allergic contact dermatitis can also be triggered by para-phenylenediamine (PDD), which is used in fur and textile dyes. Other contact allergens that can cause contact dermatitis include latex, rubber accelerators, chrome, and cobalt.

Metallic fasteners and elastic used in clothing that come in contact with the skin can also cause contact dermatitis.

Textile contact dermatitis is characterised by delayed redness, itchiness, and scaling reactions. These symptoms can appear after a few hours of contact with the material or after a few days.

The affected body sites include areas that come the most in contact with clothing, such as the crooks of the arm, armpits, backs of the knees, and the buttocks. The condition may worsen if constant rubbing between skin and fabric occurs, as well as through sweating in hot and humid environments. In some cases, the rash can become secondarily infected with bacterial organisms or yeast.

A higher prevalence of textile contact dermatitis is found in women than in men. One possible explanation is that women tend to wear more form-fitting and colourful clothing. Individuals with sensitive skin or atopic dermatitis are at higher risk, as are those who carry excess body weight. Textile contact dermatitis is also very common among people who work in hot or humid environments, such as restaurant kitchens, bakeries, foundries, and laundries, as well as those employed in the textile industry.

Diagnosis of textile contact dermatitis requires an initial consultation with a dermatologist, after which patients are referred for patch testing. This procedure involves testing against a wide range of different chemicals, as many potential allergens can be present in fabric.

Once the fabric or clothing causing contact dermatitis is removed, the skin is expected to clear relatively quickly. In mild cases, over-the-counter creams and ointments, such as hydrocortisone 0.5 to 2.5%, may be used to reduce redness, swelling, and itching. In more severe cases, a prescribed steroid cream may be required. Oral antibiotics may be prescribed if a skin infection is identified.

The most effective way to prevent textile contact dermatitis from recurring is to avoid contact with clothing or fabrics that contain allergens to which an individual is sensitive. However, it may be difficult to completely eliminate certain textiles or to individually identify each allergen. Several recommendations are advised to reduce the risk of contact dermatitis:

• Wearing clothing made from natural fabrics such as linen and cotton is suggested.
• Light-coloured clothing is preferable, as it contains fewer dyes.
• In hot or humid environments, loose-fitting clothing is recommended.
• Clothing labelled "wash separately" is best avoided, as its dyes are likely to bleed easily from the fabric.