Textile contact dermatitis, also called clothing dermatitis, is a skin disorder caused by wearing certain clothing and/or having fabric(s) coming in contact with the skin. This issue can arise from fabric itself which is individual’s reaction to textile fibres, or be a contact allergy to the chemical additives used in fabric’s production, such as finishing agents or textile dyes. 

Textile fibre can be either 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 due to formaldehyde finishing dyes, resins, glues, tanning agents, and chemical additives used in process clothing or fabric. For example, they are often used to make fabrics wrinkle-resistant. Moreover, allergic contact dermatitis can 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.   

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

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

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

The higher prevalence of textile contact dermatitis is found in women than in men. One of the possible explanations is that women tend to wear more “fitting” and colourful clothing. Moreover, individuals with sensitive skin or atopic dermatitis are at higher risk of being affected. Obese or heavier individuals are also at greater risk. Also, textile contact dermatitis is very common among people who work at hot/humid environments, such as restaurant kitchens, bakeries, foundries, and laundries as well as those in the textile industry. 

Diagnosis of textile contact dermatitis requires initial consultation with a dermatologist and then these patients are refereed for patch testing. This procedure requires testing against a wide range of different chemicals since many potential allergens can be found in the fabric. 

Once the fabric/clothing that causes contact dermatitis is removed, the skin is expected to clear very soon. In mild cases, over-the-counter creams and ointments, such as hydrocortisone 0.5-2.5%, 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 skin’s infection is found.

The best way to prevent textile contact dermatitis from re-occurring is to avoid wearing and coming into contact with clothing and/or fabrics that contain allergen one is sensitive to. However, it may be difficult to completely eliminate certain textiles and individually identify each allergen. There are some recommendations advised to follow in order to reduce contact dermatitis. For example, it is suggested to wear clothing made out of natural fabrics like linen and cotton. Wearing clothing which is light-coloured because it contains less dyes. In hot/humid environments, it is suggested to wear loose fitting clothing. Lastly, if the clothing item is marked “wash separately,”  it is recommended to avoid it because its dyes will easily bleed from fabric. 

Centre for Medical and Surgical Dermatology offers different Textile contact dermatitis treatments unique to each patient.

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