As the body’s largest organ, the skin requires constant care and attention. Though it is resilient, the skin can also be aggravated by various irritants, substances, materials and other allergens, often found in personal hygiene products, resulting in a red, itchy and uncomfortable rash known as allergic contact dermatitis. When left unresolved, this inflammatory skin condition can diminish your comfort, confidence and quality of life. Unfortunately, many patients suffer persistent discomfort for years before seeking treatment, while others are dependent on topical and oral medications that only result in temporary relief. However, once allergic contact triggers are identified and effective allergen avoidance strategy is executed, the skin rash condition can be treated with less dependence on medications.
At California Dermatology Care, clinical specialists led by Dr. William Ting are committed to helping patients improve and restore their skin health. For those seeking to test for skin allergies, he offers North American Extended Patch Test series with 80 allergens, which arguably is among the most comprehensive patch testing available in clinical private practice. Skin allergy patch test (testing for delayed typed skin contact sensitivity) is different from allergy skin prick test done by allergists (testing for immediate type hypersensitivity) that are more relevant for allergic rhinitis or asthma but typically not very useful for skin rash investigation. As a member of the American Contact Dermatitis Society, Dr. Ting is recognized as an authority in skin allergy patch testing in the East Bay. He draws on the most advanced techniques and tools to help patients identify potential triggers of their skin condition and possibly become better informed consumers next time they visit cosmetic counters or grocery aisles.
What is Contact Dermatitis?
Contact dermatitis is characterized by an itchy red rash caused by direct contact with a particular substance or an allergic reaction to it. Though the condition is not life-threatening or contagious, it can be uncomfortable and unsightly. Allergic contact dermatitis occurs when the skin comes into contact with an allergen, triggering a response from the immune system that results in inflammation and itchiness. This condition accounts for approximately half of all contact dermatitis cases. Symptoms of allergic contact dermatitis include:
- Blistered areas that may ooze
- Dry, scaly areas of skin
- Red patches of skin
- Burning sensation with no visible skin sores
- Sun sensitivity
Why Get Tested?
When left untreated, allergic contact dermatitis can lead to persistent uncomfortable symptoms. Without an accurate diagnosis, the condition can also worsen and cause more severe symptoms that affect your ability to complete certain tasks or daily activities. Patients who turn to medication may find temporary relief, though they can also become burdened with additional side effects or medical costs while the main issue remains unresolved.
Patch testing boasts a myriad of benefits for patients suffering from allergic contact dermatitis. By accurately identifying the cause of the problem, patients can be aware of potential triggers and become better-informed consumers as a result. Grasping a clear understanding of the substances that harm your skin can help you avoid allergens, eliminate uncomfortable symptoms and effectively resolve the condition.
Allergic contact dermatitis occurs when your immune system responds adversely to a specific substance. Strong allergens, such as poison ivy, may trigger a reaction after a single exposure, while weaker allergens may trigger an allergy after multiple exposures over several years. Some of the most common allergens include:
- Nickel, which is used in jewelry, buckles, door knobs, keys and other metal items.
- Fragrances, which can be found in perfumes, soaps, lotions and shampoos.
- Medications such as over-the-counter antibiotic creams.
- Cosmetics and personal care products, such as deodorants, body washes, hair dyes and nail polish.
- Preservatives, such as formaldehyde and sulfites, which are used in foods, cosmetics and skincare products to extend their shelf-life.
- Chemical sunscreen, which can cause a hive-like rash that appears hours or days after application.
- Rubber or latex ingredients, which can result in itching or burning.
- Parabens, which are used in shampoos, moisturizers, shaving gels and cosmetics.
There is a wide variety of ingredients, substances and materials that can cause skin sensitivities and allergies. At California Dermatology Care, we encourage anyone experiencing redness, itchiness and irritated skin to undergo North American Extended Patch Test series patch testing for a comprehensive analysis of potential allergens that may be harming your skin.
Patch Testing – The Gold Standard
Patch testing remains the gold standard for evaluating allergic contact dermatitis. As a recognized leading dermatologist in the East Bay, Dr. Ting along with clinical specialists at California Dermatology Care conducts a meticulous patch testing process to efficiently and accurately test for skin allergies. He utilizes the Extended Patch Test Series by the North American Contact Dermatitis Group (NACDG), which tests for the 80 most common allergens, including nickel, preservatives and fragrance mix. Not only detailed brochures of identified allergens will be provided, a comprehensive database of commercially available skin care products free of allergens identified will be emailed to our patient upon request after skin patch testing. This comprehensive process offers the best chance for a successful diagnosis, while also ruling out other suspected ingredients.
What Happens During A Patch Test?
A medical assistant will apply the prepared panels of testing chemicals to your back after has been cleaned. They will then secure the panels with tape and mark the edges for future reading. If you are allergic to adhesives, you can apply over-the-counter hydrocortisone cream to the taped areas after the first patch test reading. Please inform your provider if you are on immunosuppressant therapy including (but not limited to) oral steroids(ex.prednisone), intramuscular steroid injections, and full-body light therapy (NBUVB).
Day 1: Patch test application
Day 2: No action or office visit needed. Avoid wetting the back/showering.
Day 3: First patch test reading. We will take off the patches but leave the marking for next day’s reading. Light showering is allowed. Avoid scrubbing.
Day 4: Final patch test reading.
Patch Test Reading
The severity of allergic reaction is ranked from trace, 1+, 2+ to 3+, with trace being the most minimal and 3+ being the most severe reaction. Depending on the allergen(s) you test positive to, the ways to avoid the allergens will likely vary. In addition to skin products, clothing and even diet need to be changed. Consult your medical provider if you are interested in patch test or believe that you have allergic contact dermatitis. Consult your insurance for pricing/coverage.
How can I manage my skin allergies?
You will receive:
- CAMP list: it is a comprehensive list of products appropriate to use that excludes any allergen you test positive to (sent via email)
- Information sheets of detailed description of the allergens(at each patch test reading visits)
Please utilize the CAMP list for your future shopping. Ingredient listings often do not contain all ingredients or may use less common names of allergens.
80 Allergens Tested
5. imidazolidinyl urea
7. amerchol l-101
8. carba mix
10. thiuram mix
12. ethylenediamine dihydrochloride
13. epoxy resin
15. 4-tert-butylphenolformaldehyde resin
16. mercapto mix
18. potassium dichromate
19. balsam peru
20. nickel(ii)sulfate hexahydrate
21. diazolidinyl urea
22. dmdm hydantoin
24. mixed dialkyl thiourea
26. paraben mix
27. methyldibromo glutaronitrile
28. fragrance mix i
31.sesquiterpene lactone mix
32. fragrance mix ii
33. propylene glycol
34. 2-hydroxy-4-methoxybenzophenone (eusolex436)
35. chloroxylenol (pcmx)
36. ethyleneurea, melamine formaldehyde mix
37. iodopropynyl butylcarbamate
38. disperse blue mix 106 / 124
39. ethyl acrylate
40. glyceryl thioglycolate
41. toluenesulfonamide formaldehyde resin
42. methyl methacrylate
43. cobalt(ii)chloride hexahydrate
46. compositae mix ii
47. hydrocortisone-17-butyrate 1
48. dimethylol dihydroxy ethylene urea
49. cocamidopropyl betaine
50. triamcinolone acetonide
52. dibucaine hydrochloride
53. lauryl polyglucoside
56. hema (2-hydroxyethyl methacrylate)
58. lyral (hydroxyisohexyl 3-cyclohexene
59. benzyl alcohol
60. dl-alpha-tocopherol 1
62. fusidic acid sodium salt
63. coconut diethanolamide
64. tea tree oil
65. ylang ylang oil
66. benzalkonium chloride
68. gold(i)sodium thiosulfate dihydrate
71. sodium lauryl sulfate
73. isoamyl p-methoxycinnamate
74. 2-tert-Butyl-4-methoxyphenol (BHA)
76. disperse orange 3
77. disperse yellow 3
78. benzyl salicylate
79. isopropyl myristate
80. polysorbate 80
What are the Other Testing Options Available?
Patch testing is the most common and most effective test available for allergic contact dermatitis. Skin prick allergy testing is a completely different process performed by allergists to identify the cause of conditions such as allergic rhinitis or asthma. This procedure involves pricking the skin surface with different extracts and substances to provoke a reaction. Skin prick testing helps to identify type I immediate-type hypersensitivity commonly associated with pollens, trees, grasses, dust mite and food. However, since skin allergies involve type IV delayed-type hypersensitivity, skin prick testing is rarely helpful for skin sensitivities. Patch testing is specifically designed to isolate potential delayed-type skin hypersensitivities from contact triggers, which is most relevant for allergic contact dermatitis.
Food allergies are not typically the cause behind skin rashes, so food allergy testing is usually not necessary for skin eruptions, particularly for adults 18 years and older. However, for special circumstances and upon request, Dr. Ting may order bloodwork for food allergen RAST panels.
Schedule Your Patch Test at California Dermatology Care
At California Dermatology Care, we have helped countless men and women effectively diagnose and treat skin allergies. Our clinical specialists are experienced and expertly trained by Dr. William Ting in managing various skin concerns and conditions. California Dermatology Care is proud to be a leading clinic for skin patch testing in the Bay Area and beyond. If you are experiencing redness, itchiness or inflammation on your skin and would like to identify the cause, text us at 925-328-0255 to schedule your consultation today.