Textile contact dermatitis | DermNet

Author: Vanessa Ngan, Staff Writer.

What is textile contact dermatitis?

Textile contact dermatitis or clothing dermatitis can be defined as skin manifestations caused by wearing clothing and/or other fabrics that come into contact with skin. The source of the skin problem may be the fabric itself (i.e. reaction to textile fibres) or more commonly a contact allergy to the chemical additives used in processing the fabric, e.g. textile dyes and finishing agents.

Textile dermatitis

Rubber dermatitis

Nickel dermatitis

Intertrigo

What causes textile contact dermatitis?

Textile fibre can be natural, synthetic or a combination of the two materials. Natural fibres include silk, wool, cotton and linen. Synthetic or man-made fibres include rayon, nylon, polyester, rubber, fibreglass, and spandex. Although all fibres can cause irritant and allergic contact dermatitis, it is rare for them to cause allergic contact dermatitis.

Allergic skin reactions to clothing is most often a result of the formaldehyde finishing resins, dyes, glues, chemical additives and tanning agents used in processing the fabric or clothing. Cases of allergic contact dermatitis have been reported for the following fabric additives.

• Formaldehyde resins used in fabrics to make them wrinkle-resistant
• Para-phenylenediamine (PPD) used in textile and fur dyes
• Azo and anthraquinone based dispersal dyes. These dyes are loosely bound to the fabric structure and can easily rub off onto the skin. They are rarely used in textiles nowadays
• Flame retardants [tris(2,3-dibromopropyl) phosphate (13) and 2,3-dibromocresylglycidyl ether]

Other contact allergens that may be incorporated into the fabric of clothing and cause contact dermatitis include chrome, cobalt, latex and rubber accelerators.

Metallic fasteners and elastic in clothing can also cause contact dermatitis where they are in contact with skin. Metallic stud fasteners on blue jeans are a common cause of nickel dermatitis.

What are the symptoms of textile contact dermatitis?

Textile contact dermatitis is typically characterized by delayed reactions such as redness, scaling and itchiness. The symptoms may appear within hours of contact with the material, or sometimes a reaction may not be seen until days later.

The areas of the body most often affected are the crooks of the arm, backs of the knees, armpits, groin area and buttocks; places that are in most contact with the clothing. In addition, the dermatitis may worsen with constant rubbing by the fabric against the skin and by sweating in hot/humid environments. Sometimes the friction from clothing can cause a condition called intertrigo. In some situations the rash can become secondarily infected with yeast or bacterial organisms.

Who gets textile contact dermatitis?

Textile contact dermatitis is more common in women than in men. This is most probably because women wear more “fitting” and colourful clothing. Anyone may be affected but people with atopic dermatitis or sensitive skin are at greater risk. Other groups of people that may be at greater risk include obese or heavier individuals and those that work in hot/humid environments such as bakeries, restaurant kitchens, foundries and laundries. Textile contact dermatitis is a significant problem for workers in the textile industry.

Diagnosis by performing special allergy tests, i.e. patch tests, may involve testing against a number of different chemicals due to the many potential allergens that may be present in the fabric. It is often very difficult to determine the exact cause because textiles nowadays have been manufactured using a cocktail of dyes, resins and other substances. Also, clothing is not labeled with a list of chemicals it may possess.

See individual contact allergens for patch testing recommendations.

What is the treatment for textile contact dermatitis?

Contact dermatitis should clear rapidly once the offending fabric/clothing is removed. Over-the-counter creams and ointments containing mild topical steroids, such as hydrocortisone 0.5-2.5%, may be used to help control itching, swelling, and redness. In more severe cases, a prescription steroid cream may be required, as well as oral antibiotics if the skin becomes infected.

What should I do to avoid textile contact dermatitis?

If you suffer from textile contact dermatitis the best way to prevent any problems is by avoiding all clothing or fabrics that contain the allergen you are sensitive to. Sometimes this will be difficult to do as textiles are treated with a concoction of chemicals and dyes that are not individually identified. Some steps you can take to reducing contact dermatitis reactions include:

• Wear clothing that is made out of natural fabrics such as cotton and linen
• Wear clothing that is light coloured as these will contain less dye
• Wear loose fitting clothing in hot/humid environments
• Avoid clothing that is labeled “non-iron” and “dirt-repellent” as it is likely these have been chemically treated
• Avoid clothing marked “wash separately” as this implies dyes easily bleed from the fabric

Your dermatologist may have further specific advice, particularly if you are highly sensitive to particular textile allergens.

Which fabrics and fibres can cause allergies?

What is fabric allergy?

Have you ever had skin rashes after contact with a specific fabric? The material might make you allergic. The main sympotmps for fabric allergy are contact dermatitis (redness, scaling, and itching), burning eyes and tightness in the chest . Para-phenylenediamine and formaldehyde resins are the main causes of fabric allergies. These synthetic components provide fabrics their waterproof and wrinkle- and shrinkage-resistant properties. Formaldehyde resins can treat even some natural fibers, therefore it’s critical to research the manufacturers of your materials.

Which fabrics are most likely to cause allergies?

Common fibers including polyester, acrylics, rayon, and nylon can be harmful to those with skin problems. These fibers tend to trap moisture and are hydrophobic, which might irritate your skin. Lyocell and modal, two types of rayon manufactured from wood pulp, are acceptable alternatives. They offer good absorption qualities and are more environmentally and financially responsible solutions.

Natural fibers like wool can aggravate atopic dermatitis in most people and trigger skin reactions when used in winter clothing. 

*Wool, synthetics and nylon fabrics are the most common culprits for allergic reactions, which can also be very unpleasant.

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What kinds of fabric are best for sensitive skin?

Cotton, linen, cashmere, silk, hemp, and semi-synthetic fabrics manufactured from wood pulp are some of the most popular fabrics that are friendly to the skin. For people with various skin disorders, any fiber with good conductive and wicking qualities is beneficial.

Bamboo is a worthwhile material to purchase. This fiber has anions, which are good for the body and skin because they assist to clean the blood, relaxing the nervous system, and relieving allergy symptoms. Due to its antimicrobial qualities, which aid in keeping the skin bacteria-free, the material has seen an increase in use in the textile industry.

Although there are numerous skin-friendly materials available, not all natural fibers are always beneficial to the skin. When manufactured with hazardous colors, some materials like cotton and linen can be detrimental.

Guide for sourcing skin-friendly fabrics 

• Regardless of whether the fabric is cotton, wool, cashmere, or synthetic fibers, it is crucial to choose high-quality materials with a low micron. Possum fiber has a tapered tip that is only 1-2 microns in diameter, making it particularly comfortable to wear.
• Pick fabrics with effective moisture management capabilities. This will aid with comfort and reduce bacterial growth on the skin by drawing moisture away from the wearer’s skin. 
• Choose materials that can regulate temperature, such wool, which can control body heat in both hot and cold situations.
• Pick strong fabrics.  Strong fibers won’t break when the fabric is being made, which results in fewer fiber ends poking out of the cloth and less of a “prickle factor. ”

How can I get a fabric allergy diagnosis?

An allergy test can be administered by an allergist to determine whether you actually have a fabric allergy. An allergy patch test might help you figure out what materials or substances aggravate your skin. The test typically confirms the diagnosis in two days. In the event that the results are favorable, your doctor will create a treatment strategy for you.

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Clothes allergy… an overview of hypoallergenic fabrics

Can cotton cause allergies? What can you learn from labels on clothes? Which cotton fabric does not cause allergies? Features of linen clothing….

Why can even cotton cause allergies?

The thing is that any plant material, be it cotton, wool, silk, is treated with chemicals in the production of fabrics to increase strength and appearance, dye, and only then sew clothes from this fabric.
If you buy an item that says “100% cotton” on the label, it contains only 70% cotton, 8% chemical dyes, 14% formaldehyde, 8% softeners, etc. By the way, today there are more than 7,000 approved (but far from harmless) textile auxiliaries.
The most dangerous for sensitive skin are dyes and improvers – substances that retain the shape of clothing and prevent it from wrinkling. According to statistics, 30% of things treated with improvers are the cause of allergies. One example of improvers is formaldehyde and synthetic resins, the dangers of which you have probably already heard.

What type of cotton fabric should it be so that it does not cause allergies?

What can you learn from sewn-in labels on clothes that are on the Russian market?
• The “Euroflower” and “Eco-tex” label are safe, high-quality industrial textiles that will suit most people without any skin problems.
• Sign “100% organic cotton” and “Naturtextile” (in the presence of a license number on the package) – things of the highest ecological quality, safe even with exacerbation of skin allergies, able to alleviate the condition of dermatitis.
Refuse to buy items that have the following words on the label.
• “Mercerized”, “No Fangling” – Treated with chemicals for smoothness, strength and shine. Not recommended for exacerbations of skin diseases.
• “Easy Care”, “No Ironing”, “Machine Wash Resistant” – treated with artificial resins that contain formaldehyde – the most allergenic substance.
• “Chlorine Bleached” – may exacerbate allergic dermatitis.

However, when choosing clothes made from linen, consider the following.

As for flax, this material is processed in smaller volumes by chemicals during cultivation, which, unfortunately, cannot be said about cotton. It is strong enough in itself, does not shrink, is easily and well washed, therefore, in the production of fabrics from it, no improvers dangerous to health are needed.
In addition, it has bactericidal properties – under linen clothes, wounds and pimples heal faster than under cotton, and even more so synthetic.

• Prefer clothes in a particular linen color. But bleached linen and bright fabrics are better not to buy.
• Remember that real flax should be wrinkled (it’s as natural as real milk should go sour, not stand for years at room temperature). If it is impossible to make folds on the fabric, then it is treated with anti-crease resins. For sensitive skin, this thing is dangerous.
• Try to find linen items with soft seams.
In any case, look for stores where you have already bought clothes that do not cause skin irritation.

Types of hypoallergenic fabrics in the EcoFABRICS catalog

100% cotton fabric

White 100% cotton fabric

Patterned cotton

Heavy cotton

Thick cotton fabric, white

Natural cotton waffle fabric

hemp fabric

Unbleached undyed hemp fabric

Turquoise hemp fabric

100% hemp fabrics

White hemp fabric

Thick white hemp fabric

knitted hemp fabric with cotton

Hemp fabric with organic cotton, caramel shade

Fabric hemp jersey with cotton plum

fabrics for summer coat

Hemp fabric with yak wool

Wool fabric with hemp green

summer fabrics

Fabric black biosilk with hemp

Natural hemp and silk fabric

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Clothes are not only about fashion and comfort, but sometimes also about allergies. What causes clothing allergies and how to deal with it?

Clothing allergies usually manifest as contact dermatitis. Usually it is redness and irritation of the skin, rash, peeling, itching. In order not to confuse a skin reaction to clothes with other forms of allergies, you need to know that these symptoms most often occur under the knees, on the buttocks, in the groin, under the arms and in the folds of the arms. Symptoms may get worse if your clothes are chafing or if you sweat a lot in the heat. In places where the skin is damaged, there is a danger of bacterial and fungal infections.

Allergic rhinitis from inhalation of chemicals contained in clothing has not been ruled out; allergic conjunctivitis may also occur.

Sometimes the reaction occurs a few hours after exposure to the allergen, sometimes after a few days.

Clothing contact dermatitis is more common in women than in men. According to experts, this is because women wear more tight-fitting clothes, moreover, multi-colored, that is, made using dyes. Clothing allergies are more likely to develop in people with atopic dermatitis and people with sensitive skin. Another risk group is overweight or obese people, as well as those who work in hot and humid areas: in bakeries, in the kitchen of canteens and restaurants, in laundries, in foundries. And of course, textile workers.

Mechanism of development of the reaction

An allergic reaction develops if the immune cells perceive the substances contained in clothing as foreign and dangerous. As a result, blood cells begin to produce protective antibodies that spread throughout the body, including reaching skin cells. When antibodies and protective cells interact, histamine is released, which provokes allergy symptoms.

7 causes of clothing allergy

Allergies can be caused not only by fabrics and other materials used in clothing, but also by chemicals used to process or finish them: glue, dyes, etc.

Wool. Wool contains wool wax – fatty particles of sheep’s wool, from which lanolin is obtained by simple manipulations. That is what causes the allergic reaction. Lanolin is often used in cosmetics: skin care products, lip balms, shampoos, so if you are sensitized to lanolin, look for products that do not contain it.

Silk is a natural protein fiber and protein is a common cause of allergies. No wonder silk causes allergic contact dermatitis.

Latex is the milky sap of rubber plants, which also contains proteins. In the last 15-20 years the problem of allergy to latex has gained particular relevance. This is due to the widespread use of latex, including in medical gloves and toys. Latex gives elasticity to fabrics, which is why it is often used in clothing, in particular in underwear.

Metals. Buckles, buttons, zippers and studs made from nickel or cobalt are a common cause of contact dermatitis. According to statistics, nickel allergy in the form of contact dermatitis affects up to 12.5% ​​of the population, mostly women: they are more likely to wear jewelry in which this metal is present.

formaldehyde resins are used to provide wrinkle-resistance and strength to fabrics and to protect against disease-carrying insects and other parasites. It is the formaldehyde that remains on clothing that usually becomes the main cause of allergic contact dermatitis; in addition to skin itching, irritation and rash, it can cause burning in the eyes and even tightness in the chest.

To avoid exposure to formaldehyde, it is recommended to wash new clothes before wearing them. Washing also helps to get rid of pollen, animal hair and dust that can live in dust mites that have stuck to clothes. The content of formaldehyde resin and other allergens is greatly reduced when washed in hot water. After several washes, the formaldehyde is completely washed out.

If you are allergic to formaldehyde, avoid wrinkle-resistant cotton and spandex (elastane) blends.

Para-phenylenediamine. Allergies are often caused by dyes, mainly present in them para-phenylenediamine (PPD) . All paints contain this substance to some extent, but black dyes contain the most PPD. If you react to this substance, buy undyed or white items. Or look for clothes that don’t use PPD.

Polytetrafluoroethylene (other names are PTFE and Teflon). It is used in modern membrane materials from which high-tech clothing is sewn. From polytetrafluoroethylene, a thin porous film is obtained, which is applied to the fabric. This film can protect clothing from the wind or have water-repellent properties, but most importantly, it allows the material to breathe, that is, to let body evaporation out.