Post-surgical contact dermatitis is a localized rash that is almost always a reaction to something that came into contact with your skin.
Having any kind of surgery means being exposed to many materials and medications. The National Eczema Association says that people who have allergies to any of those things or if the skin is irritated by them may end up with a rash called contact dermatitis.
Contact dermatitis generally comes in two forms:
- Irritant contact dermatitis. It’s an acute or chronic skin irritation or inflammation caused by contact with a chemical, biologic, or physical agent. This is the most common form, accounting for around 80 percent of all cases.
- Allergic contact dermatitis. It’s skin irritation or inflammation caused by contact with an allergen (also known as contact allergy). This form accounts for the remaining percentage of cases.
Both of these conditions are usually localized to the areas of skin that come into contact with the specific substance/irritant.
The American Academy of Allergy, Asthma and Immunology shares that up to 20 percent of people have contact dermatitis.
While we don’t know how many people will experience a rash after surgery, people who have previously had contact dermatitis may have a higher chance of having a similar reaction after surgery.
A rash around a surgical incision is fairly common. It may be from the glue or adhesive used to close the wounds, or from antibiotic ointments applied to the wound to prevent infection. These materials can irritate the skin or cause an allergic reaction in some people.
There are two main causes of this type of rash:
- Medication. This includes topical medications such as antibiotic creams that are applied directly to the skin.
- Surgical supplies. These include nonhypoallergenic supplies such as surgical glue or adhesives, antiseptic prep solutions, surgical dressings like bandages and tape, and even rubber products like blood pressure cuffs.
Symptoms of contact dermatitis include:
- itchiness or burning
- redness or discoloration, or visible rash
- mild swelling
- skin blisters that may drain fluid (especially if you scratch at the rash)
- thickening or scaling on the skin
- bumps on the skin
Contact your doctor immediately if your wound or the area around it becomes red or discolored, hot, or itchy, or if green, yellow, or cloudy discharge drains out. This can indicate infection, which needs to be treated right away.
The American Academy of Dermatology Association (AADA) says that to determine the type of rash you have and what’s causing it, your doctor will consider your health history and perform a physical exam. They will examine the rash itself, noting its size, shape, color, severity, and other characteristics.
The AADA also says that a patch test can be done to determine if the rash is allergic contact dermatitis. In some cases, your doctor may want to perform a skin biopsy as well.
Treatment for contact dermatitis is generally very simple. It’s a good idea to let your doctor know if you develop a rash after surgery. While your rash may resolve quickly, you may need to change bandages or medications your doctor has prescribed.
When to seek emergency careA rash can be an early symptom of a life threatening allergic reaction called anaphylaxis. The AADA recommends emergency care if you have any of these symptoms. Call 911 if you have:
- shortness of breath or difficulty breathing
- swelling in eyes or lips
- a rash that appears quickly, spreads, and covers all or most of your body
- a fever with rash
- a rash that is painful to touch
- blisters with rash
- a rash that appears infected
Simple home and over-the-counter (OTC) treatments can treat contact dermatitis as well. If allergic dermatitis is the diagnosis, avoiding the irritant is the first line of defense. Additional options for both kinds of post-surgical rashes include:
- OTC antibiotic creams (i.e., Polysporin)
- OTC cortisone creams
- cold compresses
- calamine lotion
- colloidal oatmeal
Note: Many doctors discourage the use of OTC Neosporin, due to the risk of reaction. Neosporin, usually used for superficial wound infections, is widely known to cause allergic contact reactions.
Your doctor might decide to prescribe medications to treat your rash. These may include:
- prescription antihistamines
- prescription cortisone cream
- antibiotics if your rash is caused by an infection
- steroid pills if your rash is severe
- prescription anti-inflammatory medications
- a replacement medication if your rash was caused by a drug allergy
Post-surgical rashes often go away when your skin is no longer in contact with the irritant. The rash should go away completely within a few weeks.
In rare cases, scratching or otherwise irritating the rash can result in a skin infection. Your doctor should be notified of any symptoms of infection, so treatment can begin immediately.
Post-surgery contact dermatitis is generally caused by an allergen or something that irritates your skin. This can include contact with surgical instruments or supplies that are not hypoallergenic, such as bandages, surgical glue, or antiseptic solutions.
This type of rash is usually localized to one or two spots on the body. Treatment is simple and most cases will resolve within a few weeks.