Am I Allergic to my Clothing?

You pull on a new pair of blue jeans. They look great, but they don’t feel that way. The skin underneath them starts to get hot and itchy. What’s going on?

You might have textile dermatitis, a form of contact dermatitis. Contact dermatitis occurs when allergens come into contact with your skin, causing an allergic reaction in the form of a red, itchy rash.

What causes textile dermatitis?

Synthetic fabrics such as spandex, rayon, polyester, and rubberized cloth are more likely to cause allergic reactions.

Also, some fabrics are treated with synthetic ingredients to make them more waterproof and wrinkle-resistant. The two biggest culprits are:

• Formaldehyde resins. Yes, the chemical commonly used to preserve cadavers is also used in the clothing industry. This natural chemical is converted into a resin and applied to textiles after they have been manufactured. It can help your crisp, white shirt to resist wrinkles, and it can also ensure that the dye that makes your blue jeans blue penetrates the fabric thoroughly.
• Para-phenylenediamine. Also known as P-phenylenediamine or PPD, this chemical substance is used to get hair dye to last longer. It’s also used in henna tattoos and clothing. You know your black t-shirt that’s still black wash after wash after wash? Probably PPD at work!

My clothing never caused a reaction before. Why now?

While new clothing may cause textile dermatitis, so can old clothing you’ve worn for years without any problems. The body can develop allergies at any time, so even if you’ve worn a pair of blue jeans for years without a problem, the immune system could suddenly decide to start overreacting to them with an allergic skin rash.

Why does my body react this way?

Your immune system is in the practice of fighting off germs to keep you healthy. This comes in handy when your body is exposed to bacteria or viruses that could make you sick.

Allergies occur when your immune system starts overreacting to things that aren’t inherently harmful like pollen, food proteins, pet dander…and textiles. An overly-vigilant immune system will react to these allergens by releasing a flood of chemicals into the body (including histamine). These chemicals are famous for causing inflammation. If they’re launched in reaction to pollen, for example, the lining of your nose and the tissues of your eyes may become inflamed, causing congestion and puffy eyes. In the case of contact dermatitis, your skin will become inflamed, resulting in that red, itchy rash.

Could anything else cause me to react to my clothing?

Yes, laundry detergent and fabric softener are potential triggers. In the olden days, people washed clothing with animal fat or lye, which probably didn’t leave a fresh, clean scent. Only in recent decades have we engineered detergents and fabric softeners that smell like “spring renewal” or “lavender and vanilla bean.” The chemical cocktails that produce these scents can also irritate your skin.

Additionally, if your clothing has metal accents (buttons, studs, rivets, snaps, zippers, etc.) and your rash develops in places that these accents touch, you may have a nickel allergy. As a base metal alloy, nickel is often combined with other metals and used in jewelry and clothing accents. It can make the metal stronger and more scratch-resistant. Nickel allergy affects between 10 and 20 percent of Americans so don’t be surprised if your body reacts to nickel accents on your clothing with a rash.

It’s also possible to develop irritant dermatitis, which is not an allergy but a skin reaction that can be caused by tight-fitting clothing and exacerbated by sweat.

How do I avoid textile allergies?

• Opt for clothing made out of natural fabrics vs. synthetic ones. Natural fabrics include cotton, linen, silk, and wool. Synthetic fabrics include rayon, polyester, nylon, and spandex.
• Avoid clothing with heavy dye. If it says to wash separately, it is probably saturated in dyes that will bleed out. Lighter-colored clothing is a safer bet than dark-colored clothing.
• Beware of fabrics that are stain-resistant or wrinkle-resistant. These will likely have been treated by chemicals that can trigger allergies.
• If you have a nickel allergy, try coating buttons, snaps, etc. with a coating of clear nail polish to provide a barrier between the nickel and your skin.
• Choose loose-fitting clothing and breathable fabric, especially in warm weather.

When should I see a doctor about textile allergies?

In most cases, your rash will go away shortly after you stop wearing the clothing that is causing the reaction. In some cases, the rash will linger for several days. You should see your doctor if:

• The rash does not let up after 10-14 days.
• The rash is so bothersome that it keeps you from sleeping or going about your usual activities.
• The rash is painful or covers a lot of your body.
• The rash appears to be infected (oozes pus) or you develop a fever.

Your doctor may prescribe topical creams to soothe itching and inflammation, including corticosteroids. If you have developed an infection, your physician may prescribe antibiotics.

If you have recurring skin rashes and you are not sure what is causing them, your doctor can order an allergy test kit and perform the appropriate type of allergy testing. A patch skin test can determine the causes of contact dermatitis. Other types of testing, such as skin scratch testing, can tell you if you have allergies to foods, pollen, pets, mold, or dust that might also be triggering your skin rash.

If your allergy goes beyond just textile dermatitis, your doctor may prescribe allergy treatment in the form of allergy shots or sublingual immunotherapy (under-the-tongue allergy drops) to change your immune response to the allergens that are causing your symptoms.