Dr. Zirwas has particular expertise in the treatment and and management of allergic contact dermatitis and is a member of the esteemed American Contact Dermatitis Society.
Tips & Wisdom
Dr. Zirwas explains how Patch Testing is used to determine which agent is triggering the itchy rash of contact dermatitis.
Common triggers, also called "allergens", include metal (nickel) and chemicals used as preservatives, glue, dye, cleansers.
Many household products and clothing may contain these allergens.
Testing has shown that you have allergic contact dermatitis. This means that you are particularly sensitive to even an extremely small amount of certain substances.
You are so sensitive to these substances that if your skin comes in contact just one time with any of them, you may develop a rash. Itching, pinkness, small bumps, or blisters may appear within 4 hours, but usually starts 1 to 3 days after exposure to the substance.
You are so sensitive to these substances that if your skin comes into contact even once with one of them, you may get a rash. The skin reaction lasts from 2 to 8 weeks, even if you don’t come into contact with the agent again.
If you have had many exposures over time, it may take 3 to 6 months for your skin to get completely better after you start avoiding the substances. If you come in contact with one of the substances again during that time, that can cause a significant set-back in your recovery.
You were not sensitive to these substances for most of your life. Allergy develops from repeated exposure. You were exposed enough times to these substances that you became sensitive to them.
You must remember that just because you weren’t sensitive to something in the past doesn’t mean that you are not sensitive to it now.
Your body has changed and is sensitive now to things that didn’t cause you trouble before. You will be allergic to them for the rest of your life.
You will always need to avoid them. It is very important to learn how you can avoid the substances that cause your allergic reaction.
Note: 5-fluorouracil (5-FU) is very poisonous when ingested by dogs or cats. Even tiny amounts can be very toxic, resulting in acute gastrointestinal signs (e.g., vomiting, diarrhea), central nervous system signs (e.g., severe tremors, seizures, etc.), bone marrow suppression, and possible death. Care should be taken to prevent ingestion of this medication by pets.
Patient Education Resources
Synonyms: Many different types, all have “acrylate” in the name What are they? Acrylates are chemicals that start as liquids or powders, to which other chemicals, heat, or light is applied, causing acrylates to harden into solid substances. Acrylates are used: 1) as powerful glues; 2) and for configuring shapes since as a liquid or paste it can be molded and then hardened permanently into any shape. Where found? Acrylates can be used in/for making the following: Dentures Artificial Fingernails Orthopedic Bone Cement Temporary Dental Crowns UV-cured inks and paints Industrial Glues The vast majority of exposures to acrylates occur at work or from artificial fingernails. There are almost no “household” exposures to acrylates, except for certain glues containing it. Fingernails generally cause a rash on the face, neck, or scattered over the body. How to avoid: Acrylates generally cause all...
Where is ammonium persulfate found? Ammonium persulfate is an oxidizing agent and is used in cleaners for laboratory glassware. It is also used as an oxidating agent for vat dyes and in the bleaching and discoloring of oil. It is also used as a hair bleaching agent. How can you avoid contact with ammonium persulfate? Avoid products that list any of the following names in the ingredients: peroxydisulfate persulfate peroxydisulfate peroxydisulphate peroxymonosulfate monopersulfate What are some products that may contain ammonium persulfate? Oxidizers Pools and Hot Tubs Individuals with ammonium persulfate allergy can also have cross-reactions to potassium peroxymonopsulfate (PPMS). PPMS is a potassium triple salt (2KHSO5 • KHSO4 • K2SO4) which is used as an oxidizing compound in pools and a “shock” treatment for hot tubs.
Allergy testing has shown that you are sensitive to BACITRACIN. This means that you may develop a rash when products that contain BACITRACIN contact your skin. The main use of BACITRACIN is in antibacterial skin creams and ointments, such as “Neosporin” and “Polysporin” and generic forms of these products called “Triple Antibiotic Ointment” and “Double Antibiotic Ointment”. BACITRACIN is also used in some eyedrops, eye ointments, and ear drops. BACITRACIN is not used in “regular” products like soap, shampoo, conditioner, or moisturizer. You should do the following: Tell all healthcare providers that you are allergic to BACITRACIN. Carefully check the ingredient list of any cream or ointment that says “Antibacterial” or “Antibiotic” anywhere on the box, tube, or bottle. Avoid any product that has the word “BACITRACIN” in the ingredient list. Examples include:...
“Caine” anesthetics are used in creams, sprays, gels, etc that are supposed to relieve pain or itching. They are NOT in “regular” products. They are also used as injections before dental work or skin surgeries to numb the area. There are two types of “caine”. One type has at least two of the letter “i” in the name (the amide group) and the other type has only one letter “i” in the name (the ester group). Almost everyone who is allergic to a caine is only allegic to one group and is ok to use the other group. Where might they be found? itch relief creams vaginal anti-itch cream sore throat or cough lozenge sore throat spray toothache treatment canker sore treatment insect bite treatments poison ivy treatments hemorrhoid creams ...
Carmine is a red powder. Other names for it are: crimson lake or carmine lake, cochineal, natural red 4,C.I. 75470,or E120 The most common exposure to carmine is in make-up, especially: eye shadow blush mascara lipstick Other less common exposures include: Artificial flowers Paints Red Foods, including: Yougurt Candy Juice Ice Cream Allergic reactions from carmine in food are much less common that contact dermatitis from carmine in cosmetics and very few people who are allergic to carmine in cosmetics have problems from it in food, as these are different kinds of allergies. It is often listed in the part of the ingredient list that says “May Contain:….” You should avoid these products.
Carvone is naturally in a number of essential oils, but is most abundant in the oils from seeds of caraway (Carum carvi), spearmint (Mentha spicata), and dill. Foods Carvone is in caraway, dill and spearmint. Most people who are allergic to it won’t have a problem when eating these foods, but might have a problem if handling them while cooking. How to avoid it: Avoid handling the foods listed above. Avoid any creams, lip balms, or other products that have any type of minty smell. Consider avoiding mint flavored candy, gum, toothpaste, etc if you have problems on your lips or in your mouth.
What is it? Chlorhexidine is an antibacterial compound used mainly in soaps and disinfectants used to prepare the skin before surgery. It is in some antibacterial hand soaps and is added to personal care products as a preservative. Where might it be found? Shampoo Hair conditioners Hairstyling products Hand Soaps Mouthwash Pre-surgery Scrubs Pre-surgery skin preps Oral surgical prep Dairy cow teat care Moisturizers Facial cleansers Facial toners Aftershaves Eye make-up remover Toothpaste Gum treatment Urologic disinfectant Gynecological prep How to avoid it: Tell doctors you are allergic to chlorhexidine. There are pre-operative preps that do not contain chlorhexidine, such as betadine scrub. Check the labels of the types of products listed above to make sure they don’t have it.
What is it? Chlorhexidine is an antibacterial compound used mainly in soaps and disinfectants used to prepare the skin before surgery. It is in some antibacterial hand soaps and is added to personal care products as a preservative. Where might it be found? Shampoo Hair conditioners Hair styling products Hand Soaps Mouthwash Pre-surgery Scrubs Pre-surgery skin preps Oral surgical prep Dairy cow teat care Moisturizers Facial cleansers Facial toners Aftershaves Eye make-up remover Toothpastes Gum treatment Urologic disinfectant Gynecological prep How to avoid it: Tell doctors you are allergic to chlorhexidine. There are pre-operative preps that do not contain chlorhexidine, such as betadine scrub. Check the labels of the types of products listed above to make sure they don’t have it. Use the ACDS C...
BETAINES and DIMETHYLAMINES Allergy testing has shown that you are sensitive to betaines. These are common surfactants They allow oil and water to mix in a product and they make soaps and shampoos lather. They are also used in many conditioners to allow the oily conditioning ingredients to mix into the conditioner. Betaines and are used in many personal care products, mainly including: Shower gel Shampoo Bar soaps (specifically Dove soap) Toothpaste Dishsoaps and Household Cleaners Dimethylamines are used in hair conditioners. Dermatitis from shampoo and conditioner can occur on the scalp, face, neck, ears, or hands. Local cleansers may cause hand, face, eye lid, genital, or perianal dermatitis. Body washes or soaps containing CAPB can lead to widespread rash. Contact lens cleaners with CAPB may cause eyelid rash or conjunctivitis. Avoiding betaines is difficult because they go by three different names: Betaine Sultai Dimethylamine ...
Compositae also called…Asteracae. This is a group of common plants that makes an oily substance that coats the plants and their pollen. This oily substance is present in the extracts of these plants and it causes allergic reactions from touching the plants or from products that contain extracts of the plants. Natural Products Products that have botanical ingredients: Soaps and Bodywashes Shampoos Conditioners Moisturizers Lip Balms Aquaphor Ointment (bisabolo is in the family) Essential Oils Aromatherapy Oils Massage Oils Herbal Teas Herbal Supplements How to avoid Compositae: Avoid essential oils, botanicals, botanical extracts, botanical fragranced products, etc. Avoid teas made from chamomile, lavender, dandelion. Avoid touching plants in this family (there are over 20,000, but the common ones are listed on the next page. Avoid prolonged outdoor activity when these plants are in bloom, as airborne pollen can c...
Procedures & Services
Matt Zirwas, MD is a board-certified dermatologists providing medical dermatology care to patients in he Columbus Ohio area at Bexley Dermatology.
Formerly a Professor of Dermatology at Ohio State University, Dr. Matthew Zirwas founded Bexley Dermatology in Bexley, Ohio with his wife Dr. Jill Fichtel. Dr. Zirwas and Dr. Fichtel offer comprehensive skin care care at Bexley Dermatology for patients of all ages.
- Clinical Professor, Ohio State University – Department of Dermatology
- Director, Ohio Contact Dermatitis Center
- Dermatology Residency Training Program Director, Ohio State University Medical School, 2006 - 2015
Education & Training
- Undergraduate Degree (BS) – University of Pittsburgh 1992-1996
- Medical Degree (MD) – University of Pittsburgh – 1996-2000
- Dermatology Residency: University of Pittsburgh – 2001-2004