Toilet seats implicated in recent cases of contact dermatitis

Contact dermatitis cases caused by toilet seats appear to be making a comeback in pediatricians’ offices, according to researchers from Johns Hopkins Children’s Center in Baltimore.

Analyzing two cases from the United States and three from India in the February issue of Pediatrics, the researchers said the culprits responsible for the reemergence of the condition are harsh cleaning chemicals and exotic wooden toilet seats, which are making a comeback as bathroom décor, especially seats covered with varnishes and paints.

Pediatricians should inquire about toilet seats and cleaners used both at home and at school any time they see a toddler or a young child with skin irritation around the buttocks or upper thighs.

Most cases are fairly benign and easy to treat with topical steroids, according to the researchers, but because many pediatricians do not suspect the cause and do not treat it properly, the inflammation can persist and spread further, causing painful and itchy skin eruptions. One patient’s dermatitis reportedly became infected with methicillin-resistant Staphyloccocus aureus. Missed and delayed diagnoses were a hallmark of every case described in the review, study researcher Bernard A. Cohen, MD, of the division of pediatric dermatology at Johns Hopkins University School of Medicine, said in a press release.

To prevent toilet-seat dermatitis, Cohen and colleagues recommend:

Using paper toilet seat covers in public restrooms, including hospital and school restrooms;
Replacing wooden toilet seats with plastic ones;
Cleaning toilet seats and bowls daily;
Avoiding harsh store-brand cleaners, which often contain skin irritants like phenol or formaldehyde.

Equally effective and gentler substitutes such as rubbing alcohol and hydrogen peroxide could be used instead.

Litvinov I. Pediatrics. 2010;doi:10.1542/peds.2009-2430