From the Guidelines
Ear contact dermatitis should be managed by identifying and avoiding the triggering substance, and applying a topical corticosteroid such as hydrocortisone 1% cream twice daily for 7-10 days to reduce inflammation and itching, as recommended by the British Association of Dermatologists' guidelines for the management of contact dermatitis 2017 1.
Key Considerations
- The condition occurs due to an immune response triggered by allergens, resulting in symptoms such as redness, itching, swelling, and sometimes blistering.
- Common triggers include nickel in earrings, hair products, hearing aids, and headphones.
- For severe cases, a stronger prescription steroid like triamcinolone 0.1% may be needed, and oral antihistamines like cetirizine 10mg daily can help manage itching.
- Keeping the affected area clean and dry, and avoiding scratching, can prevent secondary infection.
Management and Prevention
- If you wear earrings, choose hypoallergenic materials like surgical steel, gold, or platinum.
- For hearing aid users, consider using a barrier cream or switching to hypoallergenic materials.
- Visiting the workplace can be essential in identifying potential allergens and irritants, and in the effective treatment and prevention of contact dermatitis 1.
- Patch testing may be necessary to determine the specific allergen causing the reaction, especially in cases of chronic or persistent dermatitis 1.
Monitoring and Follow-up
- If symptoms persist beyond two weeks of treatment, or if there are signs of infection (increased pain, warmth, discharge), seek medical attention.
- Regular follow-up with a healthcare professional can help monitor the condition and adjust treatment as needed.
From the FDA Drug Label
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: ... Contact dermatitis The prednisone (PO) can be used to treat contact dermatitis.
- The drug label explicitly mentions contact dermatitis as one of the conditions for which prednisone is indicated.
- Prednisone may be used to control severe or incapacitating allergic conditions, including contact dermatitis, that are intractable to adequate trials of conventional treatment 2.
From the Research
Ear Contact Dermatitis
- Ear contact dermatitis is a type of skin inflammation that occurs when the skin comes into contact with a foreign substance, such as poison ivy, nickel, or fragrances 3, 4.
- The condition can be categorized into two forms: irritant contact dermatitis and allergic contact dermatitis, with the latter being a delayed hypersensitivity reaction 3, 4.
- Symptoms of ear contact dermatitis may include erythema, scaling, itching, and discomfort, with acute cases potentially involving a dramatic flare with erythema, vesicles, and bullae 3.
Diagnosis and Treatment
- Diagnosis of ear contact dermatitis typically involves determining whether the problem resolves with avoidance of the suspected causative substance 3.
- Treatment options for ear contact dermatitis include mid- or high-potency topical steroids, such as triamcinolone 0.1% or clobetasol 0.05%, as well as systemic steroid therapy for more extensive cases 3, 5.
- Patch testing may be performed if the diagnosis or specific allergen remains unknown 3, 6.
- In some cases, patients may exhibit cross-reactivity to other corticoids, making it essential to identify a suitable alternative for treatment 7.
Management and Prevention
- Avoidance of the offending agent is the primary treatment for ear contact dermatitis 5, 6.
- Restoration of the skin barrier and reduction of skin inflammation through multiple treatments, such as emollients, topical corticosteroids, and antihistamines, are also crucial 6.
- Early and appropriate treatment can help prevent further deterioration and persistence of the skin condition 6.