What is the treatment for contact dermatitis on the back?

From the Guidelines

The treatment for contact dermatitis on the back should prioritize topical steroids and topical tacrolimus, as supported by the British Association of Dermatologists' guidelines 1. When managing contact dermatitis on the back, it is essential to identify and avoid the triggering substance.

• Apply over-the-counter 1% hydrocortisone cream to affected areas 2-3 times daily for up to two weeks to reduce inflammation and itching.
• For more severe cases, prescription-strength topical corticosteroids like triamcinolone 0.1% may be necessary, as they have been shown to be effective in treating contact dermatitis 1.
• Cool compresses with plain water for 15-20 minutes several times daily can soothe irritation.
• Taking oral antihistamines such as cetirizine (10mg daily) or diphenhydramine (25-50mg every 4-6 hours) can help control itching, especially at night.
• Wear loose-fitting, cotton clothing to avoid further irritation.
• If the rash covers a large area, is severely painful, shows signs of infection (increasing redness, warmth, swelling, or pus), or doesn't improve within 1-2 weeks of home treatment, seek medical attention. The most recent guidelines from the British Association of Dermatologists 1 suggest that therapy for contact dermatitis persisting despite allergen/irritant removal and skin protection largely follows the management of atopic/endogenous dermatitis, with topical steroids and topical tacrolimus being effective treatments.
• Second-line treatment includes phototherapy and systemic immunomodulators such as methotrexate and mycophenolate mofetil, but these should only be considered under the guidance of a healthcare professional. Given the potential difficulty in treating contact dermatitis on the back due to the location, it is crucial to seek medical attention if the condition does not improve with home treatment or if there are signs of infection.

From the FDA Drug Label

Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema psoriasis poison ivy, oak, sumac insect bites detergents jewelry cosmetics soaps seborrheic dermatitis Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily

The treatment for contact dermatitis on the back is to apply hydrocortisone (TOP) to the affected area not more than 3 to 4 times daily for adults and children 2 years of age and older.

• Key points:
  • Apply to affected area
  • Not more than 3 to 4 times daily
  • For adults and children 2 years of age and older 2 2

From the Research

Treatment for Contact Dermatitis on the Back

The treatment for contact dermatitis on the back involves several steps, including:

• Avoiding the causative substance or allergen [ 3, 4 ]
• Using topical corticosteroids, such as triamcinolone 0.1% or clobetasol 0.05%, for localized acute allergic contact dermatitis [ 3 ]
• Considering systemic steroid therapy for extensive areas of skin involvement (greater than 20 percent) [ 3 ]
• Using emollients, antihistamines, and other treatments to restore the skin barrier and reduce inflammation [ 4 ]
• Patch testing to identify the specific allergen or substance causing the reaction [ 3, 4,5 ]

Specific Treatment Options

Some specific treatment options for contact dermatitis on the back include:

• Topical corticosteroids, such as hydrocortisone or betamethasone-17-valerate [ 6 ]
• Systemic corticosteroids, such as oral prednisone, for severe cases [ 3 ]
• Antihistamines to relieve itching and discomfort [ 5 ]
• Cold water compresses to reduce inflammation and itching [ 5 ]

Advanced Therapies

In cases where avoidance of the causative substance is not possible, advanced therapies may be considered, including:

• Treatment of secondary infections [ 5 ]
• Use of immunosuppressants [ 4 ]
• Other treatments aimed at reducing inflammation and promoting skin healing [ 7 ]