From the Guidelines
The treatment of contact dermatitis involves first identifying and avoiding the triggering substance, which is essential for long-term management, as emphasized in the guidelines for the management of contact dermatitis 1. For immediate relief, topical corticosteroids like hydrocortisone 1% cream applied twice daily for 1-2 weeks are effective for mild cases, while moderate to severe cases may require stronger prescription steroids such as triamcinolone 0.1% or fluocinonide 0.05% ointment. Some key points to consider in the management of contact dermatitis include:
- Avoiding the triggering substance, which can be identified through a detailed history and patch testing 1
- Using topical corticosteroids and oral antihistamines to control symptoms
- Applying cool compresses and moisturizers to soothe and protect the skin
- Considering a short course of oral corticosteroids for extensive or severe reactions The most common contact allergens in patients with contact dermatitis include nickel, neomycin, fragrance, formaldehyde, and other preservatives, lanolin, and rubber chemicals, as noted in the guidelines for the management of atopic dermatitis 1. Patch testing is a useful diagnostic tool for identifying contact allergens, with a sensitivity of 60-80% 1. It is essential to correlate patch test results with the patient's clinical history and physical examination to determine the relevance of the allergen to the patient's dermatitis. In cases where the diagnosis is unclear or the patient is not responding to standard therapies, patch testing and other diagnostic approaches may be necessary to identify the underlying cause of the contact dermatitis. Overall, the management of contact dermatitis requires a comprehensive approach that includes avoidance of triggering substances, control of symptoms, and protection of the skin.
From the Research
Treatment Options for Contact Dermatitis
The treatment for contact dermatitis involves a multi-faceted approach, including:
- Avoidance of the offending agent or irritant [(2,3)]
- Restoration of the skin barrier and reduction of skin inflammation through various treatments 2
- Use of emollients, topical corticosteroids, and antihistamines [(2,4)]
- Systemic corticosteroids and immunosuppressants for more severe cases [(2,5)]
- Topical calcineurin inhibitors, azathioprine, and ciclosporin 4
- Methotrexate and alitretinoin as recent additions to the treatment armamentarium 4
Specific Treatments
Some specific treatments that have been studied include:
- Topical pimecrolimus, which was found to be ineffective in the treatment of ongoing Toxicodendron-induced allergic contact dermatitis 6
- Corticosteroids, which are a common treatment option for contact dermatitis [(3,4)]
- Dietary manipulation, which may be considered in certain cases 3
Importance of Early Treatment
Early and appropriate treatment is crucial to prevent further deterioration and persistence of the skin condition 2