What medications can be used to treat contact dermatitis?

From the Guidelines

Topical steroids and topical tacrolimus are the primary medications used to treat contact dermatitis, with second-line treatment options including phototherapy and systemic immunomodulators like methotrexate and mycophenolate mofetil. When managing contact dermatitis, it's essential to consider the severity of the condition and the patient's overall health. For persistent contact dermatitis, therapy largely follows the management of atopic/endogenous dermatitis, as stated in the British Association of Dermatologists' guidelines 1. Some key points to consider when treating contact dermatitis include:

• Topical steroids are effective in reducing inflammation and suppressing the immune response that causes the rash
• Topical tacrolimus is a steroid-free alternative, especially useful for sensitive areas like the face
• Second-line treatment options, such as phototherapy and systemic immunomodulators, may be necessary for more severe cases
• Identifying and avoiding the triggering substance is crucial to prevent recurrence
• Cool compresses, moisturizers, and avoiding scratching can complement medication therapy. It's also important to note that while other medications like oral antihistamines may be beneficial for relieving inflammation of the skin 1, the most recent and highest quality study recommends topical steroids and topical tacrolimus as the primary treatment options 1.

From the FDA Drug Label

The corticosteroids are a class of compounds comprising steroid hormones secreted by the adrenal cortex and their synthetic analogs. In pharmacologic doses, corticosteroids are used primarily for their anti-inflammatory and/or immunosuppressive effects Topical corticosteroids such as clobetasol propionate are effective in the treatment of corticosteroid-responsive dermatoses primarily because of their anti-inflammatory, antipruritic, and vasoconstrictive actions. Topical corticosteroids share anti-inflammatory, antipruritic and vasoconstrictive actions.

The medications that can be used to treat contact dermatitis include:

• Clobetasol propionate 2
• Triamcinolone 3 These are topical corticosteroids that are effective in treating corticosteroid-responsive dermatoses, including contact dermatitis, due to their anti-inflammatory, antipruritic, and vasoconstrictive actions.

From the Research

Medications for Contact Dermatitis

• Topical corticosteroids, such as triamcinolone 0.1% or clobetasol 0.05%, are effective in treating localized acute allergic contact dermatitis lesions 4
• Systemic steroid therapy, such as oral prednisone, may be required for extensive areas of skin (greater than 20 percent) and can offer relief within 12 to 24 hours 4
• Immunomodulators, such as tacrolimus and pimecrolimus, can provide steroid-sparing options in the long-term topical treatment of allergic contact dermatitis 5
• Antihistamines and emollients can also be used to reduce skin inflammation and restore the skin barrier 6
• Systemic corticosteroids and immunosuppressants may be necessary in severe cases 6

Considerations for Treatment

• The choice of medication may depend on the severity and extent of the contact dermatitis, as well as the presence of any underlying conditions or allergies 4, 6
• Patch testing and other diagnostic tests can help identify the causative allergens and guide treatment 4, 6
• Some individuals may be allergic to topical corticosteroids, and alternative treatments may be necessary 7
• The potential for systemic contact dermatitis from oral corticosteroids, such as prednisolone, should be considered in patients with a history of allergic contact dermatitis 7