What is the treatment for allergic contact dermatitis caused by glue exposure?

Treatment for Allergic Contact Dermatitis Caused by Glue

For allergic contact dermatitis caused by glue, the first-line treatment includes allergen identification and avoidance, immediate application of moisturizers, and topical corticosteroids for symptomatic relief. 1, 2

First Steps in Management

• Identify and avoid the specific glue causing the reaction - ethyl cyanoacrylate (superglue) is a common culprit in adhesive-related allergic contact dermatitis 1
• Wash the affected area gently with lukewarm or cool water and mild soap that is free of allergenic surfactants, preservatives, fragrances, or dyes 1, 2
• Pat dry the area gently rather than rubbing, which can further irritate the skin 1
• Apply moisturizer immediately after cleansing to help restore the skin barrier 1, 2

Topical Treatment Options

• Apply a low to medium potency topical corticosteroid such as hydrocortisone to the affected area 3-4 times daily for adults and children over 2 years of age 3
• For more severe or extensive reactions (covering >20% of body surface area), systemic corticosteroids may be necessary 4
• Continue topical steroid application until the rash resolves, typically within 1-2 weeks 2, 4
• For recalcitrant cases, stronger topical steroids may be required under medical supervision 2

Supportive Measures

• Use moisturizers packaged in tubes rather than jars to prevent contamination 1
• Consider the "soak and smear" technique for severe cases: soak the affected area in plain water for 20 minutes and immediately apply moisturizer to damp skin nightly for up to 2 weeks 1, 2
• For hand dermatitis caused by glue, apply moisturizer before wearing gloves to create a protective barrier 1
• Avoid applying superglue (ethyl cyanoacrylate) to inflammatory or healing fissures, as this can worsen the condition 1

When to Seek Specialist Care

• Refer to a dermatologist when:
  • The dermatitis does not improve after 2-3 weeks of treatment 2
  • The reaction is severe or widespread 4
  • The specific allergen needs to be identified through patch testing 2, 5
  • There is suspicion of secondary bacterial infection (increased pain, warmth, swelling, yellow crusting) 2

Advanced Treatment for Persistent Cases

• For recalcitrant cases that fail to respond to topical treatments, consider:
  • Stronger prescription topical steroids 2
  • Phototherapy 1, 2
  • Systemic therapy such as oral corticosteroids, cyclosporine, or other immunosuppressants for severe cases 6, 5

Common Pitfalls to Avoid

• Do not use very hot water for washing the affected area, as this can worsen skin barrier damage 1, 2
• Avoid using disinfectant wipes to clean the affected area 1
• Do not apply known allergens or irritants to the affected area 1
• Avoid washing hands with dish detergent or other known irritants 1
• Do not apply occlusive dressings without underlying moisturizer application 1, 2

Prevention of Recurrence

• Once the specific glue causing the reaction is identified, avoid future exposure 2, 5
• Consider using hypoallergenic alternatives if glue must be used 2
• Apply barrier creams before potential exposure to protect the skin 1, 2
• Maintain regular moisturizing routine to strengthen the skin barrier 1, 2