From the Research
For contact dermatitis, a typical oral corticosteroid tapering regimen would be prednisone starting at 40-60mg daily for 5 days, then 30mg daily for 5 days, followed by 20mg daily for 5 days, 10mg daily for 5 days, and finally 5mg daily for 5 days before discontinuing, as suggested by the most recent and highest quality study available 1. This regimen is based on the principle of gradually reducing the dose of corticosteroids to prevent rebound dermatitis, which can occur when steroids are stopped abruptly. The gradual reduction allows the skin to adjust and the body's natural cortisol production to resume.
Key Considerations
- Topical steroids can be tapered by gradually reducing the potency and frequency of application over 2-3 weeks, starting with a medium-potency steroid like triamcinolone 0.1% twice daily for one week, then once daily for one week, then switching to a lower-potency option like hydrocortisone 1% once daily for a final week.
- During the tapering period, it is essential to continue using gentle skin care, avoiding triggers, and applying moisturizers frequently to support skin healing and prevent flare-ups.
- The diagnosis and management of contact dermatitis involve identifying and avoiding the causative allergen or irritant, and using topical or systemic corticosteroids to reduce inflammation and prevent further deterioration of the skin condition, as discussed in 2 and 1.
Tapering Regimen
- Oral prednisone: 40-60mg daily for 5 days, then 30mg daily for 5 days, followed by 20mg daily for 5 days, 10mg daily for 5 days, and finally 5mg daily for 5 days before discontinuing.
- Topical steroids: gradually reduce potency and frequency of application over 2-3 weeks, starting with a medium-potency steroid like triamcinolone 0.1% twice daily for one week, then once daily for one week, then switching to a lower-potency option like hydrocortisone 1% once daily for a final week. It is crucial to note that the tapering regimen may vary depending on the severity and extent of the contact dermatitis, as well as the individual patient's response to treatment, as discussed in 3.