What medication is used to treat glandular erythema with burning and itching but no pain?

Treatment of Glandular Erythema with Burning and Itching (No Pain)

For glandular erythema with burning and itching but no pain, use topical corticosteroids as first-line therapy, specifically high-potency agents like clobetasol propionate or betamethasone dipropionate for body areas, combined with oral antihistamines such as cetirizine 10 mg daily or hydroxyzine 10-25 mg QID for symptomatic relief. 1

First-Line Treatment Approach

Topical Corticosteroids

• Apply high-potency topical corticosteroids (Class I) such as clobetasol propionate, halobetasol propionate, or betamethasone dipropionate cream or ointment to affected areas 1
• For facial involvement, use lower-potency agents like hydrocortisone 2.5% cream to avoid skin atrophy 1
• Medium- to high-potency formulations are recommended for body surface areas with erythema 1

Oral Antihistamines for Symptomatic Relief

• Cetirizine or loratadine 10 mg daily (non-sedating options) 1
• Hydroxyzine 10-25 mg QID or at bedtime (sedating option, useful if sleep disruption occurs) 1
• Antihistamines provide symptomatic relief of itching and burning sensations 1

Adjunctive Measures

Emollients and Skin Care

• Apply emollients with cream or ointment-based, fragrance-free products to maintain skin barrier function 1
• Use urea- or polidocanol-containing lotions to soothe pruritus 1
• Avoid hot water, excessive soaps, and alcohol-containing lotions that can worsen xerosis 1

Escalation Strategy if No Response After 2 Weeks

For Persistent or Worsening Symptoms

• Consider short-term oral corticosteroids: Prednisone 0.5-1 mg/kg/day for 7 days, then taper over 4-6 weeks 1
• Reassess after 2 weeks of initial therapy; if no improvement, escalate treatment 1
• Rule out secondary bacterial infection if erythema worsens or develops purulent features 1

Important Clinical Caveats

Monitoring and Safety

• Topical corticosteroids should not be used long-term on the face due to risk of skin atrophy, telangiectasia, and acneiform eruptions 1
• Itching or mild burning may persist for days after inflammation resolves and is not a reason for re-treatment 1
• If symptoms are asymptomatic and stable, observation without treatment is an acceptable alternative 1

When to Refer

• Refer to dermatology if symptoms do not improve after 2 weeks of appropriate therapy 1
• Immediate dermatology consultation needed if unusual appearance, distribution, or signs of systemic involvement develop 1