From the Guidelines
Contact dermatitis treatment should primarily involve topical steroids and topical tacrolimus, as these have been shown to be effective in managing the condition, according to the British Association of Dermatologists' guidelines 1. When managing contact dermatitis, it is crucial to first identify and avoid the irritant or allergen causing the reaction. For mild cases, simple measures such as washing the affected area with mild soap and water and applying cool compresses can help reduce inflammation.
- Over-the-counter treatments include 1% hydrocortisone cream applied 2-3 times daily for up to two weeks to reduce inflammation.
- Oral antihistamines like cetirizine (10mg once daily) or diphenhydramine (25-50mg every 4-6 hours) can be used to control itching.
- Calamine lotion can also provide itch relief. For more severe or persistent cases, topical tacrolimus and topical steroids are recommended as first-line treatments, with second-line options including phototherapy and systemic immunomodulators like methotrexate and mycophenolate mofetil 1. In cases of chronic hand dermatitis, treatments such as psoralen plus UVA, ciclosporin, and alitretinoin have been demonstrated to be useful 1. Regular moisturization with fragrance-free products is also essential to help repair the skin barrier. If the rash shows signs of infection (increased pain, swelling, warmth, pus), it is critical to seek medical attention as antibiotics may be necessary. The goal of treatment is to reduce inflammation and support the skin's natural healing process, which typically takes 2-3 weeks for complete resolution.
From the FDA Drug Label
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: ... Contact dermatitis
Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily
- Treatment for contact dermatitis can include topical hydrocortisone (2) or oral prednisone (3) for severe cases.
- For mild to moderate cases, apply hydrocortisone to the affected area not more than 3 to 4 times daily.
- For severe cases, prednisone may be used as an adjunctive therapy.
From the Research
Contact Dermatitis Treatment Overview
- Contact dermatitis is a common inflammatory skin disease caused by exposure to contact allergens and irritants 4.
- The treatment of contact dermatitis lies principally in the avoidance of the offending agent 5.
- If the contactant is identified and eliminated, the contact dermatitis can be a self-limited, mild condition 6.
Diagnostic Tests and Identification of Causative Allergens
- A complete medical history, including occupational history, is very important for the diagnosis of contact dermatitis 4.
- Patch testing, photopatch test, skin tests for detecting of immediate contact reactions, serum allergen-specific IgE test, and qualitative and quantitative testing of allergen in the suspected materials patients exposed to and challenge test can be used to help diagnosis of contact dermatitis and identify the causative allergens 4.
Treatment Options
- Topical corticosteroids, antihistamines, and emollients can be used to restore the skin barrier and reduce skin inflammation 4, 6.
- Systemic corticosteroids and immunosuppressants may be necessary for more severe cases 4.
- Dietary manipulation and immunomodulatory and anti-inflammatory agents are also promising new therapies for contact dermatitis 5.
- Patient education is critical to the proper treatment and management of allergic contact dermatitis, including detailed education on avoiding causative allergens 7.