From the Guidelines
Oral prednisone and Zyrtec (cetirizine) can be effective for treating contact dermatitis, but the most recent and highest quality study recommends topical steroids and topical tacrolimus as first-line treatment. For moderate to severe contact dermatitis, oral prednisone is typically prescribed at 0.5-1 mg/kg/day for 5-14 days, often with a tapering dose to prevent rebound inflammation, as supported by the British Association of Dermatologists' guidelines 1. Zyrtec, an antihistamine, can be taken at 10 mg once daily to help control itching. These medications work well together because prednisone reduces inflammation by suppressing the immune response, while Zyrtec blocks histamine receptors to decrease itching and allergic symptoms.
Key Considerations
- Side effects of prednisone may include increased appetite, mood changes, and elevated blood sugar, especially with longer courses.
- Zyrtec may cause mild drowsiness in some people.
- It's essential to identify and avoid the triggering substance that caused the contact dermatitis to prevent recurrence.
- Topical treatments like moisturizers and cool compresses can provide additional relief.
- If symptoms don't improve within a few days of treatment, or if there are signs of infection (increasing pain, warmth, pus, or fever), medical attention should be sought.
Treatment Approach
- The British Association of Dermatologists' guidelines recommend therapy for contact dermatitis persisting despite allergen/irritant removal and skin protection, which largely follows the management of atopic/endogenous dermatitis 1.
- Topical corticosteroids and topical tacrolimus have been shown to be effective in treating contact dermatitis, with studies supporting their efficacy 1.
- Second-line treatment includes phototherapy and systemic immunomodulators such as methotrexate and mycophenolate mofetil, as recommended by the British Association of Dermatologists' guidelines 1.
From the Research
Treatment Options for Contact Dermatitis
- Oral prednisone is a treatment option for severe cases of contact dermatitis, particularly when the affected area is extensive (greater than 20 percent) 2.
- Systemic steroid therapy, such as oral prednisone, can provide relief within 12 to 24 hours 2.
- In cases of severe rhus dermatitis, oral prednisone should be tapered over two to three weeks to avoid rebound dermatitis 2.
Role of Antihistamines in Treatment
- Antihistamines, such as Zyrtec, can be used to reduce itching and discomfort associated with contact dermatitis 3, 4.
- Antihistamines are often used in conjunction with other treatments, such as topical corticosteroids and emollients, to manage symptoms of contact dermatitis 3.
Importance of Avoiding Irritants and Allergens
- Avoiding the suspected irritants or allergens is crucial in the management of contact dermatitis 5, 3.
- Removing the patient from the environment that contains the offending substances and promoting the metabolism and expulsion of absorbed allergens can help prevent further deterioration of the skin condition 3.