Contact Dermatitis
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Introduction
It is skin inflammation caused by irritants or allergic sensitizers. In allergic contact dermatitis (ACD), an antigenic substance triggers an immunologic response, sometimes several days later. Irritant contact dermatitis (ICD) is caused by an organic substance that usually results in a reaction within a few hours of exposure.
Treatment
- The first intervention involves identification, withdrawal, and avoidance of the offending agent.
- The second treatment is symptomatic relief while decreasing skin lesions. Cold compresses help soothe and cleanse the skin; they are applied to wet or oozing lesions, removed, remoistened, and reapplied every few minutes for a 20- to 30-minute period. If affected areas are already dry or hardened, wet dressings applied as soaks (without removal for up to 20–30 min) will soften and hydrate the skin; soaks should not be used on acute exudating lesions. Calamine lotion or Burow solution (aluminum acetate) may also be soothing.
- Topical corticosteroids help resolve the inflammatory process and are the main stay of treatment. ACD responds better to topical corticosteroids than does ICD. Generally, use higher potency corticosteroids initially, switching to medium or lower potency corticosteroids as the condition improves
- Oatmeal baths or oral first-generation antihistamines may provide relief for excessive itching.
- Moisturizers may be used to prevent dryness and skin fissuring.