What are the first-line treatment options for a patient diagnosed with contact dermatitis?

The first-line treatment options for a patient diagnosed with contact dermatitis primarily involve identifying and avoiding the causative stimulus, alongside supportive skin care and symptomatic relief ¹.

• Avoidance of the Stimulus: The most crucial element of treatment and prevention is advising the patient to avoid the identified causative agent ¹. Clinical improvement may take 8–12 weeks of avoidance ¹. If complete avoidance is not possible, advise measures to minimise contact, such as rinsing with water or washing with a soap substitute immediately after contact ¹. Overuse of skin-cleaning agents can worsen the condition ¹. Suggest substituting products containing identified allergens or irritants ¹. Recommend using cotton-lined rubber or plastic gloves for handling potential irritants, ensuring gloves are removed frequently to prevent sweating from aggravating dermatitis ¹. Advise avoiding the accumulation of chemicals and water under jewellery ¹.
• Emollients and Soap Substitutes: Advise the liberal use of emollients and soap substitutes to maintain skin hydration and improve barrier repair ¹. Patients must be warned about the fire risk associated with emollients in contact with dressings, clothing, or bedding, and should avoid smoking or naked flames ¹. Aqueous cream should not be prescribed as it is associated with a high risk of skin reactions ¹.
• Topical Corticosteroids: Consider the need for topical corticosteroids to control symptoms ¹. The choice of topical corticosteroid depends on the clinical situation, including the patient's age, severity, location, and extent of the dermatitis ¹.