Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
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 NICE CKS.
- Avoidance of the Stimulus: The most crucial element of treatment and prevention is advising the patient to avoid the identified causative agent NICE CKS. Clinical improvement may take 8–12 weeks of avoidance NICE CKS. 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 NICE CKS. Overuse of skin-cleaning agents can worsen the condition NICE CKS. Suggest substituting products containing identified allergens or irritants NICE CKS. Recommend using cotton-lined rubber or plastic gloves for handling potential irritants, ensuring gloves are removed frequently to prevent sweating from aggravating dermatitis NICE CKS. Advise avoiding the accumulation of chemicals and water under jewellery NICE CKS.
- Emollients and Soap Substitutes: Advise the liberal use of emollients and soap substitutes to maintain skin hydration and improve barrier repair NICE CKS. 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 NICE CKS. Aqueous cream should not be prescribed as it is associated with a high risk of skin reactions NICE CKS.
- Topical Corticosteroids: Consider the need for topical corticosteroids to control symptoms NICE CKS. The choice of topical corticosteroid depends on the clinical situation, including the patient's age, severity, location, and extent of the dermatitis NICE CKS.