How Contact Dermatitis Is Treated

In This Article

Contact dermatitis is an incredibly common skin rash. Most cases can be treated at home and will go away within a few weeks. For more stubborn cases, prescription corticosteroids may be needed. In any case, identifying and avoiding the triggering substance is imperative to allow the skin to heal.

Home Remedies and Lifestyle

Contact dermatitis is very common. The vast majority of people will develop contact dermatitis at least once in their lifetime. In most cases, contact dermatitis is not serious and will heal on its own within about three weeks. Good home care can help speed healing and keep you more comfortable while the rash heals.

Identify and Avoid the Offending Substance

One of the most important things you must do to treat contact dermatitis is to avoid the substance(s) that are causing your skin irritation. Unfortunately, this is sometimes easier said than done.

In some cases, you'll know right away what is causing contact dermatitis (a rash that develops on your underarms after switching deodorant brands, or on the eyelids after trying new eye makeup). Other times, it may take some sleuthing to figure it out.

Think of anything new in your life: skin or hair care products, laundry detergent, fragrance or perfume, household cleaners, jewelry, and even clothing. Often the location of the rash will help you figure it out.

Also, take into account products you have used for years. Could they have changed formulations? It's also quite possible, and very common, to develop a sensitivity to products you've used over a long period of time.

Use Cool Compresses

Contact dermatitis can be incredibly itchy. Cool, damp compresses can take the sting, itch, and burn from the rash. Lay a cloth dampened in cool water over the rash for 10 to 15 minutes at a time, several times per day.

Lukewarm Baths or Oatmeal Baths

Lukewarm baths are soothing. Don't add any fragranced bath products or bubble bath. These can cause more irritation.

Oatmeal, on the other hand, can be very soothing and relieve itching. You can buy colloidal oatmeal bath additives over the counter. Just make sure the brand you choose has no added fragrance, which can be irritating. Another simple and inexpensive option is to make your own oatmeal bath.

If you aren't keen to the mess in the tub, pour the oatmeal into a cotton muslin or organza bag, or tie into a thin washcloth or nylon stocking. The entire bundle is then floated in the bathwater.

While bathing, you may want to avoid fragranced soap and body washes as well. Mild, unscented soap can be used, or if these seem to aggravate the rash, use plain water until your skin has healed.

Moisturize Often

For dry, cracked skin, apply a moisturizer as a barrier and to soothe the skin until it has healed. Choose your moisturizing products carefully, though, since fragranced products can cause more irritation. Be sure to choose a fragrance-free, hypo-allergenic product.

Apply as often as needed throughout the day to relieve dryness, but especially immediately after showering (or washing your hands, if your hands are affected) and just before bed.

Continue to apply emollient moisturizers often, even after your rash has cleared up. Regular application of moisturizers can help heal and strengthen the skin's barrier and may help minimize the chance of repeated bouts of contact dermatitis.

Cover the Affected Area

Keeping the rash covered by clothing can act as a physical barrier to prevent scratching. This is an especially good tip for children, who can't help themselves when faced with an annoyingly itchy rash.

Minimizing Exposure at Work

Many people discover the cause of their contact dermatitis is a substance they're exposed to at work. Hairdressers and estheticians, health care workers, housekeepers and janitors, cooks, florists, and those who work in manufacturing jobs are especially at risk.

In this case, so there's really no way to completely avoid coming in contact with the offending substance. There are things you can do to limit your exposure, though. If your hands are affected, wear gloves whenever possible—latex can be an irritant in itself, so you may have better luck with non-latex or nitrile gloves. Also, wear protective equipment—face mask, goggles, long sleeves and pants, gloves. Avoid letting the irritants touch your skin directly.

If you need further help, ask your doctor for tips on avoiding irritating substances at work.

Tips for Contact Dermatitis Caused By Pant Snaps

Nickel is a common cause of contact dermatitis. Unfortunately, most snaps and buttons on jeans and other pants contain nickel. This can cause a rash where the back of the snap rests on your stomach.

Try using iron-on or adhesive fabric patches (found at craft and fabric stores) to cover the backing that comes in contact with your skin. They're easy to apply and you won't have to get rid of all your favorite jeans. Along the same lines, if you can't bear to stop wearing your favorite belt buckle, make sure you wear an undershirt tucked in to prevent the buckle from coming in direct contact with your skin.

Over-the-Counter (OTC) Therapies

There are several over-the-counter treatments that you can get at your local pharmacy to help reduce symptoms and make you more comfortable until the rash heals. You can ask your pharmacist for advice in choosing an appropriate OTC treatment. Take special care in choosing anti-itch remedies for children and don't hesitate to call the pediatrician for advice.

Over-the-Counter Hydrocortisone

Hydrocortisone creams help relieve itching, irritation, and inflammation. Gently apply a thin layer two to four times daily. Ask your pediatrician before using hydrocortisone on a young child. Hydrocortisone shouldn't be used long-term, though, because it can cause thinning of the skin.

Calamine Lotion

Calamine lotion is also good for relieving itch. It also can help dry weeping rashes. The drawback is that it's bubblegum pink, so you'll likely not want to wear it out in public on areas that are obvious. Calamine lotion is generally applied up to four times daily.

Non-Steroidal Anti-Itch Lotions

Anti-itch lotions relieve itching and soothe dryness. Apply up to four times daily. Monitor your skin for increased irritation, though, since sensitivities to ingredients found in these lotions are not unheard of.

Oral Antihistamines

Although they won't do anything to soothe or heal the rash itself, oral antihistamines may help reduce itching. If you aren't getting relief from any of the above therapies, you may want to give them a try. For children, talk to their pediatrician before giving them an antihistamine.

Prescriptions

For severe contact dermatitis, widespread rash, or contact dermatitis that isn't improving with home treatment, a prescription medication is in order.

Topical Corticosteroids

Topical corticosteroids (also known as steroid creams) are typically the first line treatment for contact dermatitis. Hydrocortisone (in stronger formulation than OTC options), triamcinolone, and clobetasol are commonly prescribed. These help reduce itching and irritation, and they work rather quickly.

Topical corticosteroids are applied one to two times daily. It's important that you use your medication exactly as your doctor directed. Even if the rash has cleared, you'll want to continue using the full course of treatment.

Topical corticosteroids may burn or sting when first applied, especially if your skin is cracked, broken, or very irritated. They can also cause thinning of the skin when used long-term, but for short courses of treatment, they are very safe when used as directed.

Oral Corticosteroids

An oral corticosteroid (likely prednisone) may be prescribed if the contact dermatitis is very severe or widespread, covering large areas of your body. Prednisone helps quickly relieve inflammation, and typically only a short course is needed.

Oral corticosteroids are most often used for acute cases, like severe poison ivy rash, and not very often prescribed for chronic cases of contact dermatitis. Like with topical steroids creams, it's important to follow usage directions exactly and continue the entire course of treatment, even if your rash has cleared.

Antibiotics

Oral antibiotics don't improve contact dermatitis itself, but your doctor may prescribe them if your rash shows signs of infection.

Topical Immunomodulators

Topical immunomodulators are types of drugs that suppress the immune response that triggers inflammation. Elidel (pimecrolimus) and Protopic (tacrolimus) are topical immunomodulators that are approved for treating another type of dermatitis, atopic dermatitis. They are also prescribed in certain cases to reduce inflammation of severe contact dermatitis that hasn't responded to other treatments.

Specialist-Driven Procedures

Phototherapy, also known as light therapy, isn't a common treatment for contact dermatitis, but it can be used in instances where the rash isn't improving with other treatment.

Phototherapy uses a special lamp that emits a specific wavelength of light onto the skin. For contact dermatitis, narrowband UVB light is most commonly used. The light can be used to target specific affected areas or, if contact dermatitis is widespread, the entire body may be treated.

The procedure itself only lasts from a few seconds up to a couple of minutes. But it does need to be repeated at regular intervals for several months in order to gain success.

The upside of phototherapy is that it's quite effective, even for people who haven't seen improvement with other treatments. The downside is it's a slow worker; you likely won't see marked improvement for a few months. During this time you'll need to go into your doctor's office often, sometimes several times weekly, to get your treatments done.

Phototherapy is used when conventional treatments haven't worked, and generally only in cases of severe or chronic contact dermatitis.

A Word From Verywell

The good news is that most cases of contact dermatitis will go away within three weeks or so. During this time, a bit of TLC can help minimize symptoms and keep you comfortable. If you're so uncomfortable that you can't sleep or carry on with your day-to-day life, give your doctor a call for help with treatment. The same goes for if contact dermatitis is very severe or covers large areas of your body.

Remember, though, in order to clear contact dermatitis, you must figure out what is causing your rash and avoid the offending substance. It can be frustrating when you aren't sure what is causing your contact dermatitis (which is far more common than you would think). Again, your doctor is a great resource and can help you narrow down the culprits.

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