Dr. M.J. Bazos, MD
Patient Handout
DERMATITIS,
CONTACT
About Your
Diagnosis
Contact dermatitis is a skin irritation that may
be dry, red, and can blister. It is caused by skin contact with material that
either irritates the skin or causes skin allergies. Contact dermatitis is very
common. More than 50% of adult Americans have had at least one case. Many have
contact dermatitis every time they are exposed to an allergen (like poison ivy).
Contact dermatitis is not contagious. It can be treated with topical creams and
lotions, by oral medicines, and by avoiding contact with the irritating
materials.
Living With Your
Diagnosis
Signs of contact dermatitis
include dry, red, or blistery areas of skin. Symptoms may include itching,
dryness, or mild pain. Contact dermatitis does not cause a fever. Wheezing or
nausea may occur if the irritating substance was inhaled or swallowed, or if
severe allergy occurs. Usually proper treatment causes rapid improvement in the
redness and blistering, as well as the itch. Because the skin is fragile,
repeated scratching may lead to infection, which may require use of an
antibiotic.
Treatment
The
best treatment is avoidance. If the offending substance can be identified,
exposure to it should be eliminated as much as possible. For example, if you are
allergic to wool, avoid buying wool clothes and blankets, and protect your feet
if your carpeting is wool. If you are allergic to poison ivy, learn how to
recognize it, then avoid contact as much as possible. Wearing gloves, long
sleeves, and long pants when gardening will prevent accidental exposure. Other
treatment options include anti-inflammatory medications (steroids) to be used
orally or topically, antihistamines to reduce itching, and immunotherapy
(desensitization) to minimize the reaction. Steroid medicines are powerful
anti-inflammatory drugs and will quickly reduce swelling and irritation, but
they also carry the risk of serious side effects. These may include stomach
irritation, bone loss, and confusion, if the drug is taken orally. Topical use
(creams or lotions) can produce thinning of the skin or worsening of bacterial
infection if inappropriately used. For these reasons, steroids are usually
prescribed for short periods (7–10 days). If longer use is required, your
doctor will ask you to taper the dose slowly, because your body will need time
to begin making its own steroids. Other medications that may be used include
antihistamines to reduce itching, and antibiotics to fight possible infection.
Antihistamines can be very sedating (sleep inducing), so be sure not to drive,
cook, or use machinery when taking them. Antiitch lotions such as calamine are
very soothing for oozing, blistery rashes, and may be used as needed. Oatmeal
baths are soothing as well, but use with care because they make the bathtub
slippery.
The
DOs
• Do be sure to use your oral
steroid and antibiotics each day as directed. Oral antihistamines can be used as
needed and may be skipped if the itching
improves.
• Do use steroid ointments
and creams on clean, dry skin, and repeat 2 or 3 times per day as directed.
• Do use anti-itch lotions as
needed, but avoid using them during the first hour after applying the steroid
medications. (Give the steroid time to soak in
first!)
• Do keep good nutritional
habits while contact dermatitis is being treated. If you suspect an allergy to
food, keep a diary of your meals and your skin symptoms to discuss with your
doctor.
• Although exercise is
important, hot, sweaty skin will itch more. Do wash and cool the skin soon after
exercise.
• Do use a mild soap or
cleanser (baby bath works well) to keep skin clean. Avoid any extra irritation
that might be caused by deodorants or fragrances in the
soap.
The
DON’Ts
• Don’t skip
doses of steroid or antibiotic medicines. You will not lower your risk of side
effects, and your dermatitis may
worsen.
• Don’t use
antihistamine lotions or creams. They may cause rashes.
When to Call Your
Doctor
• If fever is
present.
• If vomiting or diarrhea
occur.
• If the rash worsens despite
treatment, or a new or different rash
occurs.
• If cough or wheezing is
present.