Treatment Options
If the substance causing your contact dermatitis can be identified and avoided, your symptoms should improve and may even clear up completely. There are a number of treatments to help ease your symptoms if it's not possible for you to avoid the substance causing them. A pharmacist will be able to recommend treatments like emollients (moisturisers), which you rub on your skin to stop it becoming dry.
Avoiding the cause
One of the most important steps in treating contact dermatitis is identifying and avoiding the allergens or irritants that affect you. If you can successfully avoid or reduce your exposure to the cause, you should not experience any symptoms.
It's not always easy to avoid irritants or allergens that affect you, but a pharmacist, GP or dermatologist (skin specialist) can suggest ways to minimise your contact with things that trigger your condition.
If you're exposed to irritants as part of your job, wear protective clothing to minimise any contact. Tell your employer about your condition, so they can help you avoid the causes as much as possible.
Emollients
Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. They're often used to help manage dry or scaly skin conditions such as eczema.
Choice of emollient
Several different emollients are available. You may need to try a few to find one that works for you. You may also be advised to use a mix of emollients, such as:
- an ointment for very dry skin
- a cream or lotion for less-dry skin
- an emollient to use instead of soap
- an emollient to use on your face and hands, and a different one to use on your body
The difference between lotions, creams and ointments is the amount of oil they contain. Ointments contain the most oil so can be quite greasy, but they are the most effective at keeping moisture in the skin. Lotions contain the least amount of oil so are not greasy but can be less effective. Creams are somewhere in between.
To apply the emollient:
- use a large amount
- do not rub it in – smooth it into the skin in the same direction the hair grows
- for very dry skin, apply the emollient 2 to 4 times a day, or as prescribed by a doctor
- after a bath or shower, gently dry the skin and then immediately apply the emollient while the skin is still moist
If you're exposed to irritants at work that cause your contact dermatitis, make sure you apply emollients regularly during and after work.
Topical corticosteroids
If your skin is also sore and inflamed, a GP may prescribe a topical corticosteroid (a cream or ointment applied directly to your skin) that can quickly reduce the inflammation.
When used as instructed by a pharmacist or doctor, corticosteroids are a safe and effective treatment for contact dermatitis. Different strengths of topical corticosteroids can be prescribed, depending on the severity of your contact dermatitis and where the affected skin is.
How to use topical corticosteroids
When using corticosteroids, apply the treatment in a thin layer to all the affected areas. Unless instructed otherwise by your doctor, follow the directions on the patient information leaflet that comes with your medicine. This will give details of how much to apply.
Steroid tablets
If you have a severe episode of contact dermatitis and it covers a large area of your skin, a doctor may prescribe corticosteroid tablets. But this is rarely needed.
Further treatments
If the treatments prescribed by a GP are not successfully controlling your symptoms, they may refer you for assessment and treatment by a dermatologist. Further treatments that may be available from a dermatologist include:
- immunosuppressant therapy – medicines that reduce inflammation by suppressing your immune system
- alitretinoin – capsules licensed for severe eczema affecting the hands
- phototherapy – where the affected area of skin is exposed to ultraviolet (UV) light to reduce inflammation
Complementary therapies
Some people may choose to use complementary therapies for contact dermatitis, such as food supplements or herbal remedies, but there is often a lack of evidence to show they are effective in treating the condition.
If you are thinking about using a complementary therapy, speak to a GP first to make sure the therapy is safe for you to use. You should continue to use any other treatments prescribed by a GP.