Treatment

Treatment for contact dermatitis can help most people manage their symptoms. Some people may find their symptoms clear up entirely. There are several ways to treat contact dermatitis, including: reducing your exposure to irritants avoiding allergens Emollients topical corticosteroids (steroid ointments and creams) steroid tablets These are explained below. 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 shouldn't experience any symptoms. It's not always easy to avoidirritants or allergens that affect you, but your GP or dermatologist (specialist in treating skin conditions)can find waysto minimise your contact with them. 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 areavailable. You may need to trya fewto 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 add to bath water or use in the shower one emollient to use on your face and hands, and adifferent 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 they can be quite greasy, but are the most effective at keeping moisture in the skin. Lotions contain the least amount of oil, so aren't greasy, but can be less effective. Creams are somewhere in between. Creams and lotions tend to be more suitable for red, inflamed (swollen) areas of skin. Ointments are more suitable for areas of dry skin that aren't inflamed. If you've been using a particular emollient for some time, it may eventually become less effective or may start to irritate your skin. If this is the case, your GP can prescribe another product. How to use emollients Use your emollient frequently and in large amounts. Manypeople find it helpfulto keep separate supplies of emollients at work or school. To apply the emollient: use a large amount don't rub it in; instead, smooth it into the skin in the same direction that the hair grows for very dry skin, apply the emollient everytwo to three hours 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. Don't share emollients with other people. Side effects Occasionally, some emollients can irritate the skin. If you have contact dermatitis, your skin will be sensitive and can sometimes react to certain ingredients, such as perfume in over-the-counter emollients. If your skin reacts to the emollient, stop using it and speak to your GP, who can recommend an alternative product. Be aware that some emollients contain paraffin and can be a fire hazard, so shouldn't be used near a naked flame. Emollients added to bath water can make your bath very slippery, so take care getting in and out of the bath. Topical corticosteroids If your skin is very red, sore and inflamed, your GP may prescribe a topical corticosteroid (a cream or ointment applied directly to your skin), which can quickly reduce the inflammation. When used as instructed by your pharmacist or doctor, corticosteroids are a safe andeffective treatment for contact dermatitis. Choice of topical corticosteroid Different strengths oftopical corticosteroids can be prescribed, depending on the severity of your contact dermatitis and where the affected skin is. You may be prescribed: a strongercream for short-term use in severe contact dermatitis a weakercream if the eczema is mild a weakercream for use on your face, genitals or in the creases of your joints (such as your elbows), as your skin is thinner in these areas a strongercream to use on your palms and the soles of your feet, as the skin is thicker here 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 medication.This willgive detailsof how much to apply. During an episode of severe contact dermatitis,don't apply the corticosteroid more than twice a day. Most people only have to apply it once a day. You should apply your emollient first and wait around 30 minutes before applying the topical corticosteroid. The medication will usually start to have an effect within a few days. Speak to your GP if you've been using a topical corticosteroid and your symptoms haven't improved. Side effects Topical corticosteroids may cause a mild and short-lived burning or stinging sensation as you apply them. In some cases, they may also cause: thinning of the skin changes in skin colour acne (spots) increased hair growth Most of these side effects will improve once treatment stops. Generally, using a stronger topical corticosteroid or using a large amount of topical corticosteroid increases your risk of getting side effects. You should use the weakest and smallest amount possible to control your symptoms. Steroid tablets If you have a severe episode of contact dermatitis and it coversa large area ofyour skin, yourdoctor may prescribe corticosteroid tablets. You may be prescribed steroid tablets to take for five to seven days. Depending on how effective this is, your dose may then be may gradually reduced over two to three weeks. If steroid tablets are taken often or for a long time, they can cause a number of side effects, such as: reduced growth rate in children high blood pressure (hypertension) osteoporosis (brittle bones) diabetes For this reason, your doctor is unlikely to prescribe repeat courses ofcorticosteroid tablets without referring you to a specialist. Further treatments If the treatments prescribed by your GParen't successfully controlling your symptoms, they may refer you for assessment and treatment by a dermatologist. Further treatmentsthat may be available fromyour dermatologist include: phototherapy where the affected area of skin is exposed to ultraviolet (UV) light to help improve its appearance immunosuppressant therapy medicines that reduce inflammation by suppressing your immune system alitretinoin capsules licensed for severe eczema affecting the hands Complementary therapies Some people may choose to use complementary therapies for contact dermatitis, such as food supplements or herbal remedies, but there isoften a lack of evidence to show they are effective in treating the condition. If you are thinking about using a complementary therapy, speak to your GP first to make sure the therapy is safe for you to use. You should continue to use any other treatments prescribed by your GP.