Educating Patients About Contact Dermatitis
Contact dermatitis is acute inflammation of the skin as a result of direct contact with allergens or irritants. The symptoms and severity of the condition will vary from patient to patient, and will depend on the extent of exposure to either the allergen or the irritant. Once exposed, the skin may appear red and/or swollen, and may present with itching, bumps, blisters, pain, or tenderness. Though it is typically treated using an over-the-counter (OTC) medication, pharmacists may still be asked to provide guidance to patients about how to choose the right products to treat the condition.
Non-Prescription Topical Treatments
Treatments are in available in the form of: creams, lotions, gels, ointments, and sprays. Hydrocortisone is considered the most effective treatment when the affected area is not large, when it does not present with cracked or broken skin, and when swelling is minimal. It is available in 0.5% to 1% strength, and is safe for use in patients over two years of age. It should be used for no more than seven days, unless otherwise directed by a doctor.
Topical antihistamine products may help with itching, but should not be used by patients who are already taking oral antihistamines. Because of the risk of sensitivity and reaction, topical antihistamines should not be applied to cracked, broken, or blistered skin. Like hydrocortisone, these should be applied to large areas of the skin, or used for more than seven days unless otherwise directed by a doctor.
Other products that may provide itching and pain relief include menthol, phenol, and camphor. These are available in a variety of skin care products, but should not be applied directly to open wounds or blisters because of the potential for burning and irritation.
When appropriate, patients may be advised to use astringent products to promote drying of ooze from blisters while protecting the skin, and to use colloidal oatmeal baths or calamine lotion to relieve itching.
Patients should always be advised about when going to see a doctor is necessary, especially if they are showing signs of a skin infection. Those with a history of allergic reactions to certain skin care products should be educated about using only hypo-allergenic products.
When Patients Should See a Doctor
Patients presenting with contact dermatitis should see a doctor for treatment if:
- They are under two years of age;
- Symptoms last longer than two weeks, and show no signs of improvement, or start to worsen;
- The dermatitis affects more than 20% of the body, or affects the genitals;
- They experience extreme itching and/or swelling;
- They exhibit signs of infection;
- They experience dermatitis that affects the mucous membranes of the eyes, nose, or mouth;
- They experience eye or eyelid swelling;
- They have multiple blisters;
- They experience swelling in the extremities.