Dr. M.J. Bazos, MD Patient Handout


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.

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.