Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Irritant Contact Dermatitis Medication

  • Author: Daniel J Hogan, MD; Chief Editor: William D James, MD  more...
 
Updated: Apr 16, 2014
 

Medication Summary

After the identification and removal of any potential causal agents, the use of ceramides creams or bland emollients and bland barrier creams such as those containing dimethicone are the mainstays of medical treatment for irritant contact dermatitis.

A number of agents commonly found in therapeutic products for the skin (eg, propylene glycol, lactic acid, urea, salicylic acid) may produce further skin inflammation and may need to be avoided in these individuals. Topical corticosteroids play a limited role in the treatment of irritant contact dermatitis. They do not address the process directly, but they may be helpful for superimposed eczematous features.

Next

Corticosteroids, topical

Class Summary

Corticosteroids are immunosuppressives with anti-inflammatory properties that modify the body's immune response to diverse stimuli. Other actions include vasoconstriction and antiproliferation. These agents have limited use in the treatment of irritant contact dermatitis.

Amcinonide

 

A highly potent, fluorinated corticosteroid (class 2-3), amcinonide suppresses mitotic activity and causes vasoconstriction. It stimulates synthesis of enzymes needed to decrease inflammation and may suppress histamine release associated with pruritus.

Fluocinolone (Capex, Derma-Smoothe/FS)

 

Fluocinolone is a fluorinated corticosteroid of mid potency at the 0.025% concentration (class 4-5) and mild potency at the 0.01% concentration (class 6).

Previous
 
Contributor Information and Disclosures
Author

Daniel J Hogan, MD Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Canadian Dermatology Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

References
  1. Watkins SA, Maibach HI. The hardening phenomenon in irritant contact dermatitis: an interpretative update. Contact Dermatitis. 2009 Mar. 60(3):123-30. [Medline].

  2. Fluhr JW, Akengin A, Bornkessel A, Fuchs S, Praessler J, Norgauer J, et al. Additive impairment of the barrier function by mechanical irritation, occlusion and sodium lauryl sulphate in vivo. Br J Dermatol. 2005 Jul. 153(1):125-31. [Medline].

  3. Jacobs JJ, Lehé CL, Hasegawa H, Elliott GR, Das PK. Skin irritants and contact sensitizers induce Langerhans cell migration and maturation at irritant concentration. Exp Dermatol. 2006 Jun. 15(6):432-40. [Medline].

  4. Heinemann C, Paschold C, Fluhr J, Wigger-Alberti W, Schliemann-Willers S, Farwanah H, et al. Induction of a hardening phenomenon by repeated application of SLS: analysis of lipid changes in the stratum corneum. Acta Derm Venereol. 2005. 85(4):290-5. [Medline].

  5. de Jongh CM, Khrenova L, Verberk MM, Calkoen F, van Dijk FJ, Voss H, et al. Loss-of-function polymorphisms in the filaggrin gene are associated with an increased susceptibility to chronic irritant contact dermatitis: a case-control study. Br J Dermatol. 2008 Sep. 159(3):621-7. [Medline].

  6. Kartono F, Maibach HI. Irritants in combination with a synergistic or additive effect on the skin response: an overview of tandem irritation studies. Contact Dermatitis. 2006 Jun. 54(6):303-12. [Medline].

  7. Löffler H, Kampf G, Schmermund D, Maibach HI. How irritant is alcohol?. Br J Dermatol. 2007 Jul. 157(1):74-81. [Medline].

  8. Weston WL, Morelli JG. Dermatitis under soccer shin guards: allergy or contact irritant reaction?. Pediatr Dermatol. 2006 Jan-Feb. 23(1):19-20. [Medline].

  9. Schmid-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Physiol. 2006. 19(6):296-302. [Medline].

  10. Forrester BG, Roth VS. Hand dermatitis in intensive care units. J Occup Environ Med. 1998 Oct. 40(10):881-5. [Medline].

  11. Cvetkovski RS, Rothman KJ, Olsen J, Mathiesen B, Iversen L, Johansen JD, et al. Relation between diagnoses on severity, sick leave and loss of job among patients with occupational hand eczema. Br J Dermatol. 2005 Jan. 152(1):93-8. [Medline].

  12. Dickel H, Kuss O, Schmidt A, Kretz J, Diepgen TL. Importance of irritant contact dermatitis in occupational skin disease. Am J Clin Dermatol. 2002. 3(4):283-9. [Medline].

  13. Mangion SM, Beulke SH, Braitberg G. Hydrofluoric acid burn from a household rust remover. Med J Aust. 2001 Sep 3. 175(5):270-1. [Medline].

  14. Basketter DA, Marriott M, Gilmour NJ, White IR. Strong irritants masquerading as skin allergens: the case of benzalkonium chloride. Contact Dermatitis. 2004 Apr. 50(4):213-7. [Medline].

  15. Rietschel RL, Fowler JF Jr. Fisher's Contact Dermatitis. 4th ed. Baltimore, Md: Lippincott Williams & Wilkins; 1995.

  16. Bernstein IL, Li JT, Bernstein DI, et al. Allergy diagnostic testing: an updated practice parameter. Part 1. National Guideline Clearinghouse. Mar 2008. [Full Text].

  17. Bernstein IL, Li JT, Bernstein DI, et al. Allergy diagnostic testing: an updated practice parameter. Part 2. National Guideline Clearinghouse. Mar 2008. [Full Text].

  18. Lakshmi C, Srinivas CR, Anand CV, Mathew AC. Irritancy ranking of 31 cleansers in the Indian market in a 24-h patch test. Int J Cosmet Sci. 2008 Aug. 30(4):277-83. [Medline].

  19. Menne T, Johansen JD, Sommerlund M, Veien NK. Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema. Contact Dermatitis. 2011 Jul. 65(1):3-12. [Medline].

  20. Levin C, Zhai H, Bashir S, Chew AL, Anigbogu A, Stern R, et al. Efficacy of corticosteroids in acute experimental irritant contact dermatitis?. Skin Res Technol. 2001 Nov. 7(4):214-8. [Medline].

  21. Fuchs M, Schliemann-Willers S, Heinemann C, Elsner P. Tacrolimus enhances irritation in a 5-day human irritancy in vivo model. Contact Dermatitis. 2002 May. 46(5):290-4. [Medline].

  22. Draelos ZD. New treatments for restoring impaired epidermal barrier permeability: skin barrier repair creams. Clin Dermatol. 2012 May-Jun. 30(3):345-8. [Medline].

  23. Elias PM. Structure and function of the stratum corneum extracellular matrix. J Invest Dermatol. 2012 Sep. 132(9):2131-3. [Medline]. [Full Text].

  24. Miller DW, Koch SB, Yentzer BA, Clark AR, O'Neill JR, Fountain J, et al. An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial. J Drugs Dermatol. 2011 May. 10(5):531-7. [Medline].

  25. Slotosch CM, Kampf G, Löffler H. Effects of disinfectants and detergents on skin irritation. Contact Dermatitis. 2007 Oct. 57(4):235-41. [Medline].

Previous
Next
 
Chronic irritant contact dermatitis of the hands in an older worker; the condition resulted in early retirement.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.