Berloque Dermatitis Treatment & Management

  • Author: Ali Alikhan, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Apr 14, 2010
 

Medical Care

The primary aim of the therapeutic regime is discontinuation of the offending substance. If berloque dermatitis is the putative diagnosis, all bergamot oil-containing perfumes should be avoided. Any perfumes that are worn should be worn on covered-up areas, not on areas of sun exposure.

If the patient presents in the acute phase and is in considerable discomfort, wet compresses may be helpful in relieving the discomfort. Simple analgesia may be given if the patient is in pain.

For secondary hyperpigmentation, the natural course of the dermatitis is spontaneous resolution after several months, but some lesions may persist much longer. The most important step is to minimize exposure to the sun. This may be done by avoiding strong sunlight whenever possible, avoiding the use of sunbeds and using a strong sunscreen (SPF 30 or higher) with activity in both the UVA and UVB spectra. Camouflage also may be used on exposed hyperpigmented areas, for cosmetic reasons. Dermablend and Covermark are preparations combining a water-resistant opaque base with a broad-spectrum sunscreen.

If the pigmentation is persistent, hydroquinone constitutes the mainstay of medical therapy. It usually is given twice a day, at a concentration of about 2%, for several months. At higher concentrations, the patient would be at risk of irritation. Hydroquinone sometimes is administered in conjunction with topical tretinoin (Retin-A). Kligman and Willis[19] devised a concoction known as Kligman's formula, consisting of hydroquinone, tretinoin, dexamethasone, ethanol, and propylene glycol, which they found effective in treating hyperpigmentation.

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Contributor Information and Disclosures
Author

Ali Alikhan, MD  Resident Physician, University of Chicago, MacNeal Hospital

Ali Alikhan, MD is a member of the following medical societies: American Medical Student Association/Foundation, Islamic Medical Association of North America, and Student National Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Ai-Lean Chew, MBChB, MRCP  Honorary Consultant, St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Trust, UK and Locum Consultant, South London Healthcare NHS Trust, UK

Ai-Lean Chew, MBChB, MRCP, is a member of the following medical societies: British Association of Dermatologists, British Medical Association, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Howard I Maibach, MD  Professor and Vice Chairperson, Department of Dermatology, University of California School of Medicine at San Francisco; Consulting Staff, University of California Hospitals

Howard I Maibach, MD is a member of the following medical societies: American Academy of Dermatology, American College of Forensic Examiners, American College of Physicians, American Contact Dermatitis Society, American Dermatological Association, American Federation for Clinical Research, American Medical Association, California Medical Association, Pacific Dermatologic Association, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Marjan Garmyn, MD, PhD  Professor, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium; Chair and Adjunct Head, Department of Dermatology, University of Leuven, Belgium

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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