Self-Care Measures for Prevention and Management of Contact Dermatitis

Resolution of symptoms is a top priority for anyone experiencing contact dermatitis. Pharmacists are well positioned to provide patients experiencing mild to moderate cases of contact dermatitis with valuable information about self-care, prevention, and management measures; guide them in the selection of OTC products to resolve mild to moderate symptoms associated with contact dermatitis; and direct patients to seek further medical care when warranted.

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The American Academy of Allergy, Asthma & Immunology defines contact dermatitis as a common skin condition caused by direct contact with an irritant or allergen. It is typically classified as irritant or allergic contact dermatitis and affects approximately 15% to 20% of the population at some point, with varying degrees of severity and frequency.¹

Irritant contact dermatitis is an inflammatory skin reaction caused by direct damage to the epidermal cells as a result of exposure to an irritant such as chemicals (acids, metal salts, alkalis), soaps (abrasives, detergents), or household cleaning products.^2,3

This form of contact dermatitis commonly occurs in individuals who work in an environment that warrants frequent and repeated use of hand washing or hand hygiene products, food handling, chemical exposure, or glove use.^2,3

Allergic contact dermatitis is characterized as an inflammatory reaction of the skin due to exposure to an allergen, such as plants (poison ivy, poison oak), metal (nickel, mercury, cobalt), some products (latex, cosmetics, fragrances), and ingredients in some topical products.^2,3

Some individuals may have both irritant and allergic contact dermatitis. The skin may become inflamed and edematous after exposure to an irritant or allergen. The severity and clinical presentation vary among individuals.^1-3 In general, cases of acute irritant contact dermatitis are more painful than pruritic contact dermatitis, and clinical presentation may include 1 or more of the following^1-3: erythema, dry or scaling skin, edema, crusting, and blistering. Allergic contact dermatitis is generally more pruritic than painful, and clinical presentation may include erythema, scaling, edema, vesiculation, or severe swelling with bullae (large blisters with clear fluid).³

Literature reveals that factors determining the severity of contact dermatitis include the quantity and concentration of the irritant; duration and frequency of exposure; the skin type (thick, thin, oily, dry, very fair, or previously damaged skin); the presence of a preexisting atopic tendency; and environmental factors such as high or low temperature and humidity.⁴

In general, therapy goals are to remove and/or avoid the offending irritant or allergen when practical; to resolve symptoms, including itching and skin irritation; and to implement self-management and protective measures to manage and prevent contact dermatitis effectively.^2-4 Contact dermatitis treatment depends on the type of contact dermatitis and identification of the trigger, which can be instrumental in devising a treatment plan.

Management of Irritant Contact Dermatitis

Regardless of severity, initial management of irritant contact dermatitis includes thoroughly rinsing the affected area with tepid water and cleansing with a gentle, hypoallergenic soap. Colloidal oatmeal baths may offer additional relief from pruritus. Emollients, moisturizers, and barrier creams are recommended for restoring and maintaining epidermal barrier function.

Without contraindications, oral antihistamines may be considered when appropriate for patients experiencing significant pruritus. Older adults should avoid the use of first-generation antihistamines due to their sedation and anticholinergic effects. Due to limited and inconsistent efficacy, topical corticosteroids are not preferred in irritant contact dermatitis. Additionally, topical anesthetics of the “-caine” class should be avoided because of their potential to generate more skin irritation and induce allergic contact dermatitis.²

Management of Allergic Contact Dermatitis

Treatment of allergic contact dermatitis is guided by the severity of symptoms and the degree of antigen exposure. OTC topical agents may offer symptomatic relief. For localized, pruritic, erythematous lesions, topical hydrocortisone cream can help reduce inflammation and assist in drying weeping areas and is preferred for mild-to-moderate allergic contact dermatitis without significant edema or extensive involvement. It should be applied sparingly—up to 4 times daily—and without occlusive dressings. Ointment-based formulations are generally contraindicated for open lesions. Spray products offer convenience and can be easily applied to larger areas when appropriate.²

Supportive therapies can also be used, including Burow solution compresses and colloidal oatmeal baths or soaks. For nonexudative lesions, calamine lotion can provide additional soothing benefits. In some cases, cool or lukewarm soap-free showers may help alleviate pruritus.²

Conclusion

Before recommending any nonprescription product for contact dermatitis, pharmacists must ascertain whether self-treatment is appropriate and direct patients to seek further medical evaluation when warranted. Patients who should be referred for medical evaluation include those younger than 2 years, those with persistent or worsening symptoms despite self-treatment measures, those exhibiting signs of infection, those with extensive involvement of the skin and/or sensitive skin areas, or those with signs of swelling.²

Typically, irritant and allergic contact dermatitis resolve in 7 to 21 days with or without medical treatment, and use of nonprescription products generally results in symptomatic improvement in 5 to 7 days.²

During counseling, patients should be instructed on the proper administration and duration of use of the selected product and possible adverse effects. Pharmacists should remind patients that to avoid recurring contact dermatitis symptoms, it is critical to identify and avoid contact with the allergen or irritant that triggered the flare, if feasible, and to immediately contact their primary health care provider if there are no signs of improvement after self-treatment or if symptoms worsen.

REFERENCES

1. Contact dermatitis overview. American Academy of Allergy, Asthma & Immunology. Updated December 11, 2023. Accessed June 30, 2025. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/contact-dermatitis-overview

2. Herring M, Veach S. Contact dermatitis. In: Krinsky D, Ferreri S, Hemstreet BA, Hume AL, Rollins CJ, Tietze KJ, eds. Handbook of Nonprescription Drugs: An Interactive Approach for Self-Care. 21st ed.American Pharmaceutical Association; 2025.

3. Ruenger T. Contact dermatitis. In: Merck Manual, Professional Version. Merck & Co Inc; 2025. Updated April 2025. Accessed June 30, 2025.https://www.merckmanuals.com/professional/dermatologic-disorders/dermatitis/contact-dermatitis

4. Litchman G, Nair PA, Atwater AR, et al. Contact dermatitis. In:StatPearls. StatPearls Publishing; 2025. Accessed July 16, 2025.https://www.ncbi.nlm.nih.gov/books/NBK459230/