This guide is based on the Joint Task Force Practice Parameter for Contact Dermatitis–Update 2015.

At least 1 in 5 of the general population (more frequently in women then men) are contact-allergic to common environmental allergens. Contact dermatitis is an inflammatory skin reaction caused by exposure to irritants or allergens. Treatment focuses on symptom relief and avoiding triggers.

Characteristics specific to contact dermatitis include: 

• Glazed, parched, or scalded appearance

• Sharply circumscribed dermatitis

• Healing begins promptly on withdrawal of the offending agent
  

Industries and jobs that pose a high risk for development of occupational contact dermatitis are as follows:

1. Food service and food processing (cooks and caterers)

2. Cosmetology (beauticians and hairdressers)

3. Health care (personnel)

4. Agriculture, forestry, and fishing

5. Cleaning

6. Painting

7. Mechanics, metal working, and vehicle assembly

8. Electronics industry

9. Printing and/or lithography

10. Construction

First-line recommendations: 

• Trigger identification: Identification and avoidance of contact with the offending agent(s) is the key to successful treatment. Review any recent abnormal exposures, new lotions, garments, foods, furniture, etc. 

• Topical corticosteroids: Reduce inflammation and itching. Hydrocortisone 1% cream (FDA M017): Apply thinly to affected areas 1-2 times daily for up to 7 days.

Second-line recommendations: 

• Emollients: Moisturizers to repair the skin barrier and reduce dryness. Examples: Petroleum jelly (FDA M016) or ceramide-based creams (same class as FDA K1 10757) as needed.

• Calamine lotion (FDA M016) and colloidal oatmeal baths (FDA M016) can also provide symptomatic relief

Prevention:

• Reducing exposure: If irritant is related to job or other necessary task, examples of methods of reducing exposure include using long handled cleaning tools (brush with a handle), vacuuming, or wet sweeping

Prescription medications:

• Systemic corticosteroids: For widespread or severe cases (e.g., prednisone).

• Topical calcineurin inhibitors: For sensitive areas like the face.

Citations:

Fonacier L, Bernstein DI, Pacheco K, et al. Contact Dermatitis: A Practice Parameter–Update 2015. The Journal of Allergy and Clinical Immunology: In Practice. 2015; 3(3): p.S1-S39. doi: 10.1016/j.jaip.2015.02.009

Alinaghi, F., Bennike, N. H., Egeberg, A., Thyssen, J. P., & Johansen, J. D. (2019). Prevalence of contact allergy in the general population: a systematic review and meta‐analysis. Contact dermatitis, 80(2), 77-85.