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Treatments and drugs
By Mayo Clinic staffDermatitis treatment varies, depending on the cause:
- Contact dermatitis. Treatment consists primarily of identifying the cause of the rash and then avoiding it. Sometimes, creams containing hydrocortisone or other stronger steroidal creams with or without wet dressings may help relieve redness and itching. It can take as long as two to four weeks for this type of dermatitis to clear up.
- Neurodermatitis. Getting you to stop scratching and to avoid further aggravating your skin are the treatment objectives. Accomplishing this may mean covering the affected area to prevent you from scratching it. Hydrocortisone and similar lotions and creams may help soothe your skin. You also may find that wet compresses provide relief. Antidepressants or anti-anxiety medications are helpful for some people. Also, counseling can help you learn how your emotions and behaviors can fuel — or prevent — itching and scratching.
- Seborrheic dermatitis. Medicated shampoos are usually the first treatment choice. Commonly used shampoos contain tar, pyrithione zinc, salicylic acid or ketoconazole as the active ingredient. Hydrocortisone creams and lotions may soothe nonscalp seborrheic dermatitis. If you develop a secondary infection, you may need treatment for this, too.
- Stasis dermatitis. Treatment consists of correcting the condition that causes fluid to accumulate in your legs or ankles for extended periods. This may mean wearing elastic support hose or even having varicose vein surgery. You may also use wet dressings to soften the thickened yet fragile skin and to control infection.
- Atopic dermatitis. Treatment typically consists of applying hydrocortisone-containing lotions to ease signs and symptoms. If your skin cracks open, your doctor may prescribe wet dressings with mildly astringent properties to contract your skin, reduce secretions and prevent infection. If itching is severe, your doctor may suggest you take antihistamines. Light therapy, which involves exposing your skin to controlled amounts of natural or artificial light, also may help prevent recurrences.
- Perioral dermatitis. Treatment for this condition is usually with the oral antibiotic tetracycline. You may need to continue this treatment for several months to prevent a recurrence. Your doctor may prescribe a very mild corticosteroid cream in the initial phase of treatment to reduce signs and symptoms of perioral dermatitis. When stronger corticosteroids are used, the condition may return temporarily and even worsen when the medication is stopped.
For all types of dermatitis, occasional use of over-the-counter antihistamines can reduce itching.
Immunomodulators
A class of nonsteroidal medications called immunomodulators, such as tacrolimus (Protopic) and pimecrolimus (Elidel), may help treat seborrheic dermatitis and atopic dermatitis. These medications affect the immune system and have anti-inflammatory and mild antifungal properties.
Due to possible concerns about the effect of prolonged use of these medications on the immune system, the Food and Drug Administration recommends that Elidel and Protopic be used only when other treatments have failed, or if someone can't tolerate other treatments.
