Best practices, new perspectives and the perfect emollient: optimizing the management of contact dermatitis

J Dermatolog Treat. 2018 May;29(3):241-251. doi: 10.1080/09546634.2017.1370074. Epub 2017 Sep 19.

Abstract

Contact dermatitis (CD) is caused by environmental agents, irritants, and allergens that penetrate the epidermis and lead to inflammation. An intact skin barrier prevents penetration and is important in maintaining healthy skin. Classical diagnosis of CD is made using the patch test, and traditional treatment strategies for CD promote skin barrier integrity and resolve the inflammatory component of the condition. This can be achieved by using emollient-based therapy, which is most important for skin barrier repair, and in addition to topical glucocorticosteroids, which are used in severe cases of CD and are most effective in reducing inflammation. Preventative measures, such as irritant and allergen avoidance in the workplace, also play a pivotal role in effective CD management. Moreover, CD management necessitates a holistic approach that incorporates prevention, barrier repair, and inflammatory resolution to ensure optimized efficacy. It is also important to consider potential barriers to optimal management when evaluating individuals with CD, such as limited patient education or poor access to care. Finally, key literature and our own clinical practice experience have highlighted the value of patient preference, as well as safety, efficacy and simplicity, in building the perfect emollient.

Keywords: Contact dermatitis; emollient; skin barrier.

Publication types

  • Review

MeSH terms

  • Allergens / immunology
  • Anti-Inflammatory Agents / therapeutic use
  • Dermatitis, Contact / classification
  • Dermatitis, Contact / diagnosis
  • Dermatitis, Contact / drug therapy*
  • Emollients / therapeutic use*
  • Humans
  • Methylprednisolone / analogs & derivatives
  • Methylprednisolone / therapeutic use
  • Patch Tests
  • Skin / metabolism
  • Skin / pathology

Substances

  • Allergens
  • Anti-Inflammatory Agents
  • Emollients
  • methylprednisolone aceponate
  • Methylprednisolone