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Contact Dermatitis : Treatment
   
Western Medicine
Chinese Medicine

Several approaches can be used in treatment:

The disease responds to systemic (by injection) corticosteroids, which should be given as early as possible.
Small localized areas of involvement can be treated with a topical steroid cream.
Applications of cool, wet dressings containing Burow's solution (aluminum acetate) are helpful for treating acute lesions. The lotions are astringent and reduce swelling.
Chronic lichenified dermatitis (where skin has a thickened leathery appearance from constant scratching), which is extremely itchy, requires a potent fluorinated steroid ointment with an occlusive dressing to relieve itching and swelling.
Extensive areas of involvement or severely blistered lesions should be treated with a short but high dose of prednisone by mouth, or with intramuscular triamcinolone or methylprednisolone. .
An antibiotic may be indicated for secondary infections that result from bacterial invasion of skin that is already compromised or broken by contact dermatitis.


Antihistamines are generally not effective for controlling itching in contact dermatitis.






 

Internal Therapy

Traditional Chinese medicine aims at a holistic approach. Skin diseases are associated with internal disharmony between yin and yang and are the superficial presentations of internal damage.

1. Excessive heat accumulation

Therapeutic aim:To eliminate heat and toxic materials, cool the blood and clear the rash.

Prescription 1: Puji xiaodu dissolution drink (reduces rashes of the face and head).
ban lan gen isatis root
lian qiao large head atractylodes root
huang qin baical skullcap root
huang lian golden thread
yuan shen figwort root
ma bo puff-ball
niu bang zi great burdock achene
bo he peppermint
jiang can stiff silkworm
chen pi dried tangerine peel
jie geng platycodon root
chai hu Chinese tororwax root
sheng ma cimicifuga rhizome
gan cao liquorice root

Prescription 2: Liangxie jiedu decoction (for rashes on other parts of the body).
shang di dried rehmannia root
chia hao red peony root
jin yin hua honeysuckle flower
lian qiao weeping forsythia capsule
ban lan gen isatis root
pu gong ying dandelion
ye ju hau wild chrysanthemum flower
dan pi tree peony bark
zi cao gromwell root
huang qin baical skullcap root

2. Excessive heat mixed with dampness

Therapeutic aim: To disperse heat and dampness evils and to eliminate toxins and swelling.

Prescription: Longdan xiegan decoction.
chai hu Chinese tororwax root
huang qin baical skullcap root
long dab cao Chinese gentian
zhi zi Cape jasmine fruit
che qian zi plantain seed
shang di dried rehmannia root
dang gui Chinese angelica
ze xie oriental water plantain root
gan cao liquorice root

3. Blood deficiency and wind and dryness accumulation

Therapeutic aim: To disperse heat and wind evils, nourish the blood and re-hydrate the skin.

Prescription 1: Xiaofeng powder.
dang gui Chinese angelica
sheng di dried rehmannia root
fang feng divaricate saposhnikovia root
chan tui cicada slough
zhi mu common anemarrhena root
ku shen light yellow sophora root
hu ma common flax
jing jie fine-leaf schizonepeta herb
cang zhu atractylodes root
niu bang zi great burdock achene
shi gao gypsum
gan cao liquorice root

Prescription 2: Danggui decoction
sheng di common yam root
chuan xiong Szechwan lovage root
jing jie fine-leaf schizonepeta herb
fang feng divaricate saposhnikovia root
bai ji li puncture vine caltrop fruit
dang gui Chinese angelica
he shou wu fleece flower root
bai shao white peony root
huang qi milk vetch
gan cao liquorice root

External therapy

Of greatest importance in the treatment of contact dermatitis is the identification of the causative agent and its subsequent avoidance. Therapeutic approaches in skin lesions are also important. In order to facilitate healing, any substance used should be mild, non-stimulating and simple to apply. The following are examples:
For simple rashes: Sanhuang lotion or indigo powder lotion.
In cases of severe exudation and erosion of skin lesions: Moist dressings should be applied soaked with the following decoction:
  lu cha green tea
  ma chi xian purslane herb
  huang bai amur cork-tree
  yang di cao emilia sonchi folia
  shi wei pyrrosia leaf
  pu gong ying dandelion
  sang yu mulberry leaf
Where erosion and scarring have occurred on the skin lesion: Indigo emulsion.
In cases of scaling, thickening, coarse or lichen skin: Black soybean-distillate ointment.
Examples follow of some folk prescriptions which can be applied to skin lesions:
1. Fresh ground purslane herb.
2. If vesicles appear on the rash, the following decoction can be used as a wash or soak:
  huang qin baical skullcap root
  huang bai amur cork-tree
  ma chi xian purslane herb
  ming fan alum
 
3. Where the lesion has been scratched and there is exudate, washing or soaking with this decoction is useful:
  shang di yu fresh garden burnet root
  huang bai amur cork-tree
 
4. Fresh ground mung beans.
5. Fresh balsam pear.

Acupuncture and moxabustion
As contact dermatitis is seen as an asthenic (excessive) syndrome, acupuncture given using reduction or purgative therapeutic methods at two to four points can be helpful. Acupuncture points: chi-ze, qu-chi, he-gu, qu-ze, zu-san-li, wei-zhong, san-yin-jiao.

Dietary therapy
A congee made from mung bean and coix (raw Job's tears) seed can also be beneficial.