# Contact dermatitis (irritant or allergic) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: NICE CKS Contact Dermatitis 2021 · Egyptian National Drug Formulary - Endocrine System 2024 (betamethasone monograph) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · Contact Dermatitis - disease-level clinical article (contact-dermatitis-clinical.txt) · Egyptian National Drug Formulary - Respiratory System 2026 (cetirizine monograph) · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Endocrine System 2024 (betamethasone monograph) - Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) - Contact Dermatitis - disease-level clinical article (contact-dermatitis-clinical.txt) - Egyptian National Drug Formulary - Respiratory System 2026 (cetirizine monograph) - Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph) ## Treatment metadata - Betamethasone — topical - Referral & safety-netting (no drug therapy) - Hydrocortisone — topical - Prednisolone — 5 mg — oral.solid - Cetirizine — 10 mg — oral.solid ## Complete treatment card ```text CONTACT DERMATITIS (IRRITANT OR ALLERGIC) Sources: NICE CKS Contact Dermatitis 2021 · Egyptian National Drug Formulary - Endocrine System 2024 (betamethasone monograph) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · Contact Dermatitis - disease-level clinical article (contact-dermatitis-clinical.txt) · Egyptian National Drug Formulary - Respiratory System 2026 (cetirizine monograph) · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph) Review status: REVIEWED against 4 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (5) - Burning, stinging, or soreness are prominent early in irritant contact dermatitis - Itching (pruritus) is more prominent in the allergic form [itching] - In allergic contact dermatitis, lesions appear 24 to 72 hours after exposure and peak at 72 to 96 hours - Allergic contact dermatitis resolves more slowly but recurs within days of re-exposure - Irritant contact dermatitis peaks within minutes to a few hours of exposure, then begins healing SIGNS - what you find (4) - Acute-phase findings include erythema, edema, oozing, crusting, and vesicles or pustules [blisters · crusting · oedema · pustules · redness · vesicles] - Subacute-phase skin shows crusting, scaling, and hyperpigmentation [crusting · pigmentation change · scaling] - Chronic-phase skin becomes lichenified - Hands are a common site for allergic contact dermatitis TESTS (3) - Patch testing is the gold-standard test to confirm allergic contact dermatitis and identify the trigger - Patch test results are read 48 to 72 hours after removal at 48 hours - A dimethylglyoxime spot test on jewelry turns pink with a positive nickel reaction IF NOT THIS - what else fits (6) - Asteatotic eczema is on the differential list - Contact urticaria syndrome is a differential consideration - Drug-induced photosensitivity is on the differential list - Perioral dermatitis is a differential to distinguish from contact dermatitis - Phytophotodermatitis is on the differential list - Tinea corporis should be distinguished from contact dermatitis Source StatPearls "Contact Dermatitis" - disease-level clinical article Status traced to the source above Rx: Main treatment | Systemic steroid - severe or widespread disease MAIN TREATMENT - choose one, plus any add-on marked below 1. BETAMETHASONE [1st line] Adult Apply 0.1% cream/ointment thinly once or twice daily Peds Child >1 year: use hydrocortisone 1% cream for short courses Source Egyptian National Drug Formulary - Endocrine System 2024 (betamethasone monograph) Why Potent topical corticosteroid that suppresses the local inflammatory response driving contact dermatitis; used first-line on thicker skin away from the face and flexures, where a more potent steroid is needed to control inflammation. Caution Identify and eliminate triggering contact allergen/irritant. Apply emollients frequently as maintenance therapy. The Egyptian formulary limits a course to 5 days when this is used on the face or in a child - 0.1% betamethasone is potent and the face thins fastest. Rosacea, acne, perioral dermatitis, perianal and genital pruritus. Egypt CRONOMESONE 0.1% CREAM 15 GM PHAROPHARMA 4.00 EGP CRONOMESONE 0.1% OINT. 15 GM PHAROPHARMA 4.00 EGP BETNOVATE 0.1% TOP. OINT. 15 GM SMITHKLINE BE... 6.90 EGP BETADERM 0.1% CREAM 15 GM EIPICO 18.00 EGP BETAVAL 0.1% CREAM 20 GM ARAB DRUG COM... 20.00 EGP BETADERM 0.1% CREAM 30 GM EIPICO 23.00 EGP BETAMETHASONE DIPROPIONATE 0.05% CREAM 20 GM AMRIYA 11.50 EGP BETAMETHASONE DIPROPIONATE 0.05% OINT. 20 GM AMRIYA 11.50 EGP 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Contact Dermatitis - disease-level clinical article (contact-dermatitis-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Contact urticaria (a form of contact dermatitis) can progress to anaphylaxis. 3. HYDROCORTISONE [2nd line] Adult To be applied sparingly to the affected skin two or three times daily after gently cleansing the area. Peds Adults and children: To be applied sparingly to the affected skin two or three times daily after gently cleansing the area. Courses of treatment in children should generally be limited to not more than seven to ten days. Source Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) Why Mild-potency topical corticosteroid preferred for facial, flexural, or other delicate skin where a potent steroid like betamethasone is contraindicated; it still works by suppressing local inflammation but with lower risk of skin thinning in these sensitive areas. Caution Hydrocortisone is the preferred initial choice for facial, flexural, or delicate skin areas where potent steroids are contraindicated. Hydrocortisone is a mild potency steroid, safe for facial or pediatric contact dermatitis. Discontinue when inflammation resolves. Avoid continuous application for >2 weeks. Limit a course in a child to 7-10 days, and remember the face and scalp absorb far more than limb skin. Hydrocortisone Cream is contra-indicated in patients with bacterial, viral or fungal infections of the skin. Urticaria, rosacea, ulcers and local infection are also contra- indications. Egypt NOVACORTIN 1% CREAM 15 GM PHAROPHARMA 4.75 EGP NOVACORTIN 1% OINT. 15 GM PHAROPHARMA 4.75 EGP MICORT 1% CREAM 20 GM MISR 12.50 EGP HYDROCORTISONE 1% OINT. 20 GM MISR 21.00 EGP 4. CETIRIZINE [add-on - not a substitute] Adult 10 mg once daily - as-needed Peds Age restriction: minimum 24 months 2 to under 6 years: 2.5 mg once to twice daily 6 to under 12 years: 5 mg twice daily, or 10 mg once daily based on severity 12 years and over: 10 mg once daily (ENDF oral dosing by age band. The formulary's oral indications are allergic rhinitis and chronic idiopathic urticaria; the contact-dermatitis indication comes from the disease article.) Source Egyptian National Drug Formulary - Respiratory System 2026 (cetirizine monograph) Why The disease article adds an oral antihistamine to control pruritus alongside the topical steroid; the card carried topical treatment only. Caution The ENDF oral indications are allergic rhinitis and chronic idiopathic urticaria - use for contact-dermatitis pruritus rests on the disease article, not on the formulary indication. Egypt EPIRIZINE 10 MG 10 TABS. EIPICO 15.50 EGP (1.55/unit) CETRITIN 10MG 20 TAB. EL NILE. 42.00 EGP (2.10/unit) TOMAZINE 10MG 30 F.C. TABS. ALFACURE PHAR... 63.00 EGP (2.10/unit) CETRAK 10 MG 20 TABS. PHARCO 68.00 EGP (3.40/unit) HISTAZINE-1 10 MG 20 TABS. AMRIYA 68.00 EGP (3.40/unit) ZYRTEC 10 MG 20 TAB. GLAXO SMITHKLINE 100.00 EGP (5.00/unit) CETRICHEW 10MG 20 CHEWABLE F.C. TABS. AL ROWAD PHARMACEUTICAL INDUSTRIAL... 15.00 EGP HISTA CHEW 10 MG 20 CHEWABLE TAB. ARAB CAPS > ADVOCURE 15.00 EGP LERGFREE 5MG/5ML SYRUP 120ML DEBEIKY 9.00 EGP -> ? strength differs, ? different route - not oral solid EPIRIZINE 5MG/ML SYRUP 60 ML EIPICO 19.00 EGP -> ? strength differs, ? different route - not oral solid SYSTEMIC STEROID - SEVERE OR WIDESPREAD DISEASE 5. PREDNISOLONE [2nd line] Adult 5 to 60 mg/day as a single daily dose or in 2 to 4 divided doses, tapered Peds The ENDF prednisolone monograph gives no paediatric figure for this indication, so none is stated here. Source Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph) Why The disease article reserves systemic steroid for severe contact dermatitis and requires a gradual taper to prevent rebound. Caution Abrupt withdrawal is not recommended, particularly with doses of 40 mg or more or 3 weeks of treatment or more. The dose should be gradually decreased to the lowest dose that maintains an adequate clinical response. The ENDF gives a dose range across all systemic indications, not a contact-dermatitis regimen - the indication comes from the disease article. Egypt HOSTACORTIN H 5MG 30 TAB. SANOFI 12.00 EGP (0.40/unit) PREDNISOLONE 5 MG 20 TABS. ARAB DRUG COM... 24.00 EGP (1.20/unit) PREDILONE 5MG 10 TAB. (25 STRIPS PACK) KAHIRA 250.00 EGP (25.00/unit) EPICOPRED 5 MG 30 ORODISPERSIBLE TABS. EIPICO 69.00 EGP PREDNISOLONE-EVA 5 MG 30 ORODISPERSIBLE TABS. EVA PHARMA 79.50 EGP DISPRELONE-OD 5 MG 30 ORODISPERSABLE TABS. ANDALOUS PHARMA 84.00 EGP SOLUPRED ORO 5 MG 30 ORODISPERSIBLE TABS. SANOFI WINTHROP > SANOFI 84.00 EGP ACETASEE 1% EYE DROPS (SUSP.) 5 ML RAMEDA 7.50 EGP -> ? strength differs, ? different route - not oral solid PREDNIS 5MG/5ML SYRUP 100 ML PHAROPHARMA 9.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)