Contact Dermatitis Nursing Care Plan Notes


  • Contact dermatitis is an inflammatory reaction of the skin to physical, chemical, or biologic agents.
  • It may be of the primary irritant type, or it may be allergic.
  • The epidermis is damaged by repeated physical and chemical irritation.
  • Common causes of irritant dermatitis are soaps, detergents, scouring compounds, and industrial chemicals.
  • Predisposing factors include extremes of heat and cold, frequent use of soap and water, and a preexisting skin disease.

Contact Dermatitis

Other types of dermatitis
  • Contact dermatitis is caused by an allergen or an irritating substance. Irritant contact dermatitis accounts for 80% of all cases of contact dermatitis.
  • Atopic dermatitis is very common worldwide and increasing in prevalence. It affects males and females equally and accounts for 10%–20% of all referrals to dermatologists. Individuals who live in urban areas with low humidity are more prone to develop this type of dermatitis.
  • Dermatitis herpetiformis appears as a result of a gastrointestinal condition, known as celiac disease.
  • Seborrheic dermatitis is more common in infants and in individuals between 30 and 70 years old. It appears to affect primarily men and it occurs in 85% of people suffering from AIDS.
  • Nummular dermatitis is a less common type of dermatitis, with no known cause and which tends to appear more frequently in middle-age people.
  • Stasis dermatitis is an inflammation on the lower legs which is caused by buildups of blood and fluid and it is more likely to occur in people with varicose.
  • Perioral dermatitis is somewhat similar to rosacea; it appears more often in women between 20 and 60 years old.
  • Infective dermatitis is dermatitis secondary to a skin infection
Clinical Manifestations
  • Eruptions when the causative agent contacts the skin.
  • Itching, burning, and erythema are followed by edema, papules, vesicles, and oozing or weeping as first reactions.
  • In the subacute phase, the vesicular changes are less marked and alternate with crusting, drying, fissuring, and peeling.
  • If repeated reactions occur or the patient continually scratches the skin, lichenification and pigmentation occur; secondary bacterial invasion may follow.
Medical Management
  • Soothe and heal the involved skin and protect it from further damage.
  • Determine the distribution pattern of the reaction to differentiate between allergic type and irritant type.
  • Identify and remove the offending irritant; soap is generally not used on site until healed.
  • Use bland, unmedicated lotions for small patches of erythema; apply cool wet dressings over small areas of vesicular dermatitis; a corticosteroid ointment may be used.
  • Medicated baths at room temperature are prescribed for larger areas of dermatitis.
  • In severe, widespread conditions, a short course of systemic steroids may be prescribed.
Nursing Management

Instruct patient to adhere to the following instructions for at least 4 months, until the skin appears completely healed:

  • Find out the cause of the problem.
  • Avoid contact with the irritants, or wash skin thoroughly immediately after exposure to the irritants.
  • Avoid heat, soap, and rubbing the skin.
  • Choose bath soaps, detergents, and cosmetics that do not contain fragrance; avoid using a fabric softener dryer sheet.
  • Avoid topical medications, lotions, or ointments, except when prescribed.
  • Make sure gloves are cotton-lined; do not wear for more than 15 to 20 minutes at a time.