The Secret of Great Health Care
Causes of rash
Many things can cause a rash. This section will look at some common causes of rash and give the reader an understanding of what could be causing the rash. Table 3: Factors that trigger atopic dermatitis (Allergic Skin)
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Hydrocortisone, which became an over-the-counter product in 1979, comes in a variety of products including Cortaid, Cortisone and Aveeno. It can be used for many things, but one of the major uses is for contact dermatitis (inflammation of the skin). This dermatitis is caused by variety of things including: poison ivy, soaps, jewelry, lotions or cosmetics. Hydrocortisone with help stop itching.
It is used three to four times a day. It should not be used (unless Ok’ed by your doctor) for diaper rah, vaginal itching when there is discharge, fungal infection, acne, hair loss, warts, sunburn or dandruff. Hydrocortisone should not be used for longer than 7 days without a doctor's consult.
Those under 12 should not use it for hemorrhoids unless a doctor has recommended it. It should not be used in those less than 2-years-old should. Women who are pregnant or breastfeeding should not use it. A doctor should be consulted if the rash goes away but comes back a few days after the hydrocortisone was stopped.
Hydrocortisone comes in a variety of formulations including creams, ointments, sprays and lotions. Ointments are more greasy and do not come off as easily. Creams are more tolerable and are better for moist lesions. Lotions spread better than creams and ointments, but are easily removed by water.
Hydrocortisone is approved for:
- Allergic reactions
- Insect bites
- Rashes
- Poison ivy, sumac or oak
- Eczema
- Seborrhea dermatitis or psoriasis
Anti-itch creams
Anti-itch creams contain topical steroids, topical antihistamines or topical anesthetics. Topical steroids were discussed above with hydrocortisone and may be the best topical treatment for itching. Other products, such as Benadryl cream, contain antihistamines that treat itching. Many people are sensitive to this type of product and they may lead to itching or red skin
Oral Antihistamines
Oral antihistamines are often the initial treatment for itching, mainly because of their availability and ease of use. They are associated with more side effects when compared to topical treatments. The first-generation antihistamines (older antihistamines) are particularly associated with side effects.
Older antihistamines - chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl) and hydroxyzine (Atarax) - are associated with more side effects, particularly sedation, and are less commonly used when compared to newer medications. The most common over-the-counter first-generation antihistamine is diphenhydramine.
Second-generation medications have improved dosing schedules and are less commonly associated with sedation. There are five, second-generation antihistamines available. Multiple studies have demonstrated that cetirizine (Zyrtec) is the most potent of the OTC second-generation antihistamines. These products are only mildly effective in treating the itch from a rash.
Cetirizine and loratadine are the two over-the-counter second-generation antihistamines. Specific conditions Atopic dermatitis (Eczema) treatment involves reducing aggravating factors, keeping the skin hydrated and reducing itching. First, avoid the triggering factors as described in table 3. Reduce the amount of bathing. Bathe every other day (if possible). Use non-soap cleaners (such as Cetaphil). Keep baths or showers to 3-5 minutes and use tepid water. After getting out of the bath place a moisturizer on the skin within three minutes. When bathing the addition of an Aveeno product (such as Soothing Bath Treatment, which is a colloidal oatmeal skin protectant) may be helpful in reducing itch and skin irritation. Using lotion once a day after baths may prevent flare-ups of atopic dermatitis. Any areas that are open and draining fluid can be dried with cool tap water compresses every 4-6 hours. The use of aluminum acetate solutions (bought as an OTC product – Domeboro Aluminum Acetate Astringent Solution) for compresses can be used as well. Aluminum acetate solutions soaks are expensive and not much more effective than placing a rung out washcloth with cool water on the area. Compresses are made by soaking a clean, soft cloth in cool water or a solution made by mixing Domeboro Packets with water and applying the cloth to the affected area for 15-30 minutes. The use of OTC hydrocortisone is the best treatment choice for those who are afflicted by itching. It should be applied every 6-8 hours to affected areas. The use of creams is the best initial choice, but for those who are not responding to creams they can use ointments. Dry skin can be treated with dry skin treatment – see section on dry skin. While it may take some time for the treatment to be effective. It is important to know when to go the doctor. When home-remedies and OTC medications do not provide relief than the physician can prescribe other medications that have proven more effective for atopic dermatitis. This includes Pimecrolimus (Elidel), Tacrolimus (Protopic) and/or stronger hydrocortisone products. For a natural solution to curing eczema a great new product is Eczema Free Forever. This product offers a solution to eczema that does not require prescription medications.
Contact dermatitis will go away in 2-3 weeks, with or without treatment. Treatment should focus on protecting the skin, reducing itching and preventing the spread of the rash. Baths can help relieve the itching. Cool water (around 90 degrees Fahrenheit) is ideal. The addition of colloidal oatmeal skin protectant to the bath can help soothe the skin further. Lesions that are open can be treated with a cool compress with cool tap water or aluminum acetate. A paste can be made with sodium bicarbonate powder (Baking Soda) and water to apply directly to the rash. It should be applied for 15-30 minutes and not applied near the eyes. Medications are needed for many cases of contact dermatitis. Hydrocortisone is the best treatment available over-the-counter. Cream is best for any open or weeping areas. When the area is dry either an ointment or cream is acceptable. Do not use topical antihistamines (Benadryl), antibiotics or anesthetics. These agents have the potential to cause a worsening of the dermatitis. Some people may choose to use agents that contain a topical antihistamine or benzocaine if other agents do not work, but they should be used with caution. When over-the-counter products do not help a doctor can: Fungal infections When treatment is delayed the infection can spread and become harder to treat. Daily cleaning with a soap and water should be done. The area should be dried with a separate towel than other areas of the body. On the same note, patients should not share items that touch infected areas. Clothing in the infected area should allow the skin to breathe. Do not wear occlusive clothing. Soaking fungal infections of the feet in aluminum salts helps antifungal medications to work more effectively. Burrow’s solution should be used and the foot is immersed for 20 minutes three times a day. Creams and solutions are the most effective ways to treat disease (see chart below). Use caution with antifungal medications, as the labeling is confusing. Many products with the same brand name have different active ingredients and therefore may be indicated for different fungal infections, different ages and different methods of treatment. For example, Lamisil has multiple products that treat fungal infections. Lamisil Cream has the active ingredient Terbinafine hydrochloride that can treat athlete's foot, ringworm and jock itch. This product is indicted for one week of treatment for most fungal infections. Another Lamisil product called Lamisil Defense contains Tolnaftate as an active ingredient and this product is not labeled for jock itch and needs to be used for four weeks. This product is labeled for use in those over the age of 2 and Lamisil cream is indicated for use in those over 12-years-old. Antifungal medications come in a variety of different formulations such as creams, solutions, gels and powders. Sprays or Lotrimin Ultra Cream may be more effective if you have an infection between you toes. Powders should be used for only mild cases. Lotions, creams and gels should be rubbed in well. Natural solutions Another solution to the treatment of ringworm and athlete’s foot is the use of natural products. A natural cure for ringworm can be found at ringworm treatment. A natural cure for Athlete’s foot, nail fungus and jock itch can be found at Cure Athlete’s Foot, Nail Fungus and Jock Itch.
The first step in the treatment of contact dermatitis is to wash the area to remove the offending substance and prevent the spread. The area should be rinsed before it is washed with soap, as soap can spread the rash. Tecnu is an outdoor skin cleaner (bought over-the-counter) that is rubbed on the affected area and than rinsed with cool running water. Those who are exposed to poison ivy should wash the area under the fingernails as some of the irritant can get trapped under the fingernails.
Lamisil AT Cream for Jock Itch (12 g)
Zeasorb AF Antifungal Drying Gel .85 oz (24 g)
Treatment involves a combination of antifungal medications and non-drug treatments. Treatment takes time. It may take up to one week before an improvement is noticed and up to four weeks for a complete eradication. Some people with more severe cases need to treat up to 6 weeks.
Lamisil AT Cream for Jock Itch (12 g)
Zeasorb AF Antifungal Drying Gel .85 oz (24 g)
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Generic Name |
Brand Name |
Directions for use |
Age |
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Butenafine |
Lotrimin Ultra Cream |
For athlete's foot (most effective for athlete's foot between the toes) apply twice daily for one week or once daily for 4 weeks. The 4 week treatment is more effective. Those with jock itch or ringworm should use the product once a day for 2 weeks. Few side effects |
12 and older for athlete's foot, ringworm and jock itch |
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Tolnaftate |
Tinactin, Lamisil Defense |
Approved for the treatment and prevention of athlete's foot. It is applied twice a day for 2-4 weeks to treat athlete's foot and ringworm and to prevent athlete's foot apply once or twice a day |
2 and older for athlete's foot and ringworm |
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Miconazole |
Lotrimin A, Zeasorb-AF, |
This product is used twice a day for four weeks for athlete's foot and ringworm; twice day for two weeks for jock itch |
2 and older for athlete's foot, ringworm and jock itch |
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Desenex |
This product is used twice a day for four weeks for athlete's foot |
2-years-old and older for athlete's foot |
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Clotrimazole |
Lotrimin AF |
This product is used twice a day for four weeks for athlete's foot and ringworm; twice day for two weeks for jock itch |
2-years-old and older |
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Terbinafine hydrochloride |
Lamisil cream, Lamisil gel |
Lamisil cream – apply twice a day for one week; on the bottom or sides of the feet apply twice a day for 2 weeks; for jock itch/ringworm apply once a day for one week |
12-years-old and older |
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Lamisil gel |
Same as cream except not labeled for bottom or side of the feet |
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