Treatment for Elderly Patients with Repeat Contact Dermatitis on Face Due to Picking

Initial Management Approach

The British Journal of Dermatology recommends applying moisturizers with high lipid content immediately after cleansing to maintain skin barrier function in elderly patients with repeat contact dermatitis on the face due to picking 1, 2
The British Journal of Dermatology suggests using a low to medium potency topical corticosteroid such as hydrocortisone or clobetasone butyrate to affected areas for inflammation control in elderly patients with repeat contact dermatitis on the face due to picking 1
Gentle cleansing with mild soap substitutes and lukewarm water, followed by patting dry rather than rubbing, is recommended for elderly patients with repeat contact dermatitis on the face due to picking 3, 4
Identifying and eliminating potential irritants or allergens that may be exacerbating the condition is crucial in the management of repeat contact dermatitis on the face due to picking in elderly patients 3

Cognitive behavioral techniques such as relaxation therapy or self-hypnosis may be considered to address the picking behavior in elderly patients with repeat contact dermatitis on the face due to picking 5, 6
Evaluating for underlying psychological factors that may contribute to skin picking is essential in the management of repeat contact dermatitis on the face due to picking in elderly patients 6
Referral to a clinical psychologist for management of compulsive picking behaviors may be necessary for elderly patients with repeat contact dermatitis on the face due to picking 5, 6

The British Journal of Dermatology recommends avoiding sedative antihistamines in elderly patients with pruritus due to repeat contact dermatitis on the face 1, 2
Non-sedative antihistamines (H1 antagonists) such as fexofenadine 180 mg or loratadine 10 mg may be considered for pruritus management in elderly patients with repeat contact dermatitis on the face due to picking 1, 7
Gabapentin may be beneficial for persistent pruritus in elderly patients with repeat contact dermatitis on the face due to picking 1, 2

Reassessment of the patient is necessary if there is no response to initial treatment after 2 weeks, according to the British Journal of Dermatology 1, 2
Referral to secondary care may be considered if there is diagnostic doubt or if primary care management does not relieve symptoms in elderly patients with repeat contact dermatitis on the face due to picking 1, 2, 6
Patch testing to identify specific allergens may be considered for recalcitrant cases of repeat contact dermatitis on the face due to picking in elderly patients 3

The British Journal of Dermatology advises against using crotamiton cream for generalized pruritus in elderly patients with repeat contact dermatitis on the face due to picking 1, 7
Topical capsaicin or calamine lotion is not recommended for pruritus in elderly skin, according to the British Journal of Dermatology 1, 7
Very hot water for cleansing should be avoided as it can further damage the skin barrier in elderly patients with repeat contact dermatitis on the face due to picking 3, 4
Applying known allergens or irritants to the affected area should be avoided in the management of repeat contact dermatitis on the face due to picking in elderly patients 3

Applying moisturizers more frequently throughout the day to maintain skin hydration is recommended for elderly patients with repeat contact dermatitis on the face due to picking 3, 4