Treatment for Underarm Dermatitis

Initial Management

The American Academy of Dermatology recommends removing potential irritants such as harsh soaps, detergents, fragrances, and deodorants that may be causing or exacerbating the dermatitis 2, 1
The American Academy of Dermatology suggests using lukewarm or cool water for washing the underarm area rather than hot water which can further damage the skin barrier 1
The American Academy of Dermatology advises patting dry gently rather than rubbing the affected area 1
The British Medical Journal recommends using dispersible creams as soap substitutes to cleanse the underarm area 3
The American Academy of Dermatology recommends choosing soaps/cleansers without allergenic surfactants, preservatives, fragrances, or dyes 1
The American Academy of Dermatology advises avoiding disinfectant wipes for cleaning the affected area 2

The British Medical Journal suggests applying moisturizers immediately after bathing to damp skin for maximum effectiveness 3, 1
The American Academy of Dermatology recommends using fragrance-free moisturizers with petrolatum or mineral oil as these are most effective and least allergenic 4
The American Academy of Dermatology recommends applying a low to medium potency topical corticosteroid to affected areas for mild to moderate cases 1
The American Academy of Dermatology advises identifying and avoiding irritants for irritant contact dermatitis 2
The American Academy of Dermatology suggests applying barrier creams (humectants) which may be helpful but are equivalent to regular moisturizers for irritant contact dermatitis 2
The American Academy of Dermatology recommends using topical steroids when conservative measures fail for irritant contact dermatitis, but be cautious of potential steroid-induced damage with prolonged use 2
The American Academy of Dermatology advises patch testing to identify specific allergens for allergic contact dermatitis 2, 1
The American Academy of Dermatology recommends avoiding identified allergens for allergic contact dermatitis 2
The American Academy of Dermatology suggests applying topical corticosteroids to mitigate flares for allergic contact dermatitis 2

The American Academy of Dermatology recommends considering stronger topical steroids for limited periods for recalcitrant cases 2
The British Medical Journal suggests using antistaphylococcal antibiotics if bacterial infection is present 3
The Annals of Oncology recommends using antiseptic solutions (e.g., silver sulfadiazine 1%, polyhexanide 0.02%-0.04%) for infected dermatitis 5

The American Academy of Dermatology advises applying moisturizer at night followed by loose cotton clothing to create a less occlusive environment 2
The American Academy of Dermatology recommends considering the "soak and smear" technique: soak the affected area in plain water for 20 minutes and immediately apply moisturizer to damp skin nightly for up to 2 weeks 2, 1
The American Academy of Dermatology warns against applying known allergens or irritants to the affected area 2
The American Academy of Dermatology advises against using very hot water for washing 2
The American Academy of Dermatology recommends avoiding occlusion without underlying moisturizer application 2
The American Academy of Dermatology warns against using superglue to seal inflammatory or healing fissures 2

The American Academy of Dermatology recommends referring to a dermatologist when dermatitis does not improve after 6 weeks of treatment 1
The American Academy of Dermatology advises referring to a dermatologist for suspected allergic contact dermatitis requiring patch testing 2, 1
The American Academy of Dermatology recommends referring to a dermatologist when there is a change in baseline dermatitis pattern 1
The American Academy of Dermatology suggests referring to a dermatologist for recalcitrant cases that may require phototherapy or systemic therapy 2