Advise patient to take a shower at least once a day for 15-20 minutes for the bath water will seep into the skin saturation. Shower more frequently if signs and symptoms increased.
Advise patient to use warm water, not hot water since hot water causes vasodilation which will improve pruritus.
After bathing, allow the skin to air dry or gently pat the skin dry. Avoid rubbing or brisk drying.Rubbing the skin with a towel can irritate the skin and exacerbate the itch-scratch cycle.
Instruct patient to apply ointment or cream that had been prescribed after a shower.Application of moisturizing cream for 2-4 minutes after bathing prevents water evaporation from the skin.
When bathing, tell patient to use a moisturizing soap or soap for sensitive skin. Avoid bubble bath. Soaps which contain moisturizers should be considered with less alkaline content and do not make skin dry since dry soap may increase complaints.
Assess skin for severity of skin integrity compromise.The skin is the body’s first line of defense against infection. Disruption of the integrity of skin increases the patient’s risk of developing an infection or of scarring.
Assess for signs of infection.Patients with dermatitis are at highest risk for developing skin infections caused byStaphylococcus aureus. Purulent drainage from skin lesions indicates infection. With severe infections, the patient may have an elevated temperature.
Over-the-counter dandruff or medicated shampoos may be used to address flaking and dryness of the scalp. Look for a product that says on the label it treats seborrheic dermatitis. Such products contain ingredients such as salicylic acid, coal tar, zinc, resorcin, ketoconazole, or selenium sulfide. Use the shampoo according to label instructions.
For severe cases, a shampoo or lotion containing a stronger dose of selenium sulfide, ketoconazole, cicloprox, sodium sulfacetamide, or corticosteroid. A cream that contains an immunomodulator, such as tacrolimus or pimecrolimus, may be prescribed may be prescribed. This medicine suppresses the immune system to treat inflammation.
Apply / give an ointment or cream that had been prescribed two or three times per day to hydrate the skin.
Encourage the patient to keep fingernails trimmed short.Long fingernails used for scratching are more likely to cause skin trauma and aggravate itching.
Administer antihistamine drugs as ordered. Antihistamines such as hydroxyzine will help relieve itching and promote comfort. These drugs can be taken at bedtime. Their sedative effect may also help promote sleep. During the daytime, nonsedating antihistamines may increase the efficacy of pruritus control. Loratadine is an over-the-counter medication.
Encourage the patient to avoid aggravating factors.Some change in lifestyle may be indicated to reduce triggers.
