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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
Satisfied Customers: 890
Experience:  Board Certified Family Nurse Practitioner
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Good afternoon. I started using the Nicoderm CQ patches on

Resolved Question:

Good afternoon. I started using the Nicoderm CQ patches on about Feb 13. I stopped 4-5 days ago because I noticed that my skin remained irritated where the patches had been. As the days go by, my skin is becoming more and more itchy and irritated. Two locations are full blown hives now. So far the rashes and hives are mostly staying within the borders of where the patches were applied. Should I be concerned about spreading of the hives or other more serious things? Would an oral antihistamine product help? I have been using Benadryl spray for a couple of days with no success. Thank you so much!
Submitted: 6 years ago.
Category: Health
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.



Thank you for writing in today. It is not uncommon for people to have this type of reaction to nicotine patches. Essentially, the patch can cause a sort of contact dermatitis. The best thing for this would be a low dose topical steroid, such as hydrocortisone cream. Hydrocortisone cream is easily available over the counter. Generally, when a patient applies it twice a day after cleansing the area, he/she will some improvement within 2-3 days. Most people respond well to the topical steroid. However, given the online format and my inability to assess the area, I will have to mention that you should consult your provider to confirm a diagnosis. I hope this helps. If you have any additional questions or concerns, please let me know. Lisa

Customer: replied 6 years ago.
Relist: Incomplete answer.
Please answer. Thanks.
Customer: replied 6 years ago.
Ok. So, I probably have allergic dermatits or something. My question was really - will it spread. Since you didn't tell me to "go to the ER immediately!" I'm assuming that it won't spread and that I will live. Laughing I was worried because when a doctor asked a few years ago what allergic reaction I had had to penicillin as a child, and I told him or her "oh, just hives", the response was unexpected. I was told that it was a serious allergic reaction. I got a bit worried that this would be serious too. I can't afford to go to a doctor - and I'm guessing most of the guests of this site can't either.
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.
You are always welcome to ask follow up questions. No, this should not spread, unless the scratching starts to irritate the surrounding skin or introduces bacteria into the area. The topical hydrocortisone will likely be more beneficial than a systemic antihistamine. For future information, if you do develop hives, the important thing is to always assess for respiratory issues, such as wheezing. That the immediate danger associated with any allergic reaction. You could consider using the over the counter hydrocortisone cream (generic is usually $2-3) for a couple days. If your symptoms don't improve, get worse, or new ones develop, then definitely seek care. I will say that I would have responded sooner; however, since you relisted, I thought I would let other experts respond as well. One expert did agree; however, it doesn't appear that anyone had much to ad. I am responding now because your latest posting really did help to narrow down the additional information you were needing. Please know that anytime you ask a question here you are more than welcome to ask follow up questions as well. We really do want to help. If you need further clarification or more information, don't be afraid to let us know. Take care. Lisa
Customer: replied 6 years ago.
Thank you Lisa. I appreciate the follow up. Sorry if I sounded grumpy. The withdrawal grumpiness/irritability is one of the worst parts of quitting smoking for me!

Have a good day.
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.
No, I just want you to be satisfied. I really commend you for quitting. It is the absolute best decision you can make. Keep that in mind. It may get challenging, but it is worth it. Take care. Lisa
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