Skin Allergy

Skin Allergy

Irritated itchy skin is very common and can be caused by a variety of factors which are difficult to pinpoint.   When an allergen is responsible for triggering the skin reaction, then it is an allergic skin condition. The most common allergic skin conditions include Eczema/Atopic Dermatitis, Hives/Uritcaria and Contact Dermatitis.

Atopic Dermatitis (Eczema)
Eczema or Atopic Dermatitis is the most common skin condition, affecting 10-20% of children and 3% of adults. It is sometimes described as an “itch which rashes.” It is now thought to be due a skin barrier problem causing skin to dry out and become prone to irritation and inflammation by many environmental factors. Also, some people with eczema have a food sensitivity which can make eczema symptoms worse.

Eczema is often linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.

People with eczema, especially children, are sometimes ignored or singled out by others who believe the rash is contagious.

How can I Diagnosis Eczema?

For difficult to treat skin problems including eczema, it is important to see an allergist / immunologist for diagnosis and management.  Additional input from a dietician and dermatologist may be needed as well.

Our expert team at Breathe Easy Allergy and Asthma will complete a thorough history and Physical Exam to help identify potential food, aeroallergen and chemical/irritant triggers.  Skin prick testing and/or Immunocap blood testing may be completed to identify the culprit allergens. 

How can I treat Eczema?

Treatment is usually customized to each individual patient and depends on regular use of moisturizer and topical medicines to dampen down the inflammation. Our team will help develop comprehensive skin action plan to : Identify and avoid triggers

Suggest hypoallergenic free and clear products

Prescribe topical skin medications (ex topical steroids or nonsteroidal formulations: antibacterial, antifungals, or calcineurin inhibitiors)

Prescribe antihistamines to decrease itching

Assess the need for short bursts oral steroids or antibiotics

Start intensive emollient applications or “wet wraps”

HIVES OR URTICARIA

Hives are also known as urticaria, inflammation of the skin triggered by an immune response releasing Histamine.  Hives are described as itchy red bumps or welts that appear on the body. About 20 percent of Americans have hives at some time in their lives. Although they are often uncomfortable and sometimes painful, hives are not contagious

There are two types of urticaria:  Acute and chronic. 

Acute Urticaria are hives that last < 6 weeks.  Chronic urticaria are hives that last >6 weeks.

What are common causes of hives?

Foods and additives, especially peanuts, eggs, nuts and shellfish

  • Medications such as aspirin and antibiotics (especially penicillin and sulfa)
  • Insect stings or bites
  • Heat, exercise, pressure, cold water, sun exposure. 
  • Infections including the common cold, urinary tract infections, strep throat, infectious mononucleosis and hepatitis, or other viral infections

In most of these cases, the hives resolve when the cause is avoided, removed or treated.

How can I identify the causes of my hives?

In some cases the cause is obvious – a person eats peanuts or shrimp, and then develops hives within a short time. Because there are so many possible causes for hives, other cases require detective work by the patient and physician.

Sometimes the cause of chronic hives cannot be identified despite detailed history and testing. This condition is called idiopathic urticaria or ‘hives with no cause.”  The immune system is the cause of about 50 percent of hives that are not identified. In other cases, chronic hives may be associated with thyroid disease, other hormonal problems, or rarely cancer. In most cases, chronic hives will gradually disappear over time.

What is the treatment for hives?

The team at Breathe Easy Allergy and Asthma can perform the necessary History and Physical to help identify triggers.  In many cases skin prick testing or lab testing is indicated to help exclude other causes.  A regimen of antihistamines can help keep hives under control.  Severe episodes of hives may require short courses of steroids or immune modulator medication.  A new monthly injection called xolair may also be used if you fit the criteria.

When hives involve swelling of the tongue or trouble breathing, immediate evaluation in the emergency room is required and you will be prescribed an epinephrine self-injector will be prescribed for you to carry.

If you need more information about how to treat hives, or have any questions, your allergist will be happy to answer them.

Allergic Contact Dermatitis

Contact dermatitis is caused when the skin touches either an allergen or something that irritates it, causing symptoms such as a rash, blisters, itching and burning. Most cases of contact dermatitis are not caused by an allergen but by something that irritates the skin such as chemicals, metals, and some plants.

What causes contact dermatitis?

Irritants and allergens that can cause contact dermatitis include:

  • Cosmetics, nail care products
  • Dyes and hair coloring
  • Fragrances and perfumes added to products, such as soaps, fabric softeners, deodorants, body creams, cosmetics, tissues and toilet paper
  • Latex, which is used in things such as plastic gloves, waistbands, bras, condoms,  toys and balloons
  • Medicines
  • Metals  
  • Soaps and cleaning products
  • Poison ivy and other plants

What are the signs and symptoms of contact dermatitis?

Symptoms can range from mild to severe on the area of skin that touched the irritant or allergen. These may include:

  • Redness and swelling
  • Itching
  • Itchy bumps or blisters that may ooze fluid
  • Rash
  • Warm or hot to the touch
  • Cracking or peeling of the skin

How can I diagnose and treat contact dermatitis?

The team at Breathe Easy Allergy and Asthma will review your medical history, perform a History and Physical and perform diagnostic testing which may include Laboratory testing, skin prick testing, or patch testing. 

Depending on your sensitivities, we will help you avoid these triggers and identify cosmetics and common household items which may contain these irritants.  Common treatments also include topical steroids, oral antihistamines and oral steroid courses.