Skin Allergy Overview
Skin irritations are caused by a variety of factors. These include heat, immune system disorders, medications and infections. When an allergen is responsible for triggering an immune system response, the irritation is an allergic skin condition.
Allergic contact dermatitis occurs when your skin comes in direct contact with an allergen. For instance, if you have a nickel allergy and your skin comes in contact with jewelry made with even a very small amount of nickel, you may develop red, bumpy, scaly, itchy or swollen skin at the point of contact.
Atopic dermatitis (eczema) is a chronic skin condition related to immune disfunction in the layers of the skin. It usually begins in infancy or early childhood. It is often associated with asthma, allergic rhinitis (hay fever) or food allergy. This progressive sequence is called the atopic march.
Coming in contact with poison ivy, poison oak and poison sumac can also cause allergic dermatitis. The red, itchy rash is caused by an oily coating covering these plants. The allergic reaction can come from touching these plants, or by touching clothing, pets or even gardening tools that have come in contact with the oil.
Additionally, some individuals with eczema have a food sensitivity which can worsen eczema symptoms.
Hives are an inflammation of the skin triggered when the immune system releases histamine, causing small blood vessels to leak leading to swelling in the skin. Swelling in deep layers of the skin is called angioedema.
There are two kinds of hives – acute and chronic. Acute cases happen after eating a particular food or coming in contact with a particular substance trigger. Chronic hives can last for months or years.
Hives can result from non-allergic causes such as heat or exercise. Hives can also be an allergic reaction to medications, foods or insect bites.
Although often uncomfortable and sometimes painful, hives and eczema are not contagious.
Angioedema is swelling in the deep layers of the skin, often seen with urticaria (hives). Angioedema most often occurs in soft tissues such as the eyelids, mouth or genitals.
Angioedema is called "acute" if the condition lasts only a short time (minutes to days). This is commonly caused by an allergic reaction to medications or foods.
Chronic recurrent angioedema is when the condition returns over a long period of time. It most often does not have an identifiable cause.
Hereditary angiodema (HAE) is a rare, but serious genetic condition involving swelling in various body parts including the hands, feet, face, intestinal wall and airways.
Skin conditions are one of the most common forms of allergy treated and managed by an allergist / immunologist, a physician with specialized training and expertise to accurately diagnose your condition and provide relief for your symptoms.
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Skin Allergy Symptoms & Diagnosis
Redness, swelling and itching are common to most skin allergies. Yet there are some differences that help in the diagnosis of specific conditions.
Dermatitis (Eczema) Symptoms
Itchy bumps, blisters or very dry skin that:
• Appear as red to brownish-gray colored patches
• May “weep” or leak fluid that crusts over when scratched
In infants, eczema often appears on the cheeks, forehead or scalp. Children are prone to have the rash at the bend of the elbow joint, wrists, behind the knees and behind the ears. Adolescents and young adults typically have the rash in the same locations as children, as well as on the hands and feet.
People with atopic dermatitis can also have an extra crease, called a Dennie’s line, across the lower eyelids.
Identifying the cause of the skin irritation is essential to relieving the symptoms. An allergist / immunologist will take a complete health history and may perform tests to diagnose allergies that could be causing symptoms.
Urticaria (Hives) Symptoms
Swelling or raised red or white bumps or welts that:
• Can cover large areas and migrate from one spot to another
• Range in size
• Appear anywhere on the body
Angioedema often appears on the face around the eyes, cheeks or lips. This deeper layer of swelling can also occur on hands or feet, genitals, or inside the bowels or throat.
In acute hives, the welts disappear within minutes to a few weeks. Chronic hives last for months or even years.
In the majority of chronic cases, the exact cause cannot be determined. Routine testing such as general blood counts or screens are not cost-effective, nor do these tests make a difference in treatment strategies to relieve the symptoms. There are certain instances when allergy testing is helpful, especially when eating a particular food or coming in contact with a particular substance triggers symptoms of acute hives.
Skin Allergy Treatment & Management
Avoid scratching or rubbing the rash. Scratching can cause bleeding, skin infections, or cause permanent damage to the skin, making thick leathery patches.
Try applying cold compresses and creams or ointments to help relieve the itch. Keeping your skin moisturized will help restore the skin barrier. Be sure to use moisturizing ointments and creams rather than lotions.
Avoid using soap products that contain sodium laurel sulfate.
Avoid triggers that cause a reaction. Your allergist will help you determine what these triggers are.
Your allergist may also prescribe medications as an allergy treatment for your eczema symptoms:
• Topical corticosteroid cream medications and topical calcineurin inhibitors are most effective in treating the rash.
• Antihistamines are often recommended to help relieve the itchiness. Oral corticosteroids are sometimes prescribed in severe cases.
• Anitbiotics may be prescribed if a skin bacterial infection is suspected as a trigger for your eczema flare-up.
These skin allergy treatment and management strategies can relieve social challenges as well. People with eczema, especially children, are sometimes ignored or singled out by others who believe the rash is contagious.
If the cause of your hives can be identified, you can manage the condition by avoiding that trigger.
Treatment of hives is often successful with oral antihistamines that control the itch and recurrence of the rash.
Severe flare-ups may require taking corticosteroids to reduce inflammation.