Skin Allergies


Skin conditions are one of the most common forms of allergy treated and managed by an allergist, a physician with specialized training and expertise to accurately diagnose your condition and provide relief for your symptoms. Skin allergies are caused by allergic reactions that occur on or under the skin. Irritated skin can be caused by a variety of factors. These include immune system disorders, medications and infections. Our thorough testing process can help pinpoint any allergies you may have and lead the way toward an effective treatment strategy.

For more information on the treating skin allergies or to schedule an appointment with an allergist, call Alabama Allergy & Asthma Center at 205-871-9661.

ATOPIC DERMATITIS (ECZEMA)

Atopic dermatitis, also known as eczema, is an itchy, red rash often associated with allergies. It commonly begins in the first year of life. The rash frequently appears in skin crease areas such as the elbows, knees, and wrists. It often affects the ankles, hands, feet, and face as well. The skin is usually dry and scaly, and red bumps may appear. The skin can become raw or weepy when it is scratched, and skin thickening may develop in areas of chronic involvement. Affected skin may also be prone to bacterial and viral infections. Eczema usually gets better as children get older, but it may persist into adulthood. Children with eczema often have other allergic issues. Approximately 75% of children with eczema go on to develop other allergies such as allergic rhinitis (hay fever) and/or asthma. Up to 50% of children with eczema have an allergy to a food, and eating that food may make the skin rash worse.

Symptoms
  • Itching
  • Patches of red, inflamed skin
  • Skin bumps that may leak fluid when scratched
  • Thickened, cracked, dry, scaly skin
Treatment

There is no cure for eczema, but good daily skin care is essential to controlling the disease.

  • Bathing tips:
    • Brief soak in bath once/day (10-15 minutes)
    • Use mild skin cleansers
    • Keep bath water lukewarm
    • Gently pat skin dry (avoid rubbing)
  • Moisturize:
    • Use creams or ointments free of dyes and fragrance to seal in moisture
    • Apply moisturizers immediately after a bath and several times/day
  • Stop itching and scratching:
    • Use antihistamines to relieve itching. Several are available over the counter or by prescription.
    • Keep fingernails trimmed and filed
  • Treat the rash:
    • Apply topical steroids or other topical medications as directed by your doctor.  These vary in potency.
    • In severe cases, your doctor may prescribe oral medications or medication injections to treat the rash

HIVES AND ANGIOEDEMA

Urticaria, or hives, is an inflammation of the skin triggered when the immune system releases histamine. This causes small blood vessels to leak, which leads to swelling in the skin. Urticaria is itchy, red and white raised bumps or welts that range in size and can appear anywhere on the body.   There are two kinds of urticaria, acute and chronic. Acute urticaria occurs after eating a particular food or coming in contact with a particular trigger. It can also be triggered by non-allergic causes such as heat or exercise, as well as medications, foods or insect bites. Chronic urticaria is rarely caused by specific triggers and so allergy tests are usually not helpful. Chronic urticaria can last for many months or years. Although they are often uncomfortable and sometimes painful, hives are not contagious.

Symptoms:

Angioedema is swelling in the deep layers of the skin. It is often seen together with urticaria (hives). Angioedema many times occurs in soft tissues such as the eyelids, mouth or other parts of the body.  This deeper layer of swelling can also occur on hands, feet, genitals, or inside the bowels or throat. Angioedema is called “acute” if the condition lasts only a short time such as minutes to hours. Acute angioedema 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 typically does not have an identifiable cause.

Hereditary angioedema (HAE) is a rare, but serious genetic condition involving swelling in various body parts including the hands, feet, face, intestinal wall and airways. It does not respond to treatment with antihistamines or adrenaline so it is important to go see a specialist.

Treatment:

If the cause of your hives can be identified, you can manage the condition by avoiding that trigger. Treating hives or angioedema is often successful with oral antihistamines that control the itch and recurrence of the rash.

If the rash is not controlled with a standard dose of the antihistamine, your doctor may suggest increasing the dose for better control of your symptoms. If antihistamines do not control the rash, or if it leaves bruises, then it is important that your doctor rules out other causes which may need alternative therapies.

If you are on certain blood pressure medicines (ACE inhibitors) and develop angioedema, it is important to consult your doctor. Changing to another blood pressure medicine may help the angioedema go away.

CONTACT DERMATITIS

When certain substances come into contact with your skin, they may cause a rash called contact dermatitis. There are two kinds of contact dermatitis: irritant and allergic.

Irritant contact dermatitis occurs when a substance damages the part of skin the substance comes in contact with. It is often more painful than itchy. The longer your skin is in contact with the substance, or the stronger the substance is, the more severe your reaction will be. These reactions appear most often on the hands and are frequently due to substances contacted in the workplace.

For irritant contact dermatitis, avoid the substance causing the reaction. Wearing gloves can sometimes be helpful. Avoiding the substance will relieve your symptoms and prevent lasting damage to your skin.

Allergic contact dermatitis is best known by the itchy, red, blistered reaction experienced after you touch poison ivy. This allergic reaction is caused by a chemical in the plant called urushiol. Reactions can happen from touching other items the plant has come into contact with. However, once your skin has been washed, you cannot get another reaction from touching the rash or blisters. Allergic contact dermatitis reactions can happen 24 to 48 hours after contact. Once a reaction starts, it may take 14 to 28 days to go away, even with treatment.

Nickel, perfumes, dyes, rubber (latex) products and cosmetics also frequently cause allergic contact dermatitis. Some ingredients in medications applied to the skin can cause a reaction. A common offender is neomycin, an ingredient in antibiotic creams.

Treatment depends on the severity of the symptoms. Cold soaks and compresses can offer relief for the early, itchy blistered stage of a rash. Topical corticosteroid creams may be prescribed. For severe reactions such as poison ivy, oral prednisone may be prescribed as well.

To prevent the reaction from returning, avoid contact with the offending substance our allergist may conduct allergy tests to help identify the cause.