Skin Allergy Management and Treatment

Eczema

Overview

Eczema, also known as atopic dermatitis, is a chronic, non-contagious, inflammatory skin condition characterized by itching, redness, and scaly rashes.

Atopic DermatitisTreatment and Management

Children and adults diagnosed with eczema can manage the condition with the guidance of an allergist. In cases of moderate or severe eczema, an allergist may recommend prescription medication, including topical steroids and/or antihistamine. Milder cases may be treated with ointments such as petroleum jelly, and moisturizers. Those should be applied daily, even when the skin appears clear, to help prevent dryness.

People with eczema should avoid harsh cleansers, drink water often, wear gloves in cold weather, and avoid wearing materials such as wool, which could irritate the skin. Flare-ups of eczema can be caused by foods, cosmetics, soaps, wool, dust mites, mold, pollen, dog or cat dander, dry climate and other variables.

If you have an infant with eczema, your allergist might advise you to bathe him at least once a day and immediately apply moisturizer after the bath. Limited use of pH balanced skin cleansers should also be part of frequent bathing, along with gentle patting dry, and the immediate application of a moisturizer to "seal" in moisture. This technique is called "soak and smear" and can provide relief from the itching that comes with eczema.

There are also some new treatments available for eczema. In 2016, the U.S. Food and Drug Administration approved a topical treatment for children and adults with mild to moderate eczema. It is the first new FDA-approved medication for eczema in more than 10 years. The clinical trials have shown the medication is effective at decreasing inflammation and is well-tolerated with long term use.

Hives (Urticaria)

Overview

Hives, also known as urticaria, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts. The itching may be mild to severe. Scratching, alcoholic beverages, exercise and emotional stress may worsen the itching

Management and Treatment

Researchers have identified many - but not all - of the factors that can cause hives. These include food and other substances you take, such as medications. Some people develop hives just by touching certain items. Some illnesses also cause hives. Here are a few of the most common causes:

  • Some food (especially peanuts, eggs, nuts and shellfish)
  • Medications, such as antibiotics (especially penicillin and sulfa), aspirin and ibuprofen
  • Insect stings or bites
  • Physical stimuli such as pressure, cold, heat, exercise or sun exposure
  • Latex
  • Blood transfusions
  • Bacterial infections, including urinary tract infections and strep throat
  • Viral infections, including the common cold, infectious mononucleosis and hepatitis
  • Pet dander
  • Pollen
  • Some plants, such as poison oak and poison ivy

Antihistamines - available either over the counter or by prescription - are a frequently recommended treatment for hives. They work by blocking the effect of histamine, a chemical in the skin that can cause allergy symptoms, including welts. Low-sedating or nonsedating antihistamines are preferred. They are effective and long-lasting (may be taken once a day) and have few side effects. Your allergist may recommend a combination of two or three antihistamines to treat your hives, along with cold compresses or anti-itch salves to ease the symptoms.

Severe episodes of urticaria may require temporary treatment with prednisone, a similar corticosteroid medication or an immune modulator, which can reduce the severity of the symptoms.

If your reaction involves swelling of your tongue or lips, or you have trouble breathing, your allergist may prescribe an epinephrine (adrenaline) auto-injector for you to keep on hand at all times. These can be early symptoms of anaphylaxis, a potentially fatal allergic reaction that impairs breathing and can send the body into shock. The only treatment for anaphylaxis is epinephrine. If you develop hives and your injector is not nearby - or if using the auto-injector doesn't cause the symptoms to immediately improve - go to an emergency room immediately. You should also go to the emergency room after using an auto-injector.

If the cause of hives can be identified, the best treatment is to avoid the trigger or eliminate it:

  • Foods: Don't eat foods that have been identified to cause your symptoms.
  • Rubbing or scratching: Avoid harsh soaps. Frequent baths may reduce itching and scratching – beneficial because itching and scratching can make the hives feel worse.
  • Constant pressure: Avoid tight clothing. Pressure hives can be relieved by wearing loose-fitting clothes.
  • Temperature: If you develop hives when exposed to cold, do not swim alone in cold water and always carry an epinephrine auto-injector. Avoid exposure to cold air and use a scarf around your nose and mouth in cold weather. If you must be out in the cold, wear warm clothing.
  • Sun exposure: Wear protective clothing; apply sunblock.
  • Medications: Notify your physician or pharmacist immediately if you suspect that a specific medication is causing your hives.

Contact Dermatitis

Overview

Do you develop red, itchy bumps around your ankles hours after hiking through the woods? Did a rash appear on your neck after you wore a new necklace? Has your face broken out in hives during an afternoon at the beach?

Poison ivy, jewelry made of certain metals (especially nickel or gold) and sunscreen all can cause contact dermatitis — a skin condition that results from exposure to something to which you're either sensitive or allergic.

Management and Treatment

There are two parts to addressing contact dermatitis: First, treat the irritated skin. Next, determine what caused the reaction so you can avoid that allergen or irritant in the future.

Your allergist can prescribe creams — or, in some cases, oral medication — to relieve the itching and help the damaged skin to heal. Antihistamines and ointments can also help. Avoid scratching the affected area to prevent infection.

To help your allergist identify potential causes of your contact dermatitis, record your activities and the items you think led to a reaction — or, if you're unsure, simply list anything that may have touched your skin in the two days before your symptoms started.

Your allergist might use a patch test to determine potential causes, such as rubber, fragrances or hair dye. Patients are typically asked to wear the patch for 48 hours, keeping it dry for that period. Your allergist will then ask you to return twice — one day after the patches are removed and again a week later — to check on your reaction.


Content was based on American College of Allergy, Asthma & Immunology