If you or your child suffer from itchy rashes or skin swelling, you may have an allergy. Skin allergies can be unpleasant, causing discomfort and significantly affecting your quality of life. However, there's no need to suffer. There are many things you can do to address them and improve your quality of life.
How is skin allergy diagnosed?
Diagnosis is done at an allergy clinic. The process begins by classifying the symptoms to assess whether it is indeed an allergic reaction and, if so, to determine the specific type. Further evaluation includes various tests and sometimes skin tests.
Hives (Urticaria):
Urticaria is a red, itchy rash that appears on the skin as a result of allergic reactions. The rash lasts for several hours to days, disappears, and then reappears on different parts of the body. In about 40% of cases, hives are accompanied by angioedema, a swelling that can occur on the face (sometimes involving the tongue), hands, or feet.
Acute urticaria is a common condition that usually lasts a short period, up to a few weeks. Chronic urticaria is defined as hives that persist for over 6 weeks. Those affected may suffer from skin issues for months to years. In some rare cases, acute urticaria is triggered by food products, medications, or infections. Chronic urticaria can result from autoimmune reactions (when the body attacks itself) or heightened sensitivity to external physical factors such as heat, cold, pressure, or sun exposure. Although efforts are made to identify the cause, in most cases, it remains unknown.
Treatment for urticaria primarily involves using antihistamine medications. In many cases, treatment is free of side effects, especially when using "second-generation" drugs that cause minimal drowsiness. Some patients may require combined and prolonged treatment with additional medications. Recently, Anti-IgE therapy has shown promise in treating chronic urticaria, significantly reducing patients' suffering.
Eczema (Itchy Rash):
Atopic dermatitis, also known as eczema, is a common allergic reaction that often appears on the face, elbows, and knees. It is a red, itchy rash frequently seen in young children and individuals with a personal or family history of allergies. In some cases, it may persist into adulthood.
Triggers for eczema flare-ups can include excessive heat or sweating, contact with irritating substances such as drying soaps, heightened sensitivity to cat or dust mite allergens, and even emotional stress. In some cases, various food products can also contribute to eczema. Bacterial infections can worsen the condition.
Treatment for eczema includes several components:
The main focus of treatment is to identify and avoid the allergens that trigger the skin condition, as well as prevent infections. Keeping the skin moisturized and avoiding scratching is essential. Cool compresses or suitable creams containing steroids or calcineurin inhibitors are effective in reducing inflammation and maintaining healthy skin. In severe cases where conservative treatment is ineffective, further testing and specific treatments may be necessary.
Allergic Contact Dermatitis:
When certain substances come into contact with the skin, they can cause localized chemical or inflammatory reactions. If the reaction is mainly painful or burning rather than itchy, it is typically a chemical irritation rather than an allergic response (caused by the immune system's activation of immune cells). The longer the skin is exposed to the irritating substance, the more severe the reaction becomes. These reactions usually appear on the hands (e.g., contact with certain metals like nickel), and they may also occur in exposed areas of the body and even in more distant regions.
To diagnose allergic contact dermatitis, a Patch Test is conducted, which assesses a slow (delayed) allergic reaction that occurs between a few hours to several days after contact with the test substances. The test involves leaving adhesive patches containing specific allergens on the skin for 48-72 hours and then checking for a reaction. If the causative agent is not identified in the initial tests, specialized tests tailored to the individual's complaints or occupation may be conducted.
The treatment for hypersensitivity to contact substances primarily involves avoiding exposure to the triggering substance. In some cases, complete avoidance may not be possible, and the use of protective measures (e.g., appropriate gloves) can help.