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Many people describe having “sensitive skin” and often having problems with various toiletry or personal care products such as soaps, lotions, cleansers, shampoos, and make up products. Various skin reactions can occur and cause redness, itching, rashes, blisters, hives, or irritation. Sometimes, it is just mild irritation, but other times, the symptoms can be severe and actually a chemical-induced skin allergy called allergic contact dermatitis.

There are numerous chemicals that can cause allergic contact dermatitis. The most common culprits are fragrances, metals, and preservatives. It can take several days after exposure to cause symptoms, and you can develop chemical allergy to products you have been using for years! Various chemicals you may be exposed to at home, work, or through hobbies can be the culprit. People who work in healthcare, dentistry, hairdressers, machinists and those with underlying eczema are most at risk for developing allergic contact dermatitis.

After taking a thorough history, your allergy provider can order chemical patch testing which can determine specifically which chemical you may be allergic to.  Once the chemical trigger is identified, then you can avoid that chemical moving forward with only using safe products and improve your skin symptoms long term.

If you think your sensitive skin may need more evaluation, set up an appointment with your allergy provider to discuss chemical patch testing today!

 

Allergy testing is not perfect, and sometimes we can see false positives to foods that someone has no history of reaction to or have never ingested. In other times, the reaction could have been related to someone else and a patient or allergist is not sure if the food was the cause. In patients with history of food allergic reactions, sometimes they will outgrow their food allergies. Oral food challenges are ways that your allergist can help determine if you are truly allergic to a food. In many cases, your allergy provider may recommend an oral food challenge.

*What is an oral food challenge?

An oral food challenge, or OFC, is a medical procedure done in the allergy clinic where a food is eaten under medical supervision. Usually, OFCs are “graded” which means the food is eaten slowly, in increasing amounts, over several hours. Patients are monitored for development of any symptoms and treated if an allergic reaction occurs.

*What happens on the day of an oral food challenge?

Usually, patients are told to hold antihistamines prior to the OFC. Your allergy provider will examine you before starting the OFC and your vital signs will be taken before and periodically every 15-30 minutes during the test. The first dose is usually very small and after 15-30 minutes, if there are no symptoms, the next dose is taken. This process is repeated until all doses are taken, which usually equal about 1 full serving size of the food.

*What types of reactions could happen during an oral food challenge?

Because OFCs are done slowly, usually a reaction involves skin symptoms (such as mild hives), stomach symptoms (upset stomach), or mouth symptoms (itchy mouth, itchy tongue). Testing and feeding is stopped whenever there are symptoms. Usually, antihistamines are used for these milder symptoms. If there are more severe symptoms, treatments can include epinephrine or other medications.

*What are the risks and benefits of an OFC?

The risks of OFCs are the possibility for a reaction, including anaphylaxis. However, when done safely in the allergy office, these risks are minimized. The benefits to the OFC involve being able to safely incorporate this food into your diet and knowing without fear that you will not have a reaction. Even if there is a reaction, studies show that this can be beneficial by giving families more confidence to treat and recognize reactions in the future.

Chronic Spontaneous Urticaria

More than 20% of people have experienced random hives, or welts, on their skin at some point in their lives. But, there is also a longer-lasting type of hive condition called Chronic Spontaneous Urticaria (also known as Chronic Idiopathic Urticaria) that can affect up to 0.5% of people. CSU is a condition that causes random hives and welts on various locations of the body for 6 weeks or more. CSU can affect both adults and children. Usually, the condition is idiopathic, or has no known cause, but sometimes the condition can be related to a viral illness or associated with some autoimmune conditions.

It’s important to know that chronic hives that occur randomly are much different than acute, sudden-onset hives that can occur following accidental ingestion in patients with food or drug allergies, or with patients with history of allergic reactions. In those conditions, the trigger is usually very obvious, such as a food, medication, or insect sting, and leads to hives occurring usually within 30 minutes. Once treated, these hives usually resolve. One major difference is that with chronic hives, symptoms will continue and there will be no obvious trigger. Many patients suspect medications or foods as triggers, but this is not usually the case in chronic hives.

CSU is usually benign and not an indication of anything concerning or dangerous going on in the body. Sometimes, patients will have other symptoms that will require further work up with labs or other tests. However, most of the time, hives are very easy to treat using safe and effective medications to help the hives get under control and hopefully stay away for good! If you are suffering from chronic hives, be sure to address your symptoms with your allergy provider in order to get the best control and relief you need!

 

 

 

 

 

 

 

 

 

Vasomotor Rhinitis

 

Vasomotor rhinitis is a condition that causes chronic sneezing, congestion, or runny nose that can be triggered by pollutants like a dusty environment, odors, foods or beverages, or weather changes. These symptoms can often seem like typical allergic rhinitis (hay fever) symptoms. About 50% of patients with allergies will have some type of vasomotor rhinitis. While vasomotor rhinitis can cause similar symptoms, what is going on in the body is much different. In allergic rhinitis, your immune system is involved and has formed antibodies to the trigger, such as pollen. In vasomotor rhinitis, the triggers merely cause an irritation which causes congestion, sneezing, runny nose.  Have you ever had a runny nose from eating a spicy food? That’s a kind of vasomotor rhinitis called gustatory rhinitis.

 

Many patients will have mild symptoms but if symptoms are constant and very irritating, there are treatment options to help control symptoms. Often, allergy testing will be performed to see how to best manage symptoms.    Often times, patients will mistakenly think they may be allergic to a smell or a food, when it’s actually vasomotor rhinitis! It’s important to discuss with your allergist if you are experiencing symptoms like these and have questions, so they can come up with the best recommendations for you!