Hives or welts are itchy, raised, red areas on skin. About 25% of people experience hives sometime in their life. Hives can occur at any age. Most of the time, hives are not dangerous. Hives are classified based on how long they have been occurring and how long they last. Sudden hives that develop immediately after ingestion of a food or medication may suggest a food or drug allergy. Hives that occur randomly are called “spontaneous urticaria.” Most of the time, this is due to viral infection/illness or is considered to be an auto-immune condition. Spontaneous hives often have no specific trigger and can be very frustrating to patients. Chronic hives are hives that have been ongoing for 6 weeks or more. In general, the longer hives have been going on, the less likely it is a food, medication, or other substance causing them. Sometimes hives occur with swelling of lips, eyelids, hands, and feet. Over half of patients with chronic hives respond to antihistamines. The antihistamines can even help make the hive condition go away for good. Some people require Omalizumab, which is a once-monthly injection, to treat chronic hives. Chronic hives usually resolve within 3-5 years. Your allergy provider can work with you to determine if there is an underlying cause to your hives, and the treatment options available, so you can be itch and hive-free!

Are asthma and acid reflux related?


Many people have asthma, and many are also affected by acid reflux, or gastroesophageal reflux disease (GERD). Research has shown that GERD is more common in patients with asthma, and can worsen asthma symptoms. GERD has actually been identified as an underlying reason for more difficult-to-treat asthma.


Reflux can cause or contribute to asthma in a few ways. One way is via stomach acid leaking back into the esophagus, which eventually leads to the lung tissue producing more mucus and the small airways constricting. This can produce more asthma symptoms. Another possible way is that the stomach contents or acid being leaked out from the stomach can actually enter the lungs, which is a process called aspiration. This can cause irritation to the airways, causing or worsening asthma symptoms.


GERD can affect anyone, or any age. Sometimes, the symptoms are very noticeable and can consist of heartburn, regurgitation, sour taste in the mouth, frequent burping. Sometimes, GERD can be “silent” and not seem to cause any symptoms. Other times, GERD can cause other symptoms such as worsening asthma, hoarseness, or coughing.


The American Academy of Allergy, Asthma, and Immunology (AAAAI) estimates that as many as 89% of all asthmatics can be affected by GERD at some time.  It is important to work with your asthma specialist to determine if GERD could be a contributing cause to your symptoms, and how to treat your GERD. Various diets, medications, and lifestyle modifications can help. Sometimes, patients will need to see a gastroenterologist for help with diagnosis and further treatment.











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!


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!