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Skin Allergy 101

By: Risa Caldoza-De Leon MD, FPAPSHPISkin Allergy 101

All my life, I have been allergic to insect bites. A single zap of the dreaded mosquito will leave not one red, super itchy, swollen wheal but several around it and some even farther away. A flea bite is worse, so my lola had to move dogs, previously lazing free around the house, to the garage. My mom made insect repellant makers rich since we had to spray the whole house extensively night after night. I had scars to prove it then.

Becoming a skin care physician has its perks: I have long peeled, hydroquinoned, bleached and lasered the marks through the years, yes, years that they have faded. I still hate insects and take precautions (citronella, anyone?). But more than the marks, I remember that it was the itch that really bothered me. Mylolawould put a dot of pink lotion to soothe the itch and I would grab the bottle and literally slather it all over my arms or legs. The relief was incomparable. Only those who suffer from the same condition can understand the immense relief an anti-itch lotion can bring.

An allergy is an abnormal reaction of the body to one or more substances (called allergen) that are harmless to most people. Statistics show that the most common allergens are food, medications, insect stings, animal dander, pollen, dust, mold, and latex. Other contributing factors are smoking, pollution, infection, and hormonal imbalance.

Skin allergy may be caused by a host of factors — from an immune system that has gone amok, medications, food, to infections. Worldwide, the number of people suffering from allergic disease rises steadily. Four of 10 people are sensitive to foreign bodies around them. Up to one of two kids is sensitive to one or more common allergens. And to drive home the point, the World Health Organization (WHO) reported that in 2012 alone, 8.8 million children reported skin allergies.

Itch which rashes

A common cause is eczema, or an “itch which rashes.” Medically termed atopic dermatitis, it results in itchy, red or dry skin that may “weep” or leak fluid that crusts over when scratched. The more the patient scratches, the more severe the rash becomes. The symptoms come and go as it pleases. Eczema often runs in families with a history of eczema or other allergic conditions like asthma. So, if your mom, dad, brothers, or sisters have eczema, you might get it too.

In babies, eczema usually appears on the face, while older kids, teens, and young adults have it on their elbows, wrists, back of knees and behind the ears. According to the American Academy of Pediatrics (AAP), six of 10 babies develop symptoms before their first birthday, and as high as 90% of them develop symptoms before age 5. Thankfully, many babies outgrow eczema by four years old.

The culprit for eczema is unclear. Fortunately, it is not contagious. Treatment varies from regular use of moisturizer and topical medications, including mild steroids such as hydrocortisone, to antibiotics. Or you could go local to treat eczema. Our Department of Health (DOH) has endorsed akapulko (ringworm bush) and tsaang gubat (wild tea) to treat skin allergies. These can be used by anyone, for example as part of a salad, an herbal tea or supplement.

We Made Contact

No, aliens did not cause that weepy, oozy, itchy rash but by a specific chemical to which one is uniquely allergic to or that directly irritates the skin. Called allergic contact dermatitis (ACD), it affects parts of the skin which have come in direct contact with the offending substance.

Common examples of allergens causing ACD  are poison ivy, poison sumac, poison oak and reactions to costume jewelry containing nickel. Spraying on perfume may cause a reaction, too. Hair dye may cause swelling and blistering of face and neck in reaction to paraphenylenediamine. Even the preservative in baby wipes can be a culprit. There are cases of fingertip dermatitis due to acrylates used in hair extensions and nail cosmetics. Blisters may appear at the site where topical medications such as antibiotics are applied.

Allergic contact dermatitis is more common in metal workers, hairdressers, beauticians, health care workers, cleaners, painters, and florists. It occurs within 48 to 72 hours after being exposed to the allergen. The rashes settle down over several days as long as the skin is no longer in contact with the allergen. 

Irritant contact dermatitis (ICD) is another common type of contact dermatitis and happens when the skin comes in contact with a toxic material. These include battery acid, bleach, drain cleaners, kerosene, detergents and pepper spray. 

Here are some helpful tips to manage itchy skin:

1.  Use cotton undergarments to help protect the skin from irritants and from scratching.

2.  Avoid using soap products that contain sodium lauryl sulfate.

3.  Avoid any triggers (allergies or contactants) that cause a reaction.

4.  Prevent dry skin by taking warm showers and baths using mild soap.

5.  Moisturize, moisturize, moisturize!

6.  Stay away from alcohol, as it causes flushing of the skin 

7.  Do not scratch the affected areas. Keep fingernails short and smooth.

8.  Wear loose clothes that will not put pressure on the skin

9.   Avoid physical and mental stress

10. If the symptoms don’t resolve or get severe, consult your skin care physician immediately.

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