Whether you’re going for a hike on a sunny day or slathering on some moisturizer in the evening, your skin is at risk for potential allergic reactions. How can you tell if you’re having an allergic reaction on your skin and, if you are, what steps should you take? HealthScene Ohio talked to dermatologist Dr. Matthew Meier about some good things to keep in mind when dealing with skin allergies.
HealthScene Ohio: What are some of the most common types of skin allergies, and what are the most common causes?
Matthew Meier: Skin allergies occur when our immune system reacts to external agents and most commonly produce dermatitis (eczema) or urticaria (hives). There is a plethora of possible inciting agents. Plants like poison ivy, metals such as nickel in costume jewelry or belt buckles, topical antibiotics like neomycin, and preservatives and fragrances in personal care products can cause allergic contact dermatitis. Urticaria can develop after the ingestion of a new medication (like an antibiotic such as penicillin) or food (such as shellfish or peanuts) or, less commonly, after contact with the skin, as occurs sometimes with latex allergies.
HSO: Can skin allergies present themselves differently depending on whether someone is an adult or a child?
MM: Manifestation of the allergy is dependent upon the allergen. Infants are predisposed to irritant dermatitis of the diaper area (not an allergy) due to contact with wet and dirty diapers. Notably, eczema in infancy and childhood is typically not from allergies. As children get older, it can be more common to see reactions to allergens like nickel (jewelry) and poison ivy.
HSO: Are there types of allergic reactions to the skin that do not cause a person to become itchy?
MM: Most allergic reactions that involve the skin cause itching. Some deeper forms of hives, called angioedema, are painful. Cases of irritant (not allergic) dermatitis can be more painful or burning than itchy. Some medications may make people more likely to experience reactions like sunburns that may involve pain more than itching.
HSO: What are some of the most common at-home remedies for an allergic reaction on the skin?
MM: Cool compresses and soothing creams like calamine can help with itching associated with allergic reactions in the skin. Hydrocortisone 1 percent cream or ointment can help reduce the duration and severity of symptoms associated with minor cases of allergic contact dermatitis. Hives can be treated with antihistamines. Sedating antihistamines like diphenhydramine (Benadryl) can especially help at bedtime. Non-sedating antihistamines like Claritin and Zyrtec can be taken during the daytime with minimal risk of feeling drowsy.
HSO: At what point should you consider visiting an immunologist to determine if you have an allergy?
MM: When the cause of the allergy is readily apparent, no testing is necessary. When an allergy is suspected as the cause of dermatitis, but the source of that allergy is unclear, a dermatologist can apply a series of allergens to the skin to see if any reactions are elicited. This is particularly useful in cases of sensitivity to personal care products to help aid in the selection of allergen-free products. For hives, skin prick testing or blood work can help confirm the environmental allergen or medication that caused the reaction.
HSO: If you’re experiencing contact dermatitis, how do you know whether it is irritant or allergic?
MM: It isn’t always easy to know. One tip is that allergic reactions tend to spread beyond the area of contact, whereas irritant reactions tend to remain at the site of contact. A good example of an irritant reaction is a reaction from bandage adhesive that results in a rash in the shape of the bandage.
HSO: How long do allergic reactions on the skin typically last?
MM: Allergic contact dermatitis generally develops within hours to days and can last for weeks depending on continued exposure. Hives appear quickly, usually within minutes to hours, and an individual hive will typically disappear within hours.
HSO: Can allergic reactions on the skin be accompanied by any other medical symptoms? At what point would someone need to seek immediate medical attention?
MM: In reactions with hives, some patients have the potential to develop systemic manifestations. Tongue or throat swelling may cause difficulty breathing or swallowing and should prompt immediate/emergency medical care.
For any skin reactions that are more than minor – or if the rash is accompanied by fevers, chills, pain or blisters – see your doctor for evaluation and for prescriptions that can dramatically help improve or clear the reaction from the skin. Also, if reactions involve the eyes, lips or mouth, seek care from a doctor.
HSO: If you’re experiencing an allergic reaction on the skin, what type of clothing is best to wear to not exacerbate the problem? Are there any products to avoid while you’re healing?
MM: Soft, lightweight cotton clothing can help avoid irritation of already inflamed skin. Avoid scrubbing the areas with harsh soaps. Avoid using rubbing alcohol or hydrogen peroxide on the skin. Applying emollients such as petrolatum can be soothing.
Sarah Sole is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. Matthew Meier is board certified in dermatology. He served as chief resident of dermatology at University Hospital, University of Cincinnati, in 2010. In 2009, he completed his residency in dermatology at the University of Cincinnati, where he also received his Doctor of Medicine degree in 2006. Dr. Meier practices from Mercy Health – Kenwood Dermatology in Cincinnati.
