Allergic Skin Conditions

If you have red, bumpy, scaly, itchy or swollen skin, is it because of a skin allergy?

There are several types of allergic skin conditions. They are often itchy and red and may appear scaly, bumpy or swollen. An allergist/immunologist, often referred to as an allergist, is the most qualified physician to treat allergic diseases. An allergist can determine which condition you have and develop a treatment plan to help you feel better.

While skin allergies are unpleasant and troublesome, there are things you can do to treat them.

Hives and Angioedema
Hives (or urticaria) are red, itchy, raised areas of the skin that can range in size and appear anywhere on your body. Most common are acute cases, where food or drug allergies are triggers. These hives usually go away within a few days. In cases of chronic hives, people may suffer for months to years.

Angioedema is a swelling of the deeper layers of the skin that sometimes occurs with hives. Angioedema is usually not red or itchy. The areas often involved are the eyelids, lips, tongue, hands and feet.

Food or drug reactions are a common cause of acute hives and/or angioedema. Viral or bacterial infection can also trigger hives in both adults and children. Physical urticaria are hives resulting from a non-allergic source: rubbing of the skin, cold, heat, physical exertion or exercise, pressure and direct exposure to sunlight.

If the cause of your hives can be identified, you should avoid that trigger. With acute hives, some drugs or foods may take days to leave the body, so your allergist may prescribe antihistamines to relieve your symptoms until that happens.

Contact Dermatitis
When certain substances come into contact with your skin, they may cause a rash called contact dermatitis. Irritant contact dermatitis is often more painful than itchy, and is caused by a substance damaging the part of your skin it comes into contact with. The longer your skin is in contact with the substance, or the stronger the substance is, the more severe your reaction will be. These reactions appear most often on the hands and are frequently work-related.

Allergic contact dermatitis is best known by the itchy, red, blistered reaction experienced after you touch poison ivy. This allergic reaction is caused by a chemical in the plant called urushiol. You can have a reaction from touching other items the plant has come into contact with. However, once your skin has been washed, you cannot get another reaction from touching the rash or blisters. Allergic contact dermatitis reactions can happen 24 to 48 hours after contact. Once a reaction starts, it takes 14 to 28 days to go away, even with treatment.

Nickel, perfumes, dyes, rubber (latex) products and cosmetics also frequently cause allergic contact dermatitis. Some ingredients in medications applied to the skin can cause a reaction, most commonly neomycin, an ingredient in antibiotic creams. For irritant contact dermatitis, you should avoid the substance causing the reaction. You should also avoid spilling chemicals on your skin. Gloves can sometimes be helpful. Since these reactions are non-allergic, avoiding the substance will relieve your symptoms and prevent lasting damage to your skin.

Treatment for allergic contact dermatitis depends on how severe the symptoms are. Cold soaks and compresses can offer relief for the acute, early, itchy blistered stage of your rash. You may also be prescribed topical corticosteroid creams. To prevent the reaction from returning, avoid contact with the offending substance. If you and your allergist cannot determine the substance that caused the reaction, your allergist may conduct a series of patch tests to help identify it.

Eczema
A common allergic reaction often affecting the face, elbows and knees is atopic dermatitis or eczema. This red, scaly, itchy rash is more common in young infants and those who have a personal or family history of allergy.

Common triggers include aeroallergens like cat dander or house dust, overheating or sweating, and contact with irritants like wool or soaps. In older individuals, emotional stress can cause a flare-up. For some patients, usually children, certain foods can also trigger eczema. Skin staph infections can cause a flare-up in children as well. Eczema patients usually have very dry skin and “allergic shiners” (an extra crease, called a Dennie’s line, across their lower eyelids). They are also more at risk for other skin infections.

Preventing the eczema itch is the main goal of treatment. Do not scratch or rub your rash. Applying cold compresses and creams or ointments is helpful. Also remove all irritants that aggravate your condition from your environment. If a food is identified as the cause, it must be eliminated from your diet.

Topical corticosteroid cream medications and topical calcineurin inhibitors are most effective in treating the rash. Antihistamines are often recommended to help relieve the itchiness. In severe cases, oral corticosteroids are also prescribed. If a skin staph infection is suspected to be a trigger for your eczema flare-up, antibiotics are often recommended.

Healthy Tips

• If you have red, bumpy, scaly, itchy or swollen skin, you may have a skin allergy.
• Hives (or urticaria) are red, itchy, raised areas of the skin that can range in size and appear anywhere on your body. Angioedema is a swelling of the deeper layers of the skin that often occurs with hives.
• When certain substances come into contact with your skin, they may cause a rash called contact dermatitis.
• The red, scaly, itchy rash often affecting the face, elbows and knees is called atopic dermatitis or eczema.
• If you have eczema, avoid scratching or rubbing your rash to prevent an infection.
• An allergist can help figure out which allergic skin condition you have and take steps to treat it.

Feel Better. Live Better.
An allergist/immunologist, often referred to as an allergist, is a pediatrician or internist with at least two additional years of specialized training in the diagnosis and treatment of problems such as allergies, asthma, autoimmune diseases and the evaluation and treatment of patients with recurrent infections, such as immunodeficiency diseases.

The right care can make the difference between suffering with an allergic disease and feeling better. By visiting the office of an allergist, you can expect an accurate diagnosis, a treatment plan that works and educational information to help you manage your disease.

Find an allergist near you at:
www.aaaai.org/physref

The contents of this brochure are for informational purposes only. It is not intended to replace evaluation by a physician. If you have questions or medical concerns, please contact your allergist/immunologist.

A Trusted Resource
The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease.

Ordering Information
To order copies of this brochure, please see the Public Education Materials Online Store.

©2010, American Academy of Allergy, Asthma & Immunology All rights reserved. May not be duplicated or appropriated without permission. Contact copyright@aaaai.org.