Skin Allergies

Atopic dermatitis, also known as eczema, inflames the skin, causing dry, itchy, bumpy rashes on hands, elbows and knees, among other areas. Because of this, eczema can be uncomfortable, distressing, and sometimes painful if the skin breaks, creating a sore. Although eczema is a common condition, it is not contagious.

Eczema impacts approximately 10-20% of children and 1-3% of adults. 

The most common place on the body to get eczema is on the backs of the knees, inside elbows, and back of the neck, although it can develop in most places on the body. 

Eczema is caused by multiple factors that ultimately cause inflammation in the skin. The upper layer of the skin does not provide enough protection because it is damaged by dry skin, chemicals, scratching, and inflammation. The lower layer of the skin has underlying inflammation that we commonly see in allergies. 

The eczema rash is worsened by the itching and scratching of the skin. Most eczema is caused by systemic allergic inflammation.  We also know that there is a genetic predisposition to eczema. If you have a strong family history of allergies and asthma, then you are at risk for developing eczema. 

Hives, also known as urticaria, is very common and affect about 20% of people at some time during their lives. It usually starts as an itchy patch of skin that turns into swollen red welts. Hives is often mistakenly associated with Angioedema which is indicated by swelling in the eyes and mouth, swelling of the hands, feet, or throat. 

Hives can develop anywhere on your skin. For most people, hives appear on one or more of these areas: abdomen, back, buttocks, chest, upper arms, upper legs

Acute hives, which are hives lasting less than six weeks, can be caused by infections, medications, acute exposure to allergens (pollen, pets, molds, and sometimes foods) and chemicals. 

Chronic hives are associated with autoimmune disorders, infections, medications, and chronic exposure to allergens. Often, especially in chronic hives, there is no identifiable cause, and these causes are likely due to your own body internally causing the hives. 

Hive patients usually correlate the worsening of their hives with stress, anxiety, and foods, but these factors are often not the cause of hives.

Angioedema, a condition characterized by swelling in the deeper layers of the skin, can occur in conjunction with hives or on its own. This swelling is often observed around the face and lips, affecting individuals both physically and emotionally. 

Although short-lived hives and angioedema are common and typically harmless, clearing up within a day and leaving no lasting marks even without treatment, chronic hives that persist for more than six weeks can be a cause for concern.

When it comes to treatment, antihistamine medication is usually prescribed to alleviate the symptoms of hives and angioedema. However, it is important to note certain types of angioedema can pose a life-threatening risk if swelling of the tongue or throat obstructs the airway, highlighting the necessity for immediate medical attention in such cases. 

A board-certified allergist can help you distinguish between the different types of angioedema. 

Contact Dermatitis, a type of skin inflammation, is characterized by red, itchy rash caused by direct contact with a substance or an allergic reaction to it. 

There are two main types of contact dermatitis: irritant contact dermatitis, the most common type, and allergic contact dermatitis.  

Irritant dermatitis is caused by the skin touching an irritating substance or dry skin.  Allergic contact dermatitis occurs when the immune system develops an allergic reaction to a substance that comes into contact with the skin. 

According to the American Academy of Dermatology, contact dermatitis affects over 14.5 million Americans each year. The hands are the most common site of contact dermatitis, though it can occur anywhere on the body. 

Irritant contact dermatitis occurs when a material or constant rubbing and scratching damages the skin at the point of contact due to its caustic nature, rather than an immune response. More severe skin reactions happen when the skin is dry, in longer contact with the substance or in contact with a harsher substance. While these reactions can happen anywhere on the body, they commonly appear on the hands and are often due to workplace materials.

Allergic contact dermatitis occurs when skin contact with a specific material triggers an immune response manifesting as a rash. The most common example is the itchy, red, blistered reaction experienced after touching poison ivy. With poison ivy, the allergic reaction is caused by an oily plant chemical called urushiol. Once a reaction starts, it may take 14 to 28 days to go away, even with treatment.  Another common example of contact allergen is reactions to metals, like jewelry.

Most skin allergies can be managed with proper treatment. Options include creams, ointments, and oral medications. Lifestyle changes like avoiding triggers and using gentle skincare products may also help. Treatment controls symptoms, but it’s a chronic condition that needs ongoing management.

Seasonal allergies, such as pollen allergies, predispose you to having eczema (especially atopic dermatitis) and hives. These diseases are often associated with other allergic conditions such as allergic nose and asthma.  Therefore, it is possible that your skin allergies can flare at the same time as other allergic conditions, including seasonal allergies. 

Certain skin allergies, like eczema, are chronic and persist for long periods of time. If skin rashes, including hives and eczema, persist for more than 24 hours, it is advisable to consult with an allergist.

Various factors can trigger allergic reactions or flare-ups. Your immune system and your body can evolve as you age, leading to the development of new allergies and sensitivities. It is crucial to refrain from self-diagnosing skin allergies and seek the expertise of an allergist if you experience new symptoms related to skin allergies.  An allergist can help diagnose the correct skin allergy, find a possible cause, dispel any myths and misinformation, and find a treatment or management plan for your specific skin allergy.