Allergic Reaction - Skin Inflammation (Atopic Dermatitis and Eczema)

Allergic dermatitis (skin inflammation) is one of the most common skin diseases that physicians deal with. Symptoms can include dryness, itching, redness, crustiness, blisters, watery discharges, cracking and other changes in the normal condition of the skin. Contact dermatitis (a reaction to something touched) and irritation are the most common types of skin inflammation.

Much less frequently, an individual’s skin will break out after he or she has eaten something to which he or she is allergic. In that case, the skin problem is usually called ”eczema.” People with allergic dermatitis or eczema simply have hyperreactive skin, much as people with asthma have hyperreactive airways.

Exactly how many people have allergic skin problems is unknown because sometimes reactions are so mild that the individuals never seek medical help. But estimates say that somewhere between 1 and 3 percent of children under age two suffer some degree of dermatitis or eczema. It's less common in adults, but by no means rare.

Young or old, the affected person usually comes from a family with a strong history of allergy, or they themselves have hay fever, asthma or some other form of allergy. To relieve discomfort and speed healing, there are over a dozen natural remedies for skin reactions, from soothing cornstarch baths to applications of zinc oxide paste (available in pharmacies), all of which are discussed in Contact (Skin) Allergies.

But avoiding the allergens is of utmost importance; and not only for the sake of comfort and appearance. Chronic dermatitis and eczema can cause the skin to become permanently discolored and thickened and scratching can lead to infection and scarring.

The most common offenders in contact dermatitis include rubber and plastics, industrial chemicals, applied medications, cosmetics, clothing dyes, costume jewelry, poison ivy and other plants, detergents, insecticides and paints. Contact (Skin) Allergies also goes into considerable detail to help you figure out which of those items may be the culprit (or culprits) in your case.

Many helpful tips are included to help you avoid the troublemakers. People with skin allergy need to be especially wary to topical medications, prescription or over the counter. In a European study of 4,000 people with skin problems, doctors discovered that one third of all allergic contact dermatitis was caused by applied medications.

Benzocaine and neomycin were the most common offenders (Archives of Dermatology). "Drugs that commonly cause allergic skin reactions" gives a more extensive list of ingredients to watch out for. Few sights are more heartbreaking than that of a baby or toddler with a stubborn skin rash. Yet in many cases, you can quickly trace the cause to soaps or lotions applied to the youngster’s skin.

Baby lotions often contain fragrance, lanolin and mineral oil, three of the most common causes of skin allergy. ”If a child comes in with a rash and he’s being rubbed with a lotion, the cure is often as simple as substituting plain vegetable oil – sunflower, safflower or peanut – for the commercial lotion,” says Del Stigler, M.D., a pediatric allergist in Denver, Colorado. ”Even for diaper rash, I use vegetable shortening instead of medication. In fact, I rarely have to prescribe a medication.”

Of course, skin can react from the inside out. Certain foods – and milk in particular – are apt to cause allergic skin reactions. ”If you have a child who has eczema, very often even a few teaspoons of milk will cause a reaction,” says Dr. Stigler. ”In other children, it's dose related: they may have to drink a pint in order to react.”

To sort out and treat dietary causes of eczema, many allergists favor elimination diets over skin testing or immunotherapy. For one thing, skin tests for food are often incorrect, indicating allergy when none is present (or vise versa), even when testing is done by a highly proficient allergist or immunologist.

And immunotherapy is generally ineffective against dermatitis of any kind. So your best bet is to follow the instructions for an elimination diet and food rotation, described in detail in Rotary Diets. Such method work. In one study, 21 infants with allergic dermatitis were put on a strict elimination diet of soy milk, potatoes, rice, buckwheat and other hypoallergenic foods.

After two to four weeks on the diet, the dermatitis healed in 33 percent of the children and improved in another 57 percent. When cow’s milk was testes, reddening, itching and discomfort returned in 65 percent of the children, virtually providing that milk contributed to the skin rash. Other foods that triggered dermatitis in the infants were fruit, wheat, eggs and fish – all common allergens.

Blood tests confirmed the diagnosis. The authors conclude by saying that the elimination diet is very useful in controlling dermatitis – and the earlier it's used, the better (Annals of Allergy, May, 1979). In a similar study, conducted by David J. Atherton, of the Hospital for Sick Children in London, Great Britain, 36 children were put on a soy based diet that excluded cow’s milk, eggs, beef and chicken (related food allergens) for four weeks.

For the following four weeks, they ate their usual diet. For the last four weeks, they ate a control diet that included cow’s milk and eggs, disguised as milk substitutes. About two thirds of the children who completed the study improved significantly when they avoided milk, eggs, beef and chicken.

Three of the children were completely cleared of eczema. The children who did not totally improve may have been allergic to still other foods, says Dr. Atherton (Lancet, February 25, 1978).

If staying away from cow’s milk and eggs doesn’t help, Dr. Atherton suggest a testing routine similar to the elimination diets described earlier in Rotary Diets. ”At the end of several months,” says Dr. Atherton, ”each patient should have identified a list of foods to which allergy is suspected” (Acta Dermatovener, suppl. 92, 1980).

Once you have identified foods that are safe for you, be sure to eat them no more frequently than once every four day, to reduce the chances that you’ll develop new food allergies. Instruction for rotating foods, along with a week’s sample menu, also appear Rotary Diets.

Contact allergy and food allergy are sometimes related. Doctors at the Hitchcock Clinic in Hanover, New Hampshire, discovered five people who were extremely sensitive to Rhus plants – poison ivy, oak and sumac – who also reacted to raw cashew nuts.

Cashews, it seems, are related to Rhus plants and can cause generalized skin reactions when the nuts are eaten in large quantities (Archives of Dermatology, December, 1974). That just goes to show that if you have skin allergy, the more you know about the condition, the better your chances of finding relief.

Since worry and stress leave you more vulnerable to an allergic outbreak, physicians generally agree that attention to the emotional aspects of skin allergy also has a bearing on relief. In other words, if you can learn to deal calmly and rationally with your allergy, you stand a better chance of enjoying clear skin. Information in Mind Over Allergy, will help you to stay in control or the situation.