Allergic rhinitis is a major disorder causing morbidity, disturbance in the quality of living and is a major reason for loss of days of work.
Symptoms of allergic rhinitis are
watering of eyes
itching of eyes, ear and throat
stuffiness of the nose
Allergic rhinitis can lead to breathing problems and asthma
Allergy symptoms can be controlled with medication. Consult your doctor for help.
What causes these allergies?
Pollen: pollen allergies or hay fever are common, more in Europe and in the US, due to birch pollen. It is troublesome in the warm summer months when trees release their pollen in the air. Pollen is the mode of reproduction for plants and travels long distances in the air. Especially for plants with small flowers like grasses.
How to avoid pollen?
Keep doors and windows closed especially early mornings and late evening when pollen counts are high
wear a mask and full sleeve clothes while doing outside activities
take a shower and put your clothes immediately for washing after spending a long time outdoors for work or games, etc, to remove pollen stuck to your body and clothes.
get your allergy checked by allergy testing. Immunotherapy helps to control allergies
House Dust mites:
They are the most common cause of allergies
How to avoid dust mites:
They are destroyed by heat, so wash bed-sheets, blankets, pillow covers in hot water at least twice a week and dry them in the sun
Minimize dust in your house by removing soft furnishing like carpets, curtains, sofa covers, soft toys, etc. Or vacuum them regularly
Immunotherapy helps in controlling dust mite allergies.
Fungi or Molds:
They are the cause of allergy in warm and humid climates.
Fungal spores become airborne and cause allergies
They are found in air conditioning, on damp bathroom walls or walls where there is seepage of water or pipe leakage
they can cause sinusitis and allergic asthma
Prevention of fungal allergy
Basic cleanliness helps
Servicing of AC vents regularly, cleaning the bathroom with bleach, treating water leakage, removal of junk in the home, etc
Animals like cats, dogs and even birds can cause allergies
Cats are very common since they lick their fur and the saliva on it is highly allergenic
Prevention of pet allergies:
These are very difficult since the pet is a family member and minimizing contact with them is not possible. Vaccines help.
Cockroach dust causes a lot of allergy. Cockroaches like tight places so even if 1-2 are visible outside, most of them will be hidden in crevices.
Proper pest control should be done for allergy prevention
Minimize environmental pollution. These are irritants which worsen symptoms of allergy such as:
petrol and diesel fumes
insect repellents and plug in liquids
Consult your doctor as soon as possible for allergic symptoms for immediate relief and further management
With the ongoing cold and dry weather, skin disorders are coming up. With uncontrolled use of cosmetics, allergies to cosmetic products are on the rise too.
Patch testing is done for cosmetic products such as PPD and metals like nickel, chromium and various other chemicals.
TYPES OF DERMATITIS:
Contact Dermatitis: Contact dermatitis is when an outside allergen comes in contact with your skin and causes allergic and/or irritant response. Irritation to external chemicals is more common.
Sometimes the skin can become red and angry due to hypereactivity
A systemic response like extreme redness of skin, especially on the buttocks can be seen.
Contact Urticaria: When you get a typical wheal and flare reaction to an external allergen. In extreme cases you can get an anaphylactic shock.
Irritant Contact Dermatitis
The skin will look glazed, parched or scalded, with a sharply circumscribed margin. Once you remove the external irritating agent, healing will start.
There is a family history of atopy or allergic diseases
It’s common in early childhood due to food allergies. The child may grow out of most of them or develop allergic rhinitis,asthma or allergic conjunctivitis later on.
It is characterized by dry, scaly and itchy lesions, in early childhood and babies this is a rash on the face, back of joints
In adolescents and young adults it is more common in the folds of the elbow and knee joints, armpit, groin, etc.
It can be treated by avoiding the allergen, allergy skin prick tests to identify the cause. Local emollient creams help.
Immunotherapy will help control the disease, prevent development of other allergies and prevent progress to further complications.
Seborrheic Dermatitis: It is common in areas like the scalp, face and chest. It is related to sebum or the greasy substance produced by the sebaceous glands in the skin.
It is common in cold weather, and can be triggered by stress
It is seen in infants, healthy young people, but can be common in people with Parkinson’s or HIV infection.
It is not related to diet.
It is caused because of a yeast like fungus in the skin.
Reddish areas covered with greasy looking white or reddish skin scales.
In the scalp: It could result in mild flakes leading to dandruff, or a redder, scalier weeping rash. Cradle cap in infants could be due to seborrheic dermatitis
On the face: It affects the inner part of the eyebrows, the crease on the side of the nose, and the cheeks. Eyelids can become red, sensitive and inflamed.(blepharitiS)
Ears: the skin behind the ear can show reddish scaly lesions. the ear canal and Pinna too. It can lead to Otitis externa.
Chest : Front of the chest.
Folds: Elbow, armpit, knee, groin. In children the nappy area is affected.
Treatment: Treatment with seborrheic dermatitis has to be continued. Once you stop the treatment the lesions tend to recur
On the scalp:
Remove dense scales with olive oil.
Shampoos containing Zinc, selenium sulphide, or ketoconazole can be used. They should be kept for 10-15 minutes before rinsing them off.
Sometimes a strong steroidal cream will help.
Over the body: Mild steroidal and antifungal creams will help.
Ear canal: Antifungal creams used in the ear canal and antifungal/steroidal ear drops.
Application of olive oil can prevent, itching dryness and scaly lesions.
Regular use of a moisturizer or anti-fungal cream, shampoo, body lotion will help in control.
PSORIASIS: Dry silvery white scales like mica. On removal they leave a white patch with punctate bleeding.
Causes of Contact Dermatitis:
Detergents are a very common cause of irritant contact dermatitis due to their strong caustic nature and they easily erode the skin barrier.
Cosmetics, eye shadows cause allergy too.
Transfer of nail polish to the eye and face
Benzalkonium chloride, a preservative in medicated eye and ear drops is one of the common causes. Thimerosal and neomycin sulphate are other ones.
Chemicals such as lanolin, coconut oil, etc
PPD, Balsam of Peru, Parabens, colophony and many others
Nickel, chromium and cobalt in costume jewellery
The above can also be responsible for rejection in orthopedic joint replacement surgeries.Once you have allergy in the skin to these chemicals, a systemic reaction can occur.
Ultraviolet light as exposure to sun Rays can worsen the reaction.
Occupational contact dermatitis is common in the following groups:
Food handlers like cooks and caterers
Health care workers
Persons involved in cleaning
Heavy mechanics and assembling of parts
Agriculture, Forestry and Fishing
Printing and Lithography
PATCH TESTING FOR ALLERGIES:
In patch testing, chemical allergens and drugs are applied directly on the skin. They are left for 3 to 7 days. If there is an irritating lesion, from a mild rash to a severe reaction and vesicles, the patch test is said to be positive.
Readymade patches are available which can be applied to the skin.
The patches can be customised by using paste and applying pre cut linen patches covered by micropore or hypoallergenic dressing tape.
Instructions for patch testing:
The patient should not be on oral antihistaminic, anti allergic or steroidal medication for at least 3 days before the patch test.
Topical application of corticosteroids and lotions to the skin should be avoided for 3 days prior
The patches are applied to the back or upper arm. During the period of the patch test the patient cannot take a bath or apply water to the patches.
The patient should not sweat otherwise the patches will come off. The patch test is typically done in cold weather, as summers can cause sweating.
Treatment of Contact Dermatitis
Avoidance of the chemical e.g. using long handled cleaning tools like wet mops and vacuum cleaners.
Substitution wherever possible with a less allergenic chemical
Job rotation so that periods of exposure are less
Protective gloves, face shields, aprons, uniforms, eye wear, etc
Please contact your doctor for expert diagnosis and advice