Hives and other Allergic Skin Problems

Hives are red, itchy swollen blotches on the skin. They often appear suddenly and go away within a few hours but sometimes they can last several days. They frequently appear in clusters and can be very uncomfortable.

Hives are usually caused by exposure to some substance to which you are allergic. Things that cause hives include environmental allergies, foods such as tree nuts, peanuts, shellfish and medications such as antibiotics or even aspirin or NSAID's. In some, even exposure to the cold can cause hives.

The best way to treat hives is to try to avoid what causes them. Allergy medicines such as antihistamines can also be used to give a patient quick relief. Sometimes, it is necessary to take medication on a regular basis to try to prevent the hives from starting in the first place. For patients who have continual problems with hives or other allergic skin conditions, an allergy evaluation can be helpful. Your allergist will try to identify the source of your problem and then develop an effective treatment plan to help prevent these irritating skin conditions from occurring. Fortunately, most patients who have skin allergies can be given significant relief so that the skin problems bother them less and do not interfere with the quality of their life.


Atopic Dermatitis?

Atopic dermatitis is a long-term skin disease. "Atopic" refers to a tendency to develop allergy conditions. "Dermatitis" means swelling of the skin.

The most common symptoms of atopic dermatitis are:

  • Dry and itchy skin
  • Rashes on the face, inside the elbows, behind the knees, and on the hands and feet.

Scratching the skin can cause:

  • Redness
  • Swelling
  • Cracking
  • "Weeping" clear fluid
  • Crusting
  • Thick skin
  • Scaling
  • Skin Discoloration

Often, the skin gets worse (flares), then it improves or clears up (remissions).


Who Gets Atopic Dermatitis?

Atopic dermatitis is most common in babies and children, but it can happen to anyone. People who live in cities and dry climates may be more likely to get this disease.

When children with atopic dermatitis grow older, this problem can improve or go away. However, the skin may stay dry and have a tendency to get dry and easily irritated. At other times, atopic dermatitis is a problem in adulthood.

You can't "catch" the disease or give it to other people.


What Causes Atopic Dermatitis?

The cause of atopic dermatitis is not known. It is likely caused by both genetic (runs in the family) and environmental factors. People with atopic dermatitis may go on to develop hay fever and asthma.


How Is Atopic Dermatitis Diagnosed?

Diagnosis is based on the symptoms. Each person has his or her own mix of symptoms that can change over time. Doctors will ask for a medical history to:

  • Learn about your symptoms
  • Know when symptoms occur
  • Rule out other diseases
  • Look for causes of symptoms.

Doctors also may ask about:

  • Other family members with allergies
  • Whether you have conditions such as hay fever or asthma
  • Whether you have been around something that might bother the skin
  • Sleep problems
  • Foods that may lead to skin flares
  • Treatments you have had for other skin problems
  • Use of steroids or medicine.

There isn't a certain test that can be used to check for this disease. But you may be tested for allergies by a dermatologist (skin doctor) or allergist (allergy doctor).


Things That Make Atopic Dermatitis Worse

Irritants and allergens can make atopic dermatitis worse.

Irritants are things that may cause the skin to be red and itchy or to burn. They include:

  • Wool or manmade fibers
  • Soaps and cleaners
  • Some perfumes and makeup
  • Substances such as chlorine, mineral oil, or solvents
  • Dust or sand
  • Cigarette smoke.

Allergens are allergy-causing substances from foods, plants, animals, or the air. Common allergens are:

  • Eggs, peanuts, milk, fish, soy products, and wheat
  • Dust mites
  • Mold
  • Pollen
  • Dog or cat dander.

Stress, anger, and frustration can make atopic dermatitis worse, but they haven't been shown to cause it. Skin infections, temperature, and climate can also lead to skin flares. Other things that can lead to flares are:

  • Not using enough lubricants after a bath
  • Low humidity in winter
  • Dry year-round climate
  • Long or hot baths and showers
  • Going from sweating to being chilled
  • Bacterial infections.

How Is Atopic Dermatitis Treated?

Treatment works best when the patient, family members, and doctor work together. Treatment plans are based on:

  • Age
  • Symptoms
  • General health.

You need to carefully follow the treatment plan. Try to notice what is or isn't helpful. Symptoms usually improve with the right skin care and lifestyle changes.

Atopic dermatitis treatment goals are to heal the skin and prevent flares. Your doctor will help you:

  • Develop a good skin care routine, including aggressive use of moisturizers
  • Avoid things that lead to flares
  • Treat symptoms when they occur.

You and your family members should watch for changes in the skin to find out what treatments help the most.


Medications for atopic dermatitis include:

  • Skin creams or ointments that control swelling and lower allergic reactions
  • Corticosteroids
  • Antibiotics to treat infections caused by bacteria
  • Antihistamines that make people sleepy to help stop nighttime scratching
  • Drugs that suppress the immune system.

Other treatments include:

  • Light therapy
  • A mix of light therapy and a drug called psoralen
  • Skin care that helps heal the skin and keep it healthy
  • Protection from allergens.
  • Atopic Dermatitis and Vaccination Against Smallpox

People with atopic dermatitis should not get the smallpox vaccine. It may cause serious problems in people with atopic dermatitis.