Allergies - Information About Different Allergies in Mankind

Monday, 29 July 2013

Deodorant and Antiperspirant Allergy

Deodorants and antiperspirants are cosmetic products that are used by the majority of adults in the United States. Deodorants and antiperspirants are available individually or as combination products. These cosmetics are typically applied daily to the underarms in the attempt to mask odors and prevent perspiration.

Deodorants, which are classified as cosmetic agents by the Food and Drug Administration (FDA), have antimicrobial activities to reduce the growth of bacteria, as well as fragrances to mask any odors that are produced by the bacteria. Antiperspirants are classified as drugs by the FDA, and usually contain aluminum, which acts to reduce the production of sweat by the sweat glands.

Deodorants and antiperspirants are generally considered to be safe products. In the past, there was concern that parabens (used as a preservative) in these products were responsible for the increase in breast cancer rates in women. While this has been disproven in a number of studies, most manufacturers no longer use parabens in deodorants and antiperspirants. Aluminum, found in antiperspirants, has been blamed on the increase in Alzheimer’s disease. While somewhat controversial, a few studies do show a slight increase in the risk of developing Alzheimer’s disease from the use of aluminum containing cosmetic products, such as antiperspirants.

Allergic reactions to deodorants and antiperspirants are known to occur, which most often result in contact dermatitis of the underarm area. The rash that occurs is itchy, bumpy, and red and can blister, peel, flake and ooze. Contact dermatitis to deodorants and antiperspirants is usually limited to the site of application, namely the underarm area.

There are a number of chemicals responsible for contact dermatitis from deodorants and antiperspirants, the most common of which are fragrances. Fragrance allergy is very common, affecting up to 4% of all people. Since 90% deodorants and antiperspirants contain fragrances, people with fragrance allergy may have a difficult time finding a product that doesn’t cause a rash.

Other common causes of contact dermatitis to deodorants and antiperspirants include propylene glycol (a vehicle agent used as a "carrier" for active ingredients), parabens, vitamin E (as an antioxidant and moisturizer) and lanolin.

The diagnosis of contact dermatitis to deodorants and antiperspirants is made by patch testing. The only FDA approved patch testing system in the United States is the T.R.U.E test, which can fail to detect an allergy to uncommon fragrances and propylene glycol. Therefore, it is important that an allergist patch tests a patient's own deodorant or antiperspirant that is suspected of causing the problem.

There are other causes of underarm rashes not caused by contact dermatitis to deodorants and antiperspirants. These include (but are not limited to) fungal and yeast infections (such as tinea corporis and candidiasis), inverse psoriasis, acanthosis nigricans, and certain forms of cancer. If treatments are ineffective, then a person with a persistent underarm rash should be evaluated by a dermatologist, with the consideration for a skin biopsy.

The immediate treatment of deodorant and antiperspirant allergy is the use of topical corticosteroids on the underarm skin. Topical corticosteroids are the treatment of choice for mild to moderate contact dermatitis involving limited areas of the body. Severe forms may require oral or injected corticosteroids.

The long-term treatment of deodorant and antiperspirant allergy involves the avoidance of the chemical responsible for the reaction. If patch testing identifies the specific chemical, then that chemical can be avoided. If the cause of the contact dermatitis is not known, then a hypoallergenic formula of a deodorant or antiperspirant can be tried. Alternatively, naturally available zeolite crystals are available commercially as natural alternatives to deodorants and antiperspirants. These include the Crystal Body Deodorant, which is available at common drugstores nationwide. Almay Hypo-Allergenic Fragrance Free Roll On (Deodorant and Antiperspirant) Mitchum Roll-On Unscented (Deodorant and Antiperspirant) Stiefel B-Drier (Deodorant and Antiperspirant) Certain Dri (Antiperspirant) Crystal Roll-On Body Deodorant for Sensitive Skin (Deodorant) Crystal Stick Body Deodorant for Sensitive Skin (Deodorant) Secret Soft Solid Platinum Deodorant Unscented

Are There Any Generic Asthma Inhalers?

There are currently no generic asthma inhalers, either as rescue or controller medications. Since the transition to HFA-based propellant inhalers, generic albuterol is no longer available. Albuterol is now only available in multiple brand name versions, including Proventil, ProAir, Ventolin, and Xopenex (levalbuterol, which is the active form of albuterol).

Controller inhalers for asthma, which are used to prevent symptoms of asthma, are also only available in brand name versions. There are a number of inhaled steroids available for this purpose, including Flovent, Asmanex, QVAR, Alvesco, and Pulmicort. Inhalers that combine inhaled steroids and long-acting bronchodilators, such as Advair, Symbicort and Dulera, are also only available in brand name form.

Nebulizer solutions for asthma, as both rescue and controller therapies, are available in generic versions. Albuterol nebulizer solution is available only as a generic medication. Budesonide is the generic version of Pulmicort Respules, an inhaled steroid used as a controller therapy for the treatment of asthma. Budesonide is available as a generic nebulizer steroid solution, as well as in brand name form.

Learn about the differences between brands of inhaled steroids used to prevent the symptoms of asthma.

Source:

Practice Parameters for the Diagnosis and Treatment of Asthma. J Allergy Clin Immunol 1995;96:S707-870.

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Beach Allergies

Most people who live or vacation near the coast spend time at the beach during the summer months. The sunny weather, warm sand, and cool ocean or lake water makes the beach a popular attraction. While time spent at the beach is a joy for most people, others may experience allergic reactions while at the beach. Despite the ocean breezes blowing onshore keeping the pollen further inland, other causes of allergies may still be present at the beach. The growing concern over skin damage and skin cancer has led most people to use sunscreen before spending a day at the beach. This increased use of sunscreens has lead to the development of allergic reactions to the chemicals found in sunscreens. Most of these allergic reactions are contact dermatitis, a poison oak-like rash that occurs on the skin within hours of sunscreen application. This reaction can occur anywhere the substance is applied on the body, although it tends to be more common on the areas of the body with the most exposure to the sun.

Learn more about the causes and treatment of sunscreen allergies.

Many people complain of various skin symptoms with prolonged exposure to sunlight, such as itching, hives, or burning and stinging of the skin. Some people have visible rashes while others have no rash. Certain people with underlying medical conditions (such as lupus or porphyria) are more sensitive to sunlight; still others are using various medications (such as certain high blood pressure medications) that cause a reaction on the skin when exposed to sun.

Read more about the most common types of sun allergy, including solar urticaria, cholinergic urticaria, and polymorphic light eruption.

The act of swimming can also lead to allergic reactions, and the cause of this reaction depends on whether the swimming occurred in a freshwater lake or in the ocean. Swimmer's itch occurs when people swim in water contaminated with parasites. Generally, swimmer's itch occurs in freshwater, where aquatic birds and snails are likely to live. These animals serve as carriers for the parasite, although when this parasite enters human skin, it causes an irritating allergic rash as it dies.

Seabather's eruption is a different type of allergic rash that occurs after swimming in the ocean and being exposed to jellyfish larvae. These larvae get trapped between a person's skin and bathing suit, resulting in an itchy skin rash on areas covered by clothing. These symptoms usually start while the person is still swimming, but may also occur hours later. Rubbing the skin often makes the symptoms worse, since the larvae release toxin into the skin as a result of pressure or friction. Rarely, a person may also experience systemic symptoms from the toxin, such as fevers, nausea and vomiting, headache and diarrhea.

Learn more about allergic reactions that may occur from swimming.

Everyone loves a barbeque after a long day at the beach. Certain types of wood (such as mesquite, oak, cedar and hickory) are burned, the smoke from which adds flavor to the barbequed meat. Wood is obtained from trees that produce pollen to which many people with seasonal allergies are allergic. The allergen in the pollen also is present in the wood of the tree; these allergens survive combustion and remain in smoke once the wood is burned. Therefore, it is possible to be allergic to the smoke, and to any food barbequed with the smoke.

Food Allergies

Approximately 8% of children and 2% of adults suffer from true food allergies. When the culprit food is eaten, most allergic reactions will occur within minutes. Skin symptoms (itching, urticaria, angioedema) are the most common, and occur during most food reactions. Other symptoms can include nasal (sneezing, runny nose, itchy nose and eyes), gastrointestinal (nausea, vomiting, cramping, diarrhea), lung (shortness of breath, wheezing, coughing, chest tightness), and vascular (low blood pressure, light-headedness, rapid heart beat) symptoms. When severe, this reaction is called anaphylaxis, and can be life threatening.
Most reactions to food are probably not allergic in nature, but rather intolerance. This means that there is no allergic antibody present against the food in the person. Intolerance can be classified as toxic and non-toxic. Toxic reactions would be expected to occur in most people if enough of the food was eaten, examples include alcohol, caffeine or in cases of food-poisoning. Non-toxic food intolerance occurs only in certain people, such as lactose intolerance, which is due to the deficiency of lactase, the enzyme which breaks down the sugar in milk and dairy foods. Patients with lactose intolerance experience bloating, cramping and diarrhea within minutes to hours after eating lactose-containing foods, but do not experience other symptoms of food allergies. A less common form of non-allergic reactions to food involves the immune system, but there are no allergic antibodies present. This group includes celiac sprue and FPIES (food protein induced enteropathy syndromes). FPIES typically occurs in infants and young children, with gastrointestinal symptoms (vomiting, diarrhea, bloody stools, and weight loss) as the presenting signs. Milk, soy and cereal grains are the most common triggers in FPIES. Children typically outgrow FPIES by 2 to 3 years of age. Milk, soy, wheat, egg, peanut, tree nuts, fish and shellfish compromise more than 90 percent of food allergies in children. Allergy to milk and egg are by far the most common, and are usually outgrown by age 5 years. Peanut, tree nut, fish and shellfish allergies are typically the more severe and potentially life-threatening, and frequently persist into adulthood. Cross-reactivity refers to a person having allergies to similar foods within a food group. For example, all shellfish are closely related; if a person is allergic to one shellfish, there is a strong chance that person is allergic to other shellfish. The same holds true for tree-nuts, such as almonds, cashews and walnuts.

Cross-contamination refers to a food contaminating another, unrelated food leading to a "hidden allergy". For example, peanuts and tree nuts are not related foods. Peanuts are legumes, and related to the bean family, while tree nuts are true nuts. There is no cross-reactivity between the two, but both can be found in candy shops and in a can of mixed nuts, for instance.

The diagnosis is made with an appropriate history of a reaction to a specific food, along with a positive test for the allergic antibody against that food. Testing for the allergic antibody is typically accomplished with skin testing, although can be done with a blood test as well.

The blood test, called a RAST test, is not quite as good of a test as skin testing, but can be helpful in predicting if a person has outgrown a food allergy. This is especially true since in many cases the skin test can still be positive in children who have actually outgrown the food allergy.

If the diagnosis of food allergy is in question despite testing, an allergist may decide to perform an oral food challenge for the patient. This involves having the person eat increasing amounts of food over many hours under medical supervision. Since the potential for life-threatening anaphylaxis exists, this procedure should only be performed by a physician experienced in the diagnosis and treatment of allergic diseases. An oral food challenge is the only way to truly remove a diagnosis of food allergy in a patient.

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Hay Fever Symptoms

Allergic rhinitis, or hay fever, is a collection of symptoms, predominantly in the nose and eyes, to allergens such as dust, animal dander and pollen.

adam.about.net Hay fever, or allergic rhinitis, is the most common chronic disease, affecting up to 30 percent of the population. It is the most common reason for chronic sinus and nose problems. Children and young adults are the most common age groups affected by this disease, although many older adults and elderly people also experience symptoms.

Allergic rhinitis is defined as inflammation and irritation of the nasal passages due to seasonal and year-round allergens. Symptoms include sneezing, runny nose, nasal congestion, itching of the nose, and post nasal drip. Half of all people with allergic rhinitis also have a component of non-allergic rhinitis to their symptoms.

Those at risk for the development of allergic rhinitis include people with a family history of atopy, those with atopic dermatitis, a mother who smoked during pregnancy, and living a modernized lifestyle (urban setting, higher socioeconomic status, small family size). The presence of pets, especially multiple dogs, in the home at the time of birth appears to protect against the development of allergic diseases such as hay fever.

The above phenomenon is explained by the “hygiene hypothesis,” which suggests that since we live in a cleaner environment, our immune systems do not need to fight as many infections as in the past. We don't grow up on farms around animals, we don't play in the dirt, we receive vaccines to protect against infections, and we receive antibiotics when we do have infections. As a result, the immune system is less stimulated from an infection-fighting mode, and switches to allergy mode. Early pet exposure, especially to dogs, may help prevent this.

Wrong. Allergic rhinitis affects nearly 39 million Americans, leading to millions of missed work days, school days, and days of reduced productivity each year as a result. The costs of this disease process are measured in the multiple billions of dollars annually (doctor visits, missed work/school days, and medication costs). The effect of allergic rhinitis on a person’s quality of life is comparable to that of a severe asthmatic.

Allergic rhinitis also influences other diseases. Uncontrolled hay fever symptoms can lead to sinus infections, ear infections and worsening of asthma. And people with allergic rhinitis are more prone to illnesses, since the inflammation in the nose makes them more susceptible to the virus that causes the common cold.

History. Diagnosis is made by a person’s symptoms that are consistent with allergies, a physical exam by a medical professional showing signs suggestive of allergies, as well as positive allergy testing. It may be difficult to tell the difference between a common cold and allergies in some people; clues which suggest allergies include: Presence of other atopic diseases (such as atopic dermatitis) Family history of allergic diseases Symptoms associated with a season or trigger (such as a cat) Improvement of the allergy symptoms with medications The presence of itching (of the nose, eyes, ears, roof of mouth) is highly suggestive of allergiesPhysical exam. A physician will also perform a physical exam, looking for clues for allergies. The exam includes looking in the ears (fluid behind the ear drum can suggest allergies), in the nose (pale, swollen mucus membranes in the nasal passages suggest allergies), and in the mouth (evidence of post nasal drip may also suggest allergies). Dark circles under the eyes are called “allergic shiners,” and are due to nasal congestion. A horizontal crease on the nasal bridge is from upward rubbing of the nose with the palm of the hand, called an “allergic salute”.

Allergy testing. Positive allergy tests are required to diagnose allergic rhinitis; negative allergy testing suggests non-allergic rhinitis. Allergy testing is accomplished with skin testing or blood tests (called a RAST). Skin testing is considered the standard, and is performed in a variety of ways, the most common being prick (or scratch) tests.

Find out more about allergy testing and treatments for allergic rhinitis.

Sources:

Bousquet J, van Cauwenberge P, Khaltaev N. Allergic Rhinitis and Its Impact on Asthma. J Clin Allergy Immunol. 2001;108:S147-344.

Buttram J, More D, Quinn J. Allergy and Immunology. The Complete History and Physical Exam Guide. 2003:53-69.

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Milk Allergy

Milk allergy is the most common food allergy for children, and is the second most common food allergy for adults. The rate of milk allergy, similar to other food allergies, seems to be increasing, and affects at least 3% of all children. While it is relatively common for children to outgrow their milk allergy, sometimes at very young ages, milk allergy can persist into adulthood and even last a lifetime. Cow’s milk contains many allergens, which are most commonly broken down into the casein and whey components. The whey components include alpha and beta-lactoglobulins, as well as bovine immunoglobulin. The casein components include alpha and beta-casein components. Allergies to the lactoglobulin components tend to be more easily outgrown by children, whereas allergies to the casein components tend to persist into adolescence or adulthood.

In children and adults who are predisposed to allergic diseases, the body produces allergic antibodies against various milk allergens. These allergic antibodies bind to allergic cells in the body, called mast calls and basophils. When milk or dairy products are consumed, these allergic antibodies bind to the milk proteins, causing the allergic cells to release histamine and other allergic chemicals. These allergic chemicals are responsible for the allergic symptoms that occur.

Symptoms of milk allergy may vary from person to person. Classically, milk allergy most often causes allergic skin symptoms such as urticaria (hives), angioedema (swelling), pruritus (itching), atopic dermatitis (eczema) or other skin rashes. Other symptoms may involve the respiratory tract (asthma symptoms, nasal allergy symptoms), gastrointestinal tract (nausea, vomiting, diarrhea), and even anaphylaxis. These classic symptoms of milk allergy are caused by the presence of allergic antibody, and are referred to as being “IgE mediated”.

Milk allergy not caused by allergic antibodies, referred to as “non-IgE mediated,” can also occur. These reactions are still caused by the immune system, as opposed to reactions not caused by the immune system, such as with lactose intolerance. These non-IgE mediated forms of milk allergy include the food protein-induced enterocolitis syndrome (FPIES), food protein-induced proctitis, eosinophilic esophagitis (EoE; which can also be IgE-mediated) and Heiner syndrome.

IgE-mediated reactions to milk are typically diagnosed with allergy testing, which can be performed using skin testing or by demonstration of IgE against milk protein in the blood. Skin testing is the most accurate way to diagnose milk allergy, although blood testing is helpful in determining when and if a person is likely to have outgrown a milk allergy.

The diagnosis of the non-IgE mediated milk allergy reactions is more difficult to make, and allergy testing is not useful. Most commonly, the diagnosis is made based on symptoms and the lack of allergic antibodies being present. Sometimes, patch testing can be helpful in the diagnosis of FPIES and EoE, and blood testing for IgG antibodies is used to diagnose Heiner syndrome.

The only widely accepted treatment of milk allergy at the present time is avoidance of milk and dairy products. Oral immunotherapy (OIT) for milk allergy is currently being studied at medical universities around the world, with promising results. OIT involves giving very small amounts of milk protein orally to people with milk allergy, and gradually increasing the amount over time. This often results in a person being able to tolerate fairly large amounts of milk protein over time. It is important to realize, however, that OIT for milk allergy can be extremely dangerous, is only being performed in university settings under close medical supervision. OIT for milk allergy is likely to be many years away from being performed by your local allergist.

Learn how to follow a milk-free diet.

Many children will eventually outgrow their allergy to milk, especially those with non-IgE mediated allergy. For those with an IgE-mediated milk allergy, it may not occur as quickly as previously thought. Older studies suggested that 80% of children outgrow milk allergy by age 5; a more recent study performed on a larger number of children suggests that nearly 80% of children do outgrow milk allergy – but not until their 16th birthday.

Measuring the amount of allergic antibody to milk can help predict the likelihood of a person outgrowing their allergy to milk. If the allergic antibody to milk is below a certain level, an allergist may recommend performing an oral food challenge to milk under medical supervision. This is the only safe way to truly see if a person has outgrown their milk allergy.

Learn more about outgrowing food allergies.

Sources:

Fiocchi A, Schunemann HJ, Brozek J, et al. Diagnosis and Rationale for Action Against Cow’s Milk Allergy (DRACMA): A Summary Report. J Allergy Clin Immunol. 2010;126:1119-28.

Skripak JM, Matsui EC, Mudd K, Wood RA. The Natural History of IgE-Mediated Cow’s Milk Allergy. 2007; 120:1172-7.

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Hayfever downgrades children's exam hopes

15th May 2012 - Thousands of children face a struggle to make the grade in their exams this summer because of the debilitating effect of hayfever.

An estimated 38% of young people have hayfever - also known as seasonal allergic rhinitis. The national charity Allergy UK says its survey of parents of children with hayfever found that 31% said their child struggled to concentrate, while 22% said the condition made their life a misery.

Allergy UK says research has shown that 40% of children can drop a grade between mocks and final exams because of their hayfever. It says, if nothing else, hayfever adds to the pressures put on youngsters when they sit their GCSEs or Scottish Standard Grades.

Lindsey McManus from the charity says, because it will be the peak of the hayfever season, "they're going to have a streaming nose, itchy sore eyes, feel bunged up and have their sleep affected".

In fact, the survey revealed that 43% of children with hay fever found it difficult to sleep. In more extreme cases, 12% of youngsters did not even want to leave the house when their symptoms are worst.

Allergy UK wants to highlight practical solutions that can ease the impact of hayfever for children heading into their exams.

It says anti-histamines have a proven track record, and the modern one-a-day, non-drowsy kind are suitable for children over the age of 12. "Getting their symptoms under control is the key thing," says Lindsey McManus, "so check out the best medication for them. It may be that they need eye drops and nasal sprays as well."

GPs and pharmacists can advise about suitable medication.

A top tip from Allergy UK is that it might take a while to find the right medication, so avoid leaving it too close to the first exam to try them out for the first time.

Among other key advice:

Monitor pollen forecasts during exam time and take extra precautions when the pollen count is highIf you do drive children to school on exam days, keep car windows closed and the air intake on re-circulateInvest in a pair of wraparound sunglasses for your child to keep allergens out of their eyes when they are outside at schoolHelp your child get a good night's sleep by keeping windows and doors closed overnight in their bedroomMake sure they wash their hair and change their clothes before they go into their bedroom, which will help to keep pollen outTry using an air purifier in your child's bedroom to help to trap pollen particlesApply an effective pollen barrier around the edge of each nostril to trap or block pollens, these are available as balms, gels or spraysIf you have a pet, keep them away from your child during exam time as they can carry pollen in their furIf your child's hay fever is unbearable on the day of an exam, speak to a senior invigilator. There is a chance they could be given special consideration if symptoms are particularly bad. If you have any concerns in the lead up to the exams speak to your child's school as they may be able to make special arrangements

Lindsey McManus says schools can play their part by being understanding about the effect that hayfever can have on their pupils. "Something that most people see as quite a minor condition can actually be quite debilitating for children," she says.

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