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Skin irritation produces symptoms such as itching, redness, blistering and rash. It can usually be treated by a combination of avoiding triggers, and medication (both topical and oral). Severe, prolonged or unexplained skin irritation needs the advice of a dermatologist. Skin irritation is generally produced by an allergen or a non-allergenic irritant.
There are two main types of allergic skin disease, namely atopic eczema (also known just as eczema or atopic dermatitis) and urticarial, also known as hives.Eczema
Eczema is an allergic disease like asthma and hay fever and occurs among people with atopy (a tendency to allergy). It is a chronic skin inflammation produced by an over-reaction of the immune system to direct contact of the skin with an allergen. The immune system produces Immunoglobulin E antibodies which, in turn, produce chemicals including histamine from immune cells which cause the inflammation, itching, redness and blistering rash of eczema. Among the allergens which can provoke an attack of eczema are:
- House dust mite
- Animal dander
- Milk, eggs
Different parts of the body suffer the skin irritation of eczema at different times. A baby is often affected on the face, the legs, the back and the backs of the arms. Older children are more likely to suffer skin irritation in the fold of the elbows and backs of the knees. Adults tend to have eczema in restricted areas like the scalp, the hands, eyelids, chest or nipples.
An eczema flare up tends to proceed in stages, namely:
1. Intense itching and a red, dry rash
2. A blistering rash, with danger of skin infection
3. Over time, thickened, scaly skin
Anyone suffering with eczema tend to have very dry skin and this dryness tends to exacerbate skin irritation. Therefore, keeping the skin well moisturised and cared for is the key to managing eczema. Combine this with the use of steroids, either topical or oral in severe cases to treat flare ups, the condition can usually be managed. Many children grow out of eczema over time, although it can return later in life and other allergic conditions may also develop. To find out more visit our eczema information page.
It is sometimes called nettle rash because nettle stings can produce the symptoms of the condition. In fact, the word Urtica means 'nettle' in Latin and the nettle sting actually contains histamine, the inflammatory chemical produced by a true allergic reaction. Histamine makes blood vessels more leaky and the fluid that leaks out produces a pale swelling called a wheal and also a swelling process called angioedema in deeper layers of the skin. Accompanying these responses is an intense skin irritation, also mediated by histamine.
Urticaria may be acute or chronic. In acute urticaria, symptoms are severe, but short-lived, and often caused by contact with an insect sting, or a specific food or drug. Chronic urticaria can drag on for months, and it can be hard to pin down the cause. However, it does sometimes clear up of its own accord. Some of the possible causes include:
- Sensitivity to drugs like aspirin, antibiotics
- Multiple Chemical Sensitivity
- Chronic infection, often undiagnosed
- Sensitivity to food allergy
- Sensitivity to histamine in foods like wine or cheese
If you know what causes urticaria in your case, it is best to just avoid that trigger. Antihistamine drugs can be useful in controlling the skin irritation of urticaria, as can the anti-leukotriene drugs, such as montelukast (Singulair).
Contact dermatitis is a non-allergic cause of skin irritation. The symptoms occur when an irritant, also known as a sensitiser, comes into direct contact with the skin. There are two kinds of irritant which produce a non-specific reaction, and an antigen, which may produce a delayed reaction that involves the immune system (but is not a true allergic reaction). They may both be involved in producing skin irritation - an irritant makes the skin more permeable and more susceptible to subsequent exposure to an antigen. The range of irritants that can affect the skin is very wide and includes many household products and chemicals, such as detergents. Antigen sensitisers include:
- Metals such as nickel found in jewellery and metal studs on clothing
- Fragrances in cosmetics and toiletries
- Certain garden plants such as ivy and tulips
- Glues, resins
- Latex rubber
Hand dermatitis is a very common cause of skin irritation and it often occurs in the context of atopic eczema. It can be very disabling, often interfering with someone’s work and career. Nurses, hairdressers, bar workers and kitchen staff are particularly susceptible as they work with such a wide range of potential irritants. Gloves are the key to managing hand dermatitis and also the avoidance of soap for cleaning the hands. Avoidance of irritants is important of course, and you may need clinical tests to find out what you are sensitive to. Moisturisers for the hands are useful for skin care, although they should be prescribed to be sure they do not contain irritant chemicals; it is best not to use ordinary hand creams. A steroid cream may also be necessary to help manage flare ups of contact dermatitis.