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Allergy is a common problem and it is especially painful at this time of the year. What are the types of allergies, what do they depend on, how to alleviate their symptoms and whether the number of allergy sufferers has increased in recent years, explain specialists from the Sublimed Medical Center in Krakow.
Allergy, which is repeated symptoms caused by the immune system as a result of the body’s exposure to a substance (allergen) that is well tolerated by healthy people, can develop at virtually any age. – We distinguish inhalation allergywhich is a result of the exposure to the respiratory tract of allergens present in the inhaled air. Its manifestations are then such diseases as allergic rhinitis, i.e. hay fever and allergic asthma – explains Dr. Marek Kaszuba, allergologist Sublimed.
The second kind is contact allergy – arising from the contact of an allergen with the skin, as exemplified by allergic contact dermatitis. The third kind is food alergy, i.e. a situation where the symptoms are caused by an allergen entering the body through the gastrointestinal tract. There are also drug allergies and insect venom allergy.
Tests helpful in the diagnosis of allergies
Most of us automatically recall this slogan from the view of the inside of the forearm with two rows of punctures. These are the so-called skin prick tests – the basic test in the diagnosis of allergy dependent on IgE antibodies. We also have laboratory tests to determine IgE antibodies against specific allergens in blood serum. Another way to confirm allergy is to perform epidermal patch tests, which are able to show allergy to contact allergens.
– In the diagnosis of asthma, we most often perform spirometry – testing the respiratory system. For this purpose, however, the patient can also make measurements at home, the so-called peak expiratory flow. It is an easy-to-measure parameter that indicates the condition of the lower respiratory tract and can be easily tested with a peak flowmeter – an inexpensive device available in medical stores – explains Dr. Marek Kaszuba.
The skin suffers from allergies
We take care of it, rub in creams and lotions, we want it to be smooth, moisturized, firm and with an even color. However, there are situations completely independent of us. Skin changes are relatively easy to observe. Dr. Kamila Białek-Galas, a dermatologist at the Sublimed Medical Center, explains which allergic skin diseases are most often reported by patients. These are: contact dermatitis (allergic and irritation), urticaria and atopic dermatitis (AD).
Allergic contact dermatitis is characterized by contact allergy, which, as the name suggests, is caused by skin contact with sensitizing substances. The most common allergens in this group are chromium and nickel. They are found in everyday items such as a belt buckle, earring, trouser button, ring, imitation jewelry, but also in washing powders or dyes. – Dark skin is dyed with colored dyes, the hairdresser’s paint often contains allergenic paraphenyldiamine. Allergic contact dermatitis is also very common after some cosmetic procedures or cosmetics have been used. For example, patients who are allergic to glue for false eyelashes or substances used to make hybrid nails are more and more frequent – says the specialist. Unfortunately, each time you come into contact with an allergen to which your skin is allergic, this reaction will reappear.
The second type of this disease, irritant contact dermatitis, is caused by irritating substances such as disinfectants. Its occurrence depends both on the frequency and duration of skin exposure to a given substance. It may apply to all people who have contact with a given substance, not only people who are allergic to it. Inflammation occurs more often, especially in the fall and winter season, because the hands have an additional damage to their protective barrier due to exposure to wind and frost.
Contact dermatitis can also be divided into acute and chronic due to its duration. In the case of chronic contact dermatitis, the protective barrier of the epidermis is permanently damaged and chronic skin lesions develop, which can be periodically “healed”, but are characterized by relapses.
Hives at least once in your life
It is said that every person will have (or have had) hives at least once in their life. – This is a relatively common problem. It is caused by the release of histamine by cells. This compound widens small blood vessels and increases their permeability, leading to local erythema and swelling of the skin. This situation may be provoked by allergy, but also by thyroid disease, acute infection, latent infection focus (chronic inflammation) or autoimmune disease. Then, urticaria is treated as one of the symptoms of these diseases – explains Dr. Marek Kaszuba.
Does it really have something to do with the burn of a known plant? – Yes, because the skin changes that appear in it look like blisters that appear on the skin after contact with the nettle. They have a porcelain white, pink or vivid red color, various shapes and sizes, are raised above the surface of the skin and are edematous. Most of all, however, they are itchy. The hallmark of hives is that it resolves on its own within 24 hours without leaving a trace. We are talking about acute urticaria, the treatment of which is the administration of antihistamines. Chronic urticaria can last even more than 6 weeks and, unlike acute urticaria, it requires extended diagnostics, explains Dr. Kamila Białek-Galas.
Can hives be on the face? – Absolutely. There may be both typical hives on the face as well as the so-called Quincke’s edema. It is a rapidly developing swelling of the lips, tongue, mucous membranes of the mouth, throat or larynx, accompanied by increased breathlessness. This ailment requires urgent medical intervention. If immediate treatment is not taken, the laryngeal edema can even lead to the patient’s death – warns the Sublimed specialist.
Atopic dermatitis (AD) and atopic diseases
Shelves with cosmetics for people with AD are bending. Not only young mothers know about it. Is it such a common ailment? And what is its background? The phenomenon of atopy in atopic dermatitis is usually associated with a genetic predisposition to allergic diseases. It is characteristic that in the family of people with atopy there are often diseases from the circle of atopy, e.g. allergic rhinitis, bronchial asthma or allergic conjunctivitis. Virtually always in a patient with AD, one of these ailments is also present at the same time. The disease usually begins in childhood, is chronic and relapsing. Increased itching of the skin is a symptom that occurs regardless of the patient’s age.
In patients with AD there is a genetically determined so-called filaggrin defect, resulting in an abnormal structure of the epidermis. – It is one of the proteins that build the epidermis. The effect of allergens on such skin is completely different than on healthy skin. A whole range of allergens can cause changes: most often they are inhalation allergens (dust, mites, pollen, fungal spores) and food allergens (frequent reactions to milk protein, eggs or nuts) – Dr. Kamila Białek-Galas cites examples from his practice.
Treatment of AD
What exactly is on the shelves of pharmacies and drugstores, but what drugs do we use for inflammation? – These are topically rubbed steroid ointments, calcineurin inhibitors with a steroid-like effect, but most of all in AD, proper skin care is of paramount importance – the specialist Sublimed clearly emphasizes. The aforementioned genetically determined filaggrin defect, and thus the abnormal structure of the epidermis, require preparations to help it rebuild. Therefore, you should use emollients, which lubricate the skin after each washing, as well as emollient oils for the bath. And let’s not forget about antihistamines that stop itching.
Hope in desensitization
It is commonly known that it lasts a long time and usually brings the expected result. Specific allergen immunotherapy, colloquially known as “desensitization”, is the only method of causal treatment of allergic diseases. We use it in the treatment of allergic rhinitis, allergic asthma and insect venom allergy. By desensitizing, we want the body to stop recognizing a natural substance as foreign – we teach the immune system to tolerate certain allergens anew so that they no longer cause symptoms in everyday life. For this purpose, we give the patient the allergen, starting with very small doses, then gradually increasing them. Usually this is done by subcutaneous injections initially every week and then usually every 4 weeks. It is the most popular form of desensitization and currently the only one reimbursed in our country. There is also another way to carry out desensitization, namely with sublingual preparations that the patient can take alone.
Are there more allergies these days?
Epidemiological studies from the last few decades prove that, unfortunately, we are dealing with an upward trend in the number of allergic people. A disturbing phenomenon is the fact that there are more and more allergic children, especially in cities.
Sublimed allergist says that attempts to describe the cause of this phenomenon often point to the so-called “Hygienic hypothesis”. – She explains the increase in the prevalence of allergies by the fact that we live in an increasingly “sterile” environment. We are isolated from natural immune stimuli for humans and their immune systems – incl. bacteria, animals. One of the arguments in favor of this concept is the fact that in cities and highly industrialized countries far more people suffer from allergic diseases than in rural areas and in less developed countries – explains Dr. Marek Kaszuba.
Getting used to allergens
A growing body of research shows that when a healthy child comes into contact with a variety of potential allergens from early childhood, he is less likely to develop allergic diseases later in life. Therefore, it is not recommended to avoid in healthy children products that have so far been considered highly allergenic. As part of the prevention of food allergies, it seems that it is good for a child to come into contact with all the food that he will be eating in the first year of his life. Of course, the form of their administration must be adapted to the child’s age (e.g. mousses, purees), but as for their type, in the last months of the child’s first year of life, there are basically no restrictions. Milk, eggs, strawberries or even seafood are not terrible!
Check also: Changes in the oral mucosa due to allergies