Harold Kaiser (Practicing Allergist and Clinical Professor of Medicine, University of Minnesota Medical School) gives expert video advice on: How are insect allergies treated?; What are "food allergies"?; What are "hives"? and more...
What is "eczema" or "atopic dermatitis"?
Eczema is a chronic skin rash. It can occur anytime from infancy to adulthood. It's associated with itching, redness, flaking of the skin and sometimes it is associated with allergies and often its not. The treatment are local creams and lotions, avoid some harsh chemicals such as soaps to the skin. Wearing cotton as suppose to wool if possible and think the physician or allergiologist or dermatologist can help you sort out the kind of lotions, the moisturizers, the creams, the emollients which will provide some traumatic relief and even therapeutic relief. One can prevent eczema if one has allergic eczema to foods or you are allergic to something that you come in contact with such as wool allergy.
What are "insect allergies"?
A small percentage of patients with insect allergies are allergic to the hymenopter group of insects. These include insects such as bees, wasps, yellow jackets, and hornets. Another group of patients with insect allergies, an expanding group of patients, are allergic to fire ants. Fire ants can cause a local toxic reaction or a generalized allergic reaction. The patients who develop these allergic reactions if they're stung, can get anything from a large local reaction, to a general reaction, to a life threatening reaction. And there are deaths every year from stinging insects. The diagnosis can be made by history, but allergic patients when stung by an insect usually don't know if it's a wasp or a hornet, unless they happen to be a bee keeper.
What are "dust mites" and why am I allergic to them?
Dust mites are microscopic organisms. They live not just in the soil but they also live in places like mattresses and pillows and sheets and in our homes. They're allergenic. By that I mean they're one of the types of organisms commonly induces an allergic response. One of the clues about dust mite allergy is that people have trouble all year round and just during the season and when they do that one suspects something like house dust or dust mite allergy. Allergy skin testing can usually identify whether this a dust mite allergy and the allergen involved. It causes allergic reaction such as perennial allergic rhinitis or year round hay fever or allergic asthma and these diseases are breeded by dust avoidance, environmental control including putting covers, encasement on the mattresses and the springs covering of the home hepi-filters. There's a lot of things you can do to clean up your environment without driving yourself crazy which help significantly. I recommend patients do what they can and don't become a compulsive nut about cleaning the walls and scrubbing the floors. Medication and allergy injections for the treatment of dust mite allergy are very successful and it's again a sort of thing that if it bothers you sell somebody because there's a lot that can be helped.
What is "pink eye" or conjunctivitis"?
The same sort of allergies that can occur in the nose can also occur in the eyes, causing conjunctivitis, or "pink eye". In other words, wherever the mucus secreting areas are exposed to an environment where you get dust or pollen, you can get eye allergies. Pink eye is just a descriptive name for the inflammation that occurs in the eye when you get either a foreign body in the eye like dust, or you get an allergic reaction because you put some cat pollen, some ragweed, or some dust mites on your finger and scratched your eye. There's nothing specific about pink eye, it's simply a descriptive form and it can occur from infection, from allergy, from irritation, and from having something in the eye.
What should I do if I think I have pink eye?
Eyes are valuable and we only have two of them. It's important that if these your suspicions of having pink eye persist, have somebody take a look at your eye and try to nail down what it is you have and treat it. If the first physician doesn't get it, or your eyes are persistantly red, or you have recurrent pink eye, it's probably worth a visit to your opthamologist to see if there might be intrinsic eye disease contributing to this possible pink eye.
Can I treat pink eye at home?
There are a lot of over-the-counter eye drops that are symptomatically okay - they'll provide symptomatic relief, they'll clear up the pinkeye (the bloodshot eyes). If it's a matter of irritation, or you've rubbed your eye, or you've come into contact with something that's no longer in there, then eye drops may be all you need. If you're still getting recurrent symptoms after trying the drugstore type of eye drops, then it's a bigger question than we can answer over the phone. If the symptoms are chronic or chronically recurrent, you should see somebody.
Can having pink eye permanently damage my eyes?
Pink eye is a descriptive word for inflammation or irritation of the eye. If you've got a foreign body in there, if you've got a spec of metal that flew into your eye when somebody was hammering next door and it embedded itself, and it's constantly causing a source of irritation, then yes, you can damage yourself permanently. So, with eyes, if the “pink eye” symptoms persist, see somebody and if you don't get a satisfactory explanation, get a secondary opinion.
What is an "allergic ear infection"?
Some patients who have allergies also get fluid in their ears, and it causes fluid behind their eardrums, which may cause blocked hearing, a feeling you're in an airplane or in the shower, and this may be related to intermittent Eustachian tube dysfunction. The Eustachian tube is the tube that runs from the ear to the nose, and helps to keep things in balance. So when you go up in an airplane it clears; when you go down swimming, it blocks up. In allergic rhinitis, or in allergic disease of the eyes, ears, nose and throat, this tube – this part of the ear – can become swollen. And if it's swollen, then you can get fluid blocked behind your ear. This is sometimes called an allergic ear problem, and treating the basic allergy will control that, rather than just treating the ear.
What are "food allergies"?
Food allergies are reasonably common in early childhood. Certain infants can't tolerate certain foods; they develop rashes, or diarrhoea, they cough, or they wheeze. Among the common foods that infants have trouble with are milk, egg protein, juice, oranges, peanuts, and less commonly, the other foods. Many of the children outgrow their food allergy by the time they get to be three, four, or five years of age, or thereabouts, but some of them persist through the child's lifetime.
Why am I allergic to peanuts?
Now peanut allergy can range from anything from a rash or mild indigestion to death. A life threatening reaction leading to death if it's untreated. We don't know why peanut allergy is so difficult it's so violent it's so aggressive in allergic reaction but it is. And so patients or parents of patients who have been identified that has allergic to peanuts usually by having a bad reaction, they eat a candy bar with a peanut in it, the throw up hives, or they have trouble breathing or they wind up to the emergency room. They are identified and by a skin test or by blood test we can confirmed that this is a truly an allergic reaction and it wasn't something that they just have indigestion or they collapse or they fainted. After the peanut allergy has been definitely diagnose. Then patients are instructed on how to avoid peanuts what foods to avoid instructed to how to make their homes peanut free their taught to read labels and their given a happy pen.
Why do poison oak, poison ivy and poison sumac give me an allergic reaction?
Poison oak, poison ivy and poison sumac contain certain chemicals. They are called urushiols (although they have other names). They induce contact dermatitis, which means that in a fair percentage of the patients who come in contact with it, repeated exposure will cause a reaction. The reaction is a local skin reaction with swelling, itching, redness, pimples, and a very uncomfortable rash. The rash can be spread by scratching the rash and then scratching elsewhere in the non-effected body which means the rash can jump around like a wildfire. We don't know why these chemicals are so inducing; all we know is that in the same way that certain medications like penicillin cause more allergies than other medications, these plants are more likely than others to induce a contact dermatitis. The other interesting thing is the contact dermatitis typically occurs hours to a couple of days after exposure. So you can be out in the woods and then on the way home, and then an hour or two later you start to develop the itching and the rash, and then you get the typical follicles and the redness of the poison oak, poison ivy, or poison sumac.
How are reactions from poison oak, poison ivy and poison sumac treated?
One treats poison oak and poison ivy in different ways. Before the new powerful cortisone type medications were available, people would typically treat them with soap and water, wash off whatever you can, which is still good treatment, to get rid of the stuff that's left on the skin, and then they would apply calamine lotion or drugstore type creams. They would provide modest relief and they would be ok in the mild cases but patients who have typical moderate to severe allergic rhinitis require cortisone or pregnisone, which is a form of cortisone, in significant doses for a week or two to knock it out. It's a little bit like coming into the room and finding a fire in a wastebasket. You can either dribble a little water on it or you can take a bucket of water and put out the fire. The approach to treat poison ivy or poison oak is to put out the fire with the bucket of water. Strong medication to break the cycle, prevent the spread, to relive itching and suffering is the way to do it. And this is usually a cortisone type medication.
What are "hives"?
Hives are blotchy areas of the skin with about twenty-five percent of the population getting hives at one time or another. Hives can occur and they can be allergic or non-allergic. The allergic hives can be quickly detected. They know if they have penicillin, eat shrimp, or take aspirin then they will get hives. After about the second or third or fourth time that they've got hives, they tumble on the idea that there might be a relationship there. So the patients who know what causes the hives, they will try avoid these things. The problem is that about ninety percent or ninety-five percent of the patients who have chronic hives, the hives that don't go away after about six weeks, are unable to identify the cause. They're again, ideopathic. It's frustrating and we can usually treat the hives and clear them up, but the cause remains obscure. We come in contact with all sorts of stuff every day, from foods to environmental agents to chemicals to cosmetics and either one of those or a combination of those starts the hives, the body may start hiving.
How are hives treated?
Typically, hives are treated with antihistamines or with other anti-allergic medications, with advice on therapeutic trials of avoiding particular medications or foods to see if this helps. But often, cortisone-like medications are necessary to put out the fire, so to speak, and give the patient relief.
Why am I allergic to latex?
Latex allergy has become much more frequent is recent years and it's received a lot of publicity of late. Part of the reason is simply because we use more latex nowadays. Latex is used in manufacturing rubber gloves, catheters, wet suits, and all manner of things. There's a lot of latex out there. Some people who are exposed to latex frequently such as nurses who must wear rubber gloves, physicians, surgical patients who have had a catheter implanted and have to wear one permanently, people who work with latex paints, can develop a latex allergy. Latex allergy can show itself as anything from a local rash or a contact dermatitis, to shortness of breath, congestion, asthma symptoms or hives. It's a frustrating allergy because latex is hard to avoid and it's also frustrating because if someone is again a person who has to come into contact with latex on a daily basis and they develop a latex allergy, it can be a difficult lifestyle change. A nurse working in an operating room who has been working with latex and latex materials for twenty years can suddenly find she has to begin using latex-free gloves or avoid taking part in the installation of catheters or using rubber tubing. The diagnosis of latex allergy can be made by history, which is usually the way it's done. One of the tests you can do is simply put on a latex glove or cut the finger off a latex glove and wear it for a couple of days to see if you develop a rash. There's a blood test and a skin test which can be helpful for the diagnosis of latex allergy but they're not totally accurate. they are not totally sensitive tests. So when one puts together the history, the skin test, the blood test and the relief of symptoms when the patient is no longer exposed to the latex environment, then we can tell them “avoid latex”.