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Q: Allergy or stress ( Answered,   0 Comments )
Question  
Subject: Allergy or stress
Category: Health > Women's Health
Asked by: zszendro-ga
List Price: $20.00
Posted: 14 Jul 2006 12:24 PDT
Expires: 13 Aug 2006 12:24 PDT
Question ID: 746380
A friend of mine has reoccuring rashes on her face, swollen under
eyes, it is watery. She also has red rash on her face, dry above
mouth, usually at the same place.
When it breaks, she is itching all over her body, but rashes usually
occurs at the same spots (under the eyes, above the mouth, but now she
got it on her nexk). She is 44 year old woman. Syndrome does not seem
to be related to period. Allergy lab
(1st, 2nd, 3rd oppionion) did not find any typical allergens. They
claim stress which she got enough, but she is very uncomfortable when
it breaks out and just by saying it's stress won't give her any short
term remedy. Usually an outbreak last 5-10 days. Can it be sulfites
allergy, any strategies what to ask the lab to test for?

Any hint or stategy on how to proceed to figure out what's going on is
highly appreciated. Thanks

Request for Question Clarification by crabcakes-ga on 14 Jul 2006 14:40 PDT
Hello Zszendro,

   Is your friend on any medications or supplements?

   What make syou suspect sulfites?

   How long has this been happening?

   Does your friend have fair skin? Dry skin?

   Do you know what kind of allergy testing she had? Blood testing or skin testing?

   Does she smoke?

   Does she have pets of any kind?

   What is she currently doing to alleviate her discomfort? Creams,
lotions, allergy medicine?

  The more information I have, the better answer I can supply you.

  Thank you, Crabcakes
Answer  
Subject: Re: Allergy or stress
Answered By: crabcakes-ga on 14 Jul 2006 16:02 PDT
 
Hello Zszendro,

  Our notification system is not working, so I decided to answer your
question before you clarified. Please clarify if I missed anything!


   From what you describe, eczema is a possibility, and/or  allergies
and/or food and environment  sensitivities. Please note we can not
diagnose your friend, nor recommend one therapy over another. Please
have your friend consult an allergist or dermatologist to rule out any
more serious condition.


Adult Eczema (Often called atopic dermatitis)
?The condition waxes and wanes over the years with frequent flare-ups.
There are no specific tests available to confirm the diagnosis. The
majority of cases have an increase in the serum Ig E level which is a
sign of increased immunological activity.?

?Diagnosis of this condition, which has variable appearances, is
dependent on a number of factors. The features or appearance in one
person may be different from another. Skin in different locations in
the same person may also have variable appearances which change
according to the severity of eczema in that specific location.?
http://www.eczemaguide.com/eczema_basics/what_is_eczema.html

http://www.eczemaguide.com/eczema_basics/facts/triggers_and_symptoms.html

   
   A physician can prescribe several good skin creams to alleviate
symptoms, such as Elidel or prescription strength Eucerin, along with
oral medication, if it turns out to be eczema.
Here is a treatment chart:
http://www.eczemaguide.com/eczema_treatments/treatment_selection_chart.html



?What are the signs and symptoms of eczema?

?The signs and symptoms of eczema (atopic dermatitis) vary from person
to person. Most commonly, the affected skin becomes very dry, itchy,
red and swollen; sometimes it's cracked, crusty and scaly.
?	Babies may have patchy rashes on their face, elbows and knees 
?	Older children usually get the eczema rash behind the knees, inside
the elbows, on the sides of the neck, and on the wrists, ankles and
hands
?	In adults, eczema usually shows up as rashes on the arms, legs,
hands and neck, but any location can be involved?  I have seen adults
and children with red, dry skin under the eys and around the mouth
from eczema.

?Why does eczema affect some people and not others?

Over 34.8 million Americans have symptoms of eczema (atopic
dermatitis), but scientists don't really know what causes it. Many
experts think that eczema occurs when you have an inherited tendency
for the disease, and the disease is "triggered." Triggers can vary
widely, and some examples are stress, or sensitivity and exposure to
some soaps, fabrics or foods.
People with eczema may have different triggers. Some of the common
things that can trigger an eczema flare-up include:
?	Changes in temperature or humidity
?	Chemical irritants, such as pesticides, paint strippers, alcohol,
astringents, perfumes, harsh soaps, detergents, and household cleaners
?	Physical irritants, such as clothes made of rough or scratchy
fabrics, like wool or burlap
?	Allergies (to dust, pollen, mold, animal dander, etc.)
?	Intense emotion or stress
?	Infections of any kind
People with eczema must work closely with their healthcare providers
to figure out what triggers their eczema flare-ups. Then they can take
steps to avoid these triggers.?
Stress is able to trigger flare-ups of eczema.
http://www.elidel.com/info/diagnosing/eczema_faq.jsp?checked=y#1


   ?Atopic dermatitis is a long-lasting (chronic) skin condition that
causes intense itching and then a red, raised rash. In severe cases,
the rash develops clear fluid-filled blisters. Atopic dermatitis may
be worse when you are exposed to certain foods, infection, stress,
seasonal or climate changes, irritants (such as soaps or chemicals),
or allergens such as dust mites or animal dander.
Atopic dermatitis is most common in babies and children. Although
older studies have indicated that most children outgrow the condition,
more recent studies report that many people continue to have relapses
or to have the condition, although not as severely, as teenagers and
adults.1 You may also develop atopic dermatitis as an adult.

Atopic dermatitis is sometimes called eczema or atopic eczema.
However, atopic dermatitis is only one of many types of eczema.? There
is a link to a photo on this page, illustrating common areas that
eczema targets.
http://www.healthbanks.com/PatientPortal/Public/ArticlePromoted.aspx?ArticleID=HW5hw216104
More photos, of varying degrees of eczema on this page:
http://www.vivacommunications.com.au/eczema/images_eczema.htm


Treating eczema
Your friend can try using over the counter Eucerin on her face till
she sees an allergist. It?s important not to let the skin get dry.
Moist compresses can help too. Avoid getting creams and lotions in the
eyes.Moisturize every day.
  
Wear cotton or soft fabrics. Avoid rough, scratchy fibers and tight clothing.
  
Take lukewarm baths and showers, using mild soap or non-soap cleanser.
  
Gently pat your skin dry with a soft towel ? do not rub.
  
Apply a moisturizer within 3 minutes after bathing to "lock in"
moisture. When possible, avoid rapid changes of temperature and
activities that make you sweat.

  Learn your eczema triggers and avoid them.
  Keep your fingernails short to help keep scratching from breaking the skin.
  Some people with allergies find it helps to remove carpets and pets
from their houses.

From my own experience, I?ll add, wash clothes in Ivory Snow or a baby
laundry soap, use fresh towels and pillow cases every day, and don?t
wear perfume or hairspray, till your friend pinpoints the cause of her
problem. Dust and vacuum often. Take warm showers, not hot. Shower and
shampoo hair daily.

http://www.treat-eczema-now.com/info/treating/skin-care.jsp

http://www.elidel.com/info/skincaretips/eczema_treatment.jsp

http://www.skincarephysicians.com/eczemanet/steroids.html



Food allergies and sensitivities

   ?With a true food allergy, an individual's immune system will
overreact to an ordinarily harmless food. This is caused by an
allergic antibody called IgE (Immunoglobulin E), which is found in
people with allergies. This antibody may develop after eating the food
repeatedly in the past but without having problems. Food allergy may
appear more often in someone who has family members with allergies,
and symptoms may occur after that allergic individual consumes even a
tiny amount of the food.

Food intolerance is sometimes confused with food allergy. Food
intolerance refers to an abnormal response to a food or food additive
that is not an allergic reaction. It differs from an allergy in that
it does not involve the immune system. For instance, an individual may
have uncomfortable abdominal symptoms after consuming milk. This
reaction is most likely caused by a milk sugar (lactose) intolerance,
in which the individual lacks the enzymes to break down milk sugar for
proper digestion. Your allergist can help you determine the difference
between intolerance and allergy and help you in establishing a
management plan.?

?The allergist/immunologist may suggest that the patient keep a food
diary, which is a detailed record listing foods eaten, date, time and
any symptoms that occurred after eating the food. When an allergy to a
single food is suspected, the allergist may recommend eliminating the
food for a time. If symptoms are relieved, the allergist/immunologist
may add the food to the diet once again to further determine if it
causes a reaction (however, this is never done when the patient has a
history of anaphylaxis).

If the diagnosis of food allergy remains in doubt, the
allergist/immunologist may recommend a "blinded" food and/or food
additive challenge test. These tests are conducted in the doctor's
office, or at times, in the hospital under close observation. Usually,
the suspected food or a neutral food, called a placebo, is fed to the
patient in colorless capsules, or in a non-allergenic slush or
pudding. Neither the patient nor the doctor knows whether the
suspected food or the placebo is being eaten. This is called a
"double-blind" challenge. When properly performed, these challenges
are very reliable in establishing a concrete cause and effect
relationship between a food and an allergy symptom.?

?Patients should see an allergist/immunologist if they: 
?	Have a diagnosed food allergy. 
?	Have limited their diet based upon perceived adverse reactions to
foods or additives.
?	Have a family history of allergies and have or are expecting a
newborn and are interested in identifying strategies for preventing
allergy in the infant.
?	Have experienced allergic symptoms (urticaria, angiodema, itch,
wheezing, gastrointestinal responses) in association with food
exposure.
?	Experience an itchy mouth from raw fruits and vegetables.
?	Are an infant with recalcitrant gastroesophageal reflux or an older
individual with recalcitrant reflux symptoms, particularly if they
experience dysphagia.
?	Are an infant with gastrointestinal symptoms including vomiting,
diarrhea (particularly with blood), poor growth, and/or malabsorption
whose symptoms are otherwise unexplained, not responsive to medical
management, and/or possibly food-responsive (even if screening allergy
tests are negative).
?	Have known eosinophilic inflammation of the gut. 
http://www.aaaai.org/patients/publicedmat/tips/foodallergy.stm


?People are unique individuals. They have different favorite foods,
colors, temperatures, environments, etc. Sometimes a person has an
'altered response' to something that is fine for most other people.
This is more than a personal preference...it is usually something
their body reacts to automatically. This can be called a 'sensitivity
or intolerance' or 'allergy'. An allergy usually involved the immune
system. The sensitivity might involve the immune system. These terms
are often loosely used interchangeably in everyday conversation. There
are technical differences though.?

?Allergic reactions can occur under a variety of circumstances. For
instance, inhaling certain substances, such as grass pollen, house
dust, etc., may cause an allergic response. However, the consumption
of certain foods may do the same. Allergies typically bring on
complaints very rapidly upon contact with the allergen. Complaints may
vary from a runny nose, sinusitis, earache or runny eyes to itching of
the skin, eczema and shortness of breath.?

Food additives which might cause problems:
?	sulfites
?	benzoates
?	sorbates
?	artificial food colorings
?	artificial flavorings 
?	artificial sweeteners
?	flavor enhancers (MSG)
?	antioxidants
?	nitrates
?	proprionates
?	gums (xanthum, guar, etc)
?	other substances
Don?t forget molds and mildews! Does your friend have any growing in her shower?

Enzymes
?Since enzymes are proteins, it is possible that a particular
individual may be sensitive (not tolerate) a particular enzyme
proteins. This is very very rare though. Enzymes are a natural and
constant part of our healthy digestive tract. Our intestinal tract is
swimming in enzymes all the time from birth to death anyway.?
http://www.enzymestuff.com/conditionsensitivities.htm


List of potential food allergies:
http://www.clevelandclinic.org/health/health-info/docs/2900/2987.asp?index=10014


   Although this is intended for children, a food diary is a good
place to start tracking what foods could be bothering your friend.
Step one is :
?1. Eliminate the possible suspect foods, beginning with the nasty
nine, for a period of at least a week or ten days. During this time,
eat only the least allergenic foods, such as: fresh fruits (except
berries and citrus), avocados, rice, barley, millet, poultry, and
lamb. All the foods, if possible, should be organic and free of
additives, dyes, and colorings.? Please check this site for the
subsequent steps.

?At present there are no medical tests for food allergies that are
more accurate than the detective work of a parent who is a keen
observer and accurate recorder. In most cases, a carefully done
elimination diet will uncover what the allergy is to. Your doctor or
allergist can help by performing one or both of the following tests:?
Skin test or blood tests.
http://www.askdrsears.com/html/4/T041800.asp#T041806


Numerous food items can cause skin reactions. Corn, flour, citrus,
milk, shellfish, eggs, peanuts and chocolates are among the worst
offender.
http://www.nal.usda.gov/fnic/pubs/bibs/gen/allergy.htm

http://www.calgaryallergy.ca/Articles/English/corn4as.html

Some typical allergic reaction symptoms:

Allergy:
?  History
Itches excessively.
Patient may complain of rash. 
May have low-grade fever. 
May have started quickly, in reaction to something such as food,
medicine, something breathed in, an insect bite, heat, or cold.
Past or family history of allergies.
Exam
Rash may include:
?  Red, raised spots. 
?  Swelling in area of rash, face, or eyes.
?  Hives (urticaria); welts usually 1 cm or larger, raised and red. 
?	May have pink "halo" around edges, or swelling white centers due to swelling.
Exam may also show:
Shock (weakness, fast pulse, low BP), If so, go to pg. 8. 
Severe swelling, wheezing, or shortness of breath.
Patient may also have watery eyes.

Dermatitis
?  History 
?  Usually a recurrent rash.
Exam 
?  Rash ( often on the face and neck, hands and wrists, inside of
elbows, or behind knees ; caused by an irritant )
May start after:
?  touching something that may cause allergic reaction.
?  eating something patient is allergic to.
?  allergy or by contact with an irritating chemical (chemical soap, hot water). 
?  emotional upset.
In infant, may cover most of body.
In areas exposed to irritation:
?  Skin may have more or less color than normal.
?  May start as inflamed skin (tender, warm, red, swollen).
?  Itches; may burn. 
?  As described under "exam" develops pinhead-size blisters that
break, ooze, and form crusts as they dry.
?  Often small scabs form from excessive scratching.
?	If chronic, skin becomes dry, thick, and has more obvious skin lines (markings).
http://www.telemedicine.org/3assess.htm

To help alleviate allergic reactions:
Have your friend see an allergist.


   Asthmatics are the most prone to sulfite reactions. ?The Food and
Drug Administration estimates that one out of a hundred people is
sulfite-sensitive, and that 5 percent of those who have asthma, like
Karen (who asked that her last name not be used), are also at risk of
suffering an adverse reaction to the substance. "By law, adverse
reactions to drugs must be reported to FDA by doctors or
pharmaceutical companies. But with sulfites and other food
ingredients, reporting is voluntary so it's difficult to say just how
many people may be at risk," cautions FDA consumer safety officer
JoAnn Ziyad, Ph.D.?
Sulfur-based preservatives, or sulfites, have been used around the
world for centuries to:
?	inhibit oxidation ("browning") of light-colored fruits and
vegetables, such as dried apples and dehydrated potatoes
?	prevent melanosis ("black spot") on shrimp and lobster 
?	discourage bacterial growth as wine ferments 
?	"condition" dough 
?	bleach food starches 
?	maintain the stability and potency of some medications.
--- Because I am sensitive to sulfites, I can tell you that they are
still allowed in some coconut products (candy bars, and bagged
coconut), some wines, shrimp products, and some of those pre-prepared
salads and gelatins found in the deli section of most supermarkets.
http://www.fda.gov/fdac/features/096_sulf.html


ALLERGIES 
1.	For relief of allergy symptoms, such as stuffy head, runny nose
with clear mucous, itchy and watery eyes, and sneezing, take an
over-the-counter oral antihistamine (e.g. Benadryl?) to help relieve
symptoms.
2.	Antihistamine eye drops (e.g. Opcon-A?) and cold, wet compresses
can relieve itching eyes.
3.	Rinse with nasal saline spray as often as possible (e.g. Ocean
Spray? -- not the drink!-- or the generic brand).
4.	Avoid allergens as much as possible. Use dust mask to cover your
nose and mouth when doing household chores and/or yard work; use a
humidifier to keep the air moist in your bedroom, and keep the windows
closed; at bedtime, shower and shampoo your hair to wash the pollens
off your body; and change your pillowcases often.
http://www.calpoly.edu/~hps/Selfcare/resp.htm


Medications and supplements can cause rashes too. Shower and wash hair
daily, with a mild soap and shampoo-try baby products.
?Age, stress, fatigue, weather extremes, oily skin, infrequent
shampooing, and alcohol-based lotions aggravate this harmless but
bothersome condition.?
http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm

There you go. I urge your friend to visit a good physician, to rule
out a more serious underlying cause of her rash. Please visit each
site provided for complete information.

Please ask for an Answer Clarification, if anything is unclear in my
answer, before you rate.

Sincerely, Crabcakes

Search Terms
============

Rash + watery eyes
Facial rash
Eczema + adult
Atopic dermatitis + adult
Cause + facial rash + recurring
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