By Noga Askenazi, MD, FAAAAI

If your skin itches, an allergist can help. Itchy dry skin is often eczema, a type of skin allergy that may be triggered by pollens, pets or foods. Rashes that occur by chemicals contacting the skin are termed contact dermatitis. Another allergic skin reaction is hives, medically termed urticaria. This can occur as a reaction to environmental allergens or foods, but may also be drug or virally induced. An allergist can help diagnose and treat these rashes.

One of the most common skin diseases from childhood to adulthood is eczema, atopic dermatitis (allergic skin inflammation.) This is often referred to as “an itch that rashes.” Little bumps on baby’s cheeks and dry patches around elbows and knees of children are common presentations. In adulthood the rash flares in the folds of arms or behind the knees. Adults can have bad hand and scalp involvement as well.

Itchiness is worst at night and the more one scratches the worse the rash gets. Ingested foods or allergens inhaled from the environment are often triggers. An allergist can identify these triggers by skin testing for food and environmental allergens. The skin can be treated with anti-inflammatory ointments and protected with emollients, which are put on the skin to allow it to rehydrate and heal. Sometimes antibiotics are required to help the skin heal if the rash is severe. It can also help to take anti-histamines that may control the itch and prevent the rash from getting worse.

Contact dermatitis is an allergic skin reaction that appears as itchy bumps or blisters, dry patches or changes in skin color in areas of the skin that have come in contact with an allergenic compound or chemical. These compounds can be in detergents, cosmetics, creams, metals or industrial materials.

Allergy to a compound can develop anytime in life. Hand cracking and dryness can occur from chemicals handled at home or work. Nickel allergy is the most common metal to cause contact dermatitis and can appear on skin in contact with jewelry or metal snaps on clothes. Upper eyelid rashes can occur in women who wear nail polish and rub their eyes, but can also occur from other types of chemicals transferred from fingers to eyelids. Allergists can place patch tests on your skin to determine which allergen caused the rash. Treatment includes avoiding contact with the allergen and treating the skin with anti-inflammatory medications. Antihistamines can help curb the itch too.

The other common itchy rash is urticaria. It appears as intensely itchy welts or red blotches that migrate around the body and completely disappear over minutes to hours. Some swelling of the skin may also occur. If the rash appears immediately after ingesting certain foods that food should be avoided. Medications causing hives should be stopped and avoided as well. A physician should assess urticaria if it continues for 4-6 weeks because it is then considered chronic. Chronic urticaria may be associated with chronic diseases and lab tests can help rule out these diseases.

Treatment of urticaria is often successful with oral antihistamines that control the itch and recurrence of the rash. Avoidance of triggers will also help. Severe flare-ups may require taking steroids, which are anti-inflammatory hormones that quench the rash.

If you develop any itchy, persistent rash that does not go away with conventional treatment, seek the advice of an allergist to assess and treat the problem. You will sleep more soundly and keep your skin healthy.