It’s very difficult to live with itching for any length of time. There are two conditions, that we see often in allergy, eczema and hives, that are associate with a lot of itching. Most of the time, when you come to an allergist we are able to identify one or two things which may be causing these conditions. However, for both the hives and eczema, finding a specific cause is unusual.
Many time, there are issues associated with both skin conditions which have nothing to do with a particular trigger. In fact most the time we cannot find the cause. It we do, it is usually your history that tells us that something specific is aggravating either eczema or urticaria (HIVES). So after the deal is done and we done all the diagnostics we can, we focus on managing the problem to make you comfortable.
Most patients with urticaria will have it, for a defined period of time. Can’t tell you how long that will be. So while we can’t make a specific diagnosis of many the cases, that doesn’t mean we don’t try. On occasions, we can identify triggers either in the environment or the diet, And we try to remove the them. We also focus on keeping the skin well lubricated because often drying out or heating the body aggravates this condition. In addition we try to use a combination of antihistamines to include type I like Benadryl and Hydroxyzine, a type I nonsedating antihistamines like Cetirizine, Claratin or Fexofenadine. We ask you to take him on a daily basis for some time, in order to make you comfortable. If that doesn’t work or maybe in the beginning, we will give type 2 antihistamines, usually used for stomach problems, to include Pepcid, Zantac and Prilosec..
For severe chronic urticaria, we have a drug called Xolair which given once a month can improve the clinical condition and reduce the symptoms of patients with severe disease.
Eczema is primarily a skin disease. Allergies can make it itch more and if it itches more, you scratch more. When you scratch more, you get more eczema. If we can identify triggers, we remove them from the environment or the diet, but often we cannot. In either case, we ask you to keep the skin well lubricated and use steroid creams judiciously. In addition, we suggest on antihistamines, type I or type II. Finally on occasions systemic steroids are required.
We cannot always make a specific diagnosis on what causes eczema or hives. But we can do some things to manage the problems more effectively. Give us a try.