Dermatite Atopica e… anche allergica

Atopic Dermatitis and… also allergic

It often happens that those who have atopic dermatitis also develop contact allergies. Here are the basics for understanding allergic contact dermatitis. “Get away from me!” This is the reactive message that atopic skin, or skin predisposed to developing atopic dermatitis, sends out when it comes into contact with some irritants of various nature: from food, to chemical, environmental, to perfumes and metals.

Skin-deep toxicity
The skin makes him understand very well his annoyance towards something that he cannot tolerate and becomes covered with evident manifestations in the area of ​​the unfortunate contact which can vary from ulcerations and fissures, similar to fissures, up to swelling or the appearance of blisters which can break down, leaving the skin covered in scales and crusts. Furthermore, it is possible that blisters or the classic red, itchy and dry skin may appear. Whatever the skin manifestations, this is a sign of "skin-level toxicity".

Not all contacts are the same, not even for the skin... There are two forms of contact dermatitis:
• One is allergic in nature and is an inflammatory process that arises following contact with one or more allergens, mostly chemical such as metals, dyes, resins, but also natural or environmental such as oils and essences of plants and of the flowers, which in the long term, therefore in a delayed manner compared to the first contact, sensitize the skin. In fact, it can happen that for years the skin comes into close contact with a particular substance without showing any effects, and only at a certain moment develop an allergic reaction instead.
• The other is irritant contact dermatitis; also in this case it is an inflammatory skin reaction caused by repeated exposure to external chemical agents, such as solvents, physical or biological, without however involving the immune system

The peculiarity of allergic contact dermatitis is that, unlike what happens in the irritative form in which the lesion remains limited, the lesions can migrate from the initial site of contact to other areas of the body.

Do not waste time
With dermatitis, not only atopic but also contact dermatitis, wasting time can compromise control of the problem. In fact, the longer the skin remains exposed to an irritating agent, the more its condition can worsen so much so that it becomes sensitive and irritable, especially that of children, even to neutral substances such as simple water or substances for common personal use such as shampoo.
How long does it take for allergies to manifest?
Not much, even if the entire process of allergic manifestation occurs in two phases:
• At first, what is called the "sensitization phase" takes place: it takes approximately 7-15 days, i.e. the time that elapses from the first contact of the skin with the allergic substance until the mediation of the immune system, which reacts with the first demonstrations
• A second phase is when the skin comes into contact with the offending agent again and highlights its allergic lesions within 12-24 hours
A lot of allergens It is really impossible to list the array of allergens because science has identified over 3 thousand substances to which the skin can be allergic. Therefore the solution is to try to identify them "as a package", that is, grouping them by type. Is it possible to guess which substance one might be reactive to? Yes, sometimes the site where the skin manifestations are detected could help distinguish the type of substance causing the allergy.
Drugs . Among these, antibiotics cause the greatest allergy problems, especially if they are administered in the form of an ointment, therefore topically.
Clothing of all kinds, from clothing to shoes . Leather, glue, rubber, dyes or other substances used for their treatment can cause an allergic reaction. As a rule, if you are allergic to any item of clothing, the lesions mostly appear on the hands and feet.
Professional substances . Among the many we mention concrete, paints, disinfectants and soaps for hospital use, flours, acetone, dyes and resins, latex. Also in this case the most affected sites are the hands and feet.
Cosmetics. Perfumes, make-up, creams, nail polishes, dyes and other hair products can cause problems for allergic skin. The face, neck and scalp are the areas most at risk.
Metals . It is a very particular category because metals can be found in objects that you touch but also in some foods. Among the most common are:
• Nickel: it is contained in objects such as glasses, jewellery, watches, coins, but also in cosmetics, soaps, toothpastes and in some foods such as tomatoes, chocolate, nuts and soya. This is why this allergy often has a labial localization
• Chromium: the main source is cement, but this metal can also be contained in detergents, soaps, fabrics, etc.
• Cobalt: is present in cement and various metal alloys, inks, dyes, lubricating oils
Environmental and physical substances . Ultraviolet (UV) light, some ornamental plants, and sweat can also be irritating to the skin. Am I at risk of contact dermatitis?
This is the question that anyone with intolerant, sensitive, atopic skin or even just a predisposition to atopic dermatitis asks themselves. In fact, in these cases the possibility that allergic contact dermatitis may also occur is greater.
But predisposition or a history of dermatitis are not the only risk factors. There are some that cannot be changed, such as age, in fact it mainly affects those between 40 and 45, but also sex. Being a woman slightly increases the risk of developing allergic contact dermatitis over a lifetime.
Added to these are controllable factors. Among these, it is essential to avoid repeated contact with allergens, when identified, and where professional allergens are involved, it is advisable to resort to protective means such as the use of gloves, clothing and barrier creams.

Are you the officer bothering me?
There are many allergens, so how do you understand which one really causes skin discomfort? It is first necessary to undergo a dermatological examination and, if there is a suspicion of allergic dermatitis, to carry out specific skin tests. The most used are the patch test and the Rast test, as well as the measurement of total IgE. Generally, patch testing exposes small surfaces of the skin to the suspected substances. After a certain period of time, the skin is observed: if redness or small blisters are noticed, accompanied by itching, the test will be positive and will have found the offending allergic substance responsible for the onset of the lesions.

And what do I do now?
The answer would seem obvious: “I take the right measures”. Yet it is not that simple, because it is not always possible to 100% avoid contact with the substance to which you are sensitive. Then other problems can also arise, such as cross allergies: that is, an allergy to a specific substance could trigger similar reactions towards allergens that are not identical but which the body perceives as similar. This is the case of cross allergy to nickel, whereby the reaction can develop in contact with a metal but also by eating a tomato.

Can it be prevented?
Yes, sometimes you can. Above all, paying attention to personal hygiene standards. To contain the symptoms and accelerate the healing of lesions or prevent the onset of allergic contact dermatitis, in addition to avoiding contact with the allergen, it is best to avoid bathing and washing using aggressive detergents because they could impoverish or deprive the skin of its protective barrier . Out of the water it is advisable to dry the skin thoroughly to remove all traces of moisture by dabbing it and never rubbing it. Furthermore, it is necessary to regularly and carefully hydrate the skin with delicate creams specific for sensitive, intolerant or even atopic skin.
Don't get confused!
In order not to be mistaken about the two different forms of dermatitis, allergic and irritative, clarity is needed. Therefore, in conclusion, it is good to remember that:

• The main symptom of allergic contact dermatitis is itching, while in irritative contact dermatitis it is burning
• Allergic contact dermatitis can also extend to other areas of the body beyond the site of origin, unlike irritant dermatitis which instead remains limited to the place of origin
• The substance that most frequently causes allergic contact dermatitis is nickel. The advice is to always use nickel tested cosmetic products in contact with the skin so as not to have problems
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