Allergic reactions can occur in various or-gans of the body, including the skin, eyes, respiratory tract, and windpipe. By and large, they manifest themselves early as eczema, later as allergic rhinitis, asthma, and allergic conjunctivitis, and in adults as hives (urticaria).
Fortunate allergy patients suffer from one or two of these allergies. Unlucky ones may experience all of them. In any case, to bring an allergy under control you have to understand it. And the better you understand it, the greater your chances of beating it.
The symptoms of allergies, and what allergy sufferers need to pay attention to, are described below.
Eczema
Eczema (atopic dermatitis) appears in the youngest allergy sufferers. It can be found in babies as young as one or two months.
Typical eczema symptoms are itchy, dry skin, scaly patches, and red, inflamed blisters. In infants, eczema tends to appear on the face, the back of the arms and the front of the legs. Later in childhood it spreads, and moves to the front of the arms and the back of the legs. In adulthood eczema tends to return to the back of the arms and front of the legs, and also to affect the hands, the back, and the eyes.
What's the difference between eczema and an ordinary skin rash?
Dr. Tai Yang-hsia, a dermatologist at National Taiwan University Hospital, explains that there are four conditions for eczema: (1) itchy skin; (2) typical signs of dermatitis such as lichenification (hardening and peeling skin); (3) chronic recurrence; (4) a family history of allergy.
Eczema is diagnosed when three of these four conditions appear together. Babies often get diaper rashes and other rashes that are not necessarily allergies and should not overly concern mothers. Moreover, studies have shown that eczema in infants is usually an allergic reaction to cow's milk and protein-rich food, and mothers are advised to breastfeed.
Generally, if eczema is controlled, it tends to disappear before age two. But it can become a lifelong affliction if the patient is unable to stop scratching, allowing other allergens, such as yellow staphylococci, molds, and dust mites to enter the body.
People with eczema have skin that is poor at retaining moisture and insufficiently oily. The dryer it becomes the itchier it becomes, so dermatologists recommend that after showering, the affected skin be gently rubbed with Vaseline or other hypoallergenic emollients.
Oral antihistamines and topical anti-inflammatory steroid creams are common treatments for eczema. Although in recent years non-steroid external medications have been developed, their effectiveness when used on patients with moderate and severe cases of eczema is limited.
Allergic rhinitis
Allergic rhinitis affects children soon after the age of three or four.
Taiwan has a hot and damp island climate and is very polluted. Some 30-40% of Taiwanese suffer from allergic rhinitis.
As soon as a patient inhales an allergen, such as cold early morning air, carpet dust, or fibers from a stuffed toy, an itchy, runny, or stuffy nose, or sneezing can be the result. The symptoms of allergic rhinitis are often very similar to those of a common cold, making it difficult to tell the two ailments apart. Generally speaking, a cold is rarely accompanied by eye irritation, an itchy nose or palate, and other allergy symptoms. Colds usually start with a sore throat and run their course. The symptoms of allergic rhinitis, on the other hand, improve as soon as the allergens are no longer present, or if treated with the appropriate allergy medicine.
Asthma
Studies show that in 1974, 1.3% of Taipei schoolchildren had asthma. Within 20 years, the figure had risen to 10.79%, and in the past two years studies have shown it to have reached 19.8%.
Some 80 to 90% of asthma sufferers also have allergic rhinitis. Typical asthma symptoms include chronic cough, wheezing, loud and difficult breathing, and chest tightness.
It is a common misconception that you have asthma only if you're constantly huffing and puffing and have difficulty breathing. In fact, there are three major signs of asthma: (1) nocturnal coughing and frequently waking up coughing in the middle of the night or the early morning; (2) a cough that persists a long time after a cold; (3) gasping for breath and coughing during physical exercise. These symptoms must never be ignored in a child.
Studies have also shown that if an asthma sufferer has a cold and comes into contact once again with an allergen, he or she is more likely to have an attack. Sixty percent of asthma cases in adults and 85% in children are triggered by colds and other upper respiratory infections. Asthma sufferers have to be especially on guard against the common cold.
Long-acting bronchodilators are the cutting edge in asthma treatment. Patients use a peak flow meter to monitor their condition. When it is unstable, they can take medication as a preventive measure, and so greatly reduce the frequency of asthma attacks.
In the event of an asthma attack, sufferers should take a single puff from a bronchodilator inhalant. If that is not effective, the sufferer should take another puff in half an hour, and if that does not work they should immediately be rushed to an emergency ward. If the respiratory tract has contracted to the point where the bronchodilator cannot get through, the patient will need an immediate injection before it is too late. Repeated use of a bronchodilator, however, can lead to cardiac arrhythmia.
Allergic conjunctivitis
Because the nose and the eyes are connected by the tear ducts, most people who suffer from allergic rhinitis are also susceptible to allergic conjunctivitis. And because one often follows the other, the condition is also known as allergic rhinoconjunctivitis.
In spring and summer, when the flowers bloom and the weather gets warmer, people with allergic conjunctivitis get red, itchy eyes, tears, a burning sensation, and a discharge.
During an allergic conjunctivitis attack, you should avoid rubbing your eyes and taking hot showers. Eyedrops containing steroids can provide rapid relief for conjunctivitis, but as soon as the symptoms disappear, you have to stop using them, because long-term use can lower the eyes' resistance to the condition, and may even cause a rise in intraocular pressure, glaucoma, and atrophy of the optic nerve. Caution is imperative.
Hives
Hives (urticaria) mainly affects adults. Hives is common in people with a history of allergies, but independent immune reactions can also trigger it. Its causes are complex, and may include food allergens, allergic reactions to drugs, psychogenic factors such as stress, changes in weather, and even drafts.
Dr. Tai states that even if you don't have an allergic constitution, you have a 20% chance of getting hives at least once in your life.
Given its complex pathogenesis, identifying the allergen that causes hives in a particular instance is not easy. Some 60% of sufferers never discover the cause of their allergy.
Hives can be acute or chronic. In addition to skin rash, severe cases of acute urticaria can cause swelling of eyelids, lips, ears, and the face. In occasional cases, it can cause tightening of the airways and breathing difficulty.
Acute urticaria can be treated in one to two weeks with a combination of oral medication and ointments. But chronic urticaria can take one to two years to run its course.
Powerful remedies
Allergens enter the body through breathing, eating and drinking, or through skin contact. Commonly inhaled allergens include house dust mites, dust, pollen, and animal dander. Ingested allergens include food (eggs, seafood, cow's milk), medicines (antibiotics, aspirin), and alcohol. Common skin-contact allergens are cosmetics, detergents, jewelry containing copper, insects, and so forth.
In order to avoid allergens and allergy attacks in daily life, allergists recommend:
1. Using air-conditioners and dehumidifiers to maintain an appropriate temperature and humidity.
2. Maintain a clean environment, reduce dust and dust mites, and wash bedding often.
3. As far as possible, use wooden or plastic furniture. Avoid thick carpets, curtains, mattresses, and stuffed toys.
4. Don't keep pets.
5. Improve the flow of air in your home.
6. Avoid irritants such as cigarettes, mosquito coils, perfume, and insecticide.
The most important thing is to understand the causes of your allergy and your symptoms, and not to let them get the better of you. Allergies are physiological responses. Avoiding allergens is important, but remaining calm when confronting your allergy is even more so.
