Itching is not always due to an allergy. Dry skin, skin product ingredients, friction (like scratching!) can trigger itch. Some skin conditions are extremely itchy, and can make a patient have sleepless nights! Examples of itchy skin problems are atopic eczema, contact dermatitis (like poison ivy), chicken pox, “hives” (urticaria), and scabies. Usually the provider can identify the pattern of a rash to make a specific diagnosis of what kind of itchy rash a patient has.

Itching when there are no visible rashes or spots is a lot trickier to figure out. Medications or internal problems ( like thyroid, kidney or liver disease) can cause generalized itching.

Contact dermatitis

Contact dermatitis is a skin reaction caused by a substance or physical insult from the outside “in contact” with the skin surface. There are 2 main types of contact dermatitis:

Irritant Contact Dermatitis

Contact Dermatitis Irritation is direct outer skin damage, which can occur from excessive dryness, wetness, soap, friction, rubbing of the skin, bleach, alcohol, or solvents touching the skin surface. Any of these, or a combination, can trigger redness, stinging, and itching. The immune system is not a trigger for this type of skin reaction, and the diagnosis is based on exposure history and appearance of the skin. Examples of irritant contact dermatitis are “winter dry skin”, chapped lips, hand eczema from frequent handwashing, or chafing. Some types of diaper rash are due to irritation.

Allergic Contact Dermatitis

An otherwise harmless substance in contact with the skin can trigger an immune or “allergic” reaction, causing a red, usually VERY itchy dermatitis. It does not have to be anything “new” in contact with the skin, and can occur for the first time at any age. In a sense, your body’s immune system is doing its job to alert you that something is in contact with the skin! Even ingredients in baby products can cause reactions of this type, but only in very few individuals. Common examples of allergic contact dermatitis are poison ivy or oak dermatitis and nickel reactions causing a rash at sites of metal jewelry touching the skin. Allergic contact dermatitis can occur to gloves, skin product ingredients, fragrances and “botanicals”, chemicals used in the workplace, and even topical medications. If the provider suspects an allergic contact dermatitis, a type of allergy testing called “patch testing” may be ordered to help figure this out.

PLEASE NOTE
You should continue to take as prescribed the following medications:

• Antibiotics.
• All asthma medications.
• Prescription nasal sprays (like Flonase, Nasonex, Nasacort, Omnaris, etc.), with the exception of Astelin, Astepro and Patanase which are antihistamines (as noted above).
• Decongestants that are not combined with an antihistamine.
• Other medications such as those for blood pressure, diabetes, etc.

Immunotherapy does not work for everyone and is only partly effective in some people, but it offers allergy sufferers the chance to eventually reduce or stop symptomatic/rescue medication. The injections over time, cause your body to make blocking antibodies, stopping the allergic reaction from taking place.

Patients taking injections must wait 30 minutes to monitor for any adverse reaction. Most insurance companies cover injections, though co-pays may apply to each office visit. Visit our patient resources page to view the shot hours.

This test is ordered for patients who have symptoms or conditions such as:

• Asthma
• Shortness of breath
• Persistent cough
• Wheezing

The results of the test will assist our doctors and staff in making an accurate diagnosis and developing any appropriate treatment plans necessary.

What you should know:
Please do not take inhalers such as Albuterol (i.e. Proventil, Proair and Ventolin) or Xopenex for four hours before your test.

This test is ordered for patients who have normal pulmonary function tests, yet have symptoms or conditions such as:

• Persistent cough
• Wheezing
• Shortness of breath
• Asthma

The primary purpose of exercise challenge testing is to identify the severity of pulmonary impairment in the screening for asthma and exercise-induced asthma in patients.

The results of the test will assist our doctors and staff in making an accurate diagnosis and developing any appropriate treatment plans necessary.

Allergy & Asthma Center of Lake Norman’s physicians evaluate VCD in patients using fiberoptic nasolaryngoscopy. In this method a small lighted tube is passed through the nose and into the throat, and is a helpful tool that allows the physician to see and evaluate vocal cord movement and airway passaging.

The results of the evaluation will assist our doctors and staff in making an accurate diagnosis and developing any appropriate treatment plans necessary.

Initially, a skin prick test is performed, in which a tiny amount of venom is lightly pricked into the skin with a plastic applicator. If you are allergic, you will show positive reaction to either one or all tested venoms. The test is performed on the arm. If you have specific venom sensitivity, a red, raised itchy hive will appear on your skin within 15-20 minutes.
More sensitive than the skin prick test, an intradermal test may be used which involves injecting a very small amount of the allergen under the skin on the arm or back. An intradermal allergy test may be done when a substance does not cause a reaction in the skin prick test but is still suspected as an allergen for that person.

Venom immunotherapy is available to patients with positive test results, and involves a series of allergy shots to gradually desensitize you to insect sting reactions.

An oral food challenge helps to prove that a food is NOT the cause of symptoms and to verify whether a patient has outgrown food allergies.

Please contact us today for more information on our Food Challenge Testing.

Desensitization to aspirin may also help people with chronic sinus infections and nasal polyps that are allergic to aspirin. Again, many of these patients have non-allergic rhinitis and may not respond to typical allergy medications. Desensitization to aspirin may relieve much of their nasal symptoms and reduce the re-growth of polyps, resulting in the need for less sinus surgeries.

Aspirin desensitization begins with patients receiving very small doses of aspirin given over a matter of many hours, with some people experiencing an allergic reaction during this time. The allergic reaction is treated, and the patient often continues on the desensitization the next day with the same dose that caused the reaction on the previous day. This repeat dose is usually tolerated, and the process is repeated until the person can tolerate a full dose of aspirin.

Once a person is able to tolerate a daily amount of aspirin, the aspirin is typically given on a daily basis for a period of a week to months, and in some cases years, in order to treat the asthma and/or chronic sinus disease. The desensitisation is only maintained as long as aspirin is taken daily.

Symptoms occurring after the use of local anesthetics may be due to a variety of causes, including anxiety, hyperventilation, toxic effects of the drug itself, as well as reactions to epinephrine, which is frequently added to local anesthetics to make the numbing effect last longer. Many people experience contact dermatitis to local anesthetics, and it’s also possible for people to experience allergic reactions to preservatives added to local anesthetics.

The possibility of latex allergy should always be considered when a person has a reaction to local anesthetics, given the common use of latex gloves in the medical and dental industries. Some medications used in spinal anesthesia contain sulfites, another preservative that can cause allergic reactions.

Contact us today for more information on local anesthetic testing or to schedule an appointment.

Testing begins with a scratch test of a weakened dilution of the drug. Intradermal testing is used in the next level of testing. Testing may also include a graduated oral challenge to the medication.

Desensitization immunotherapy is available to patients with positive test results and gradually helps desensitize allergic reactions.