Are we just scratching the surface?

By Debbie Watson

ALLERGIES and intolerances can quickly become the bane of your life, but sometimes the hardest part is identifying the causes. In a second

feature on the subject DEBBIE WATSON discovers how skin patch-testing helps.

WHAT started out as a mild irritation has now developed into a red-raw rash across the entire length of your arms – and you've still no idea why.

Like millions of others, you could well be suffering from some degree of skin allergy.

Flesh irritants are all around us in our daily lives.

From the soap you use to bathe in, the liquid you use to wash your dishes, the pollen in the atmosphere, or even the watch you religiously place on your wrist – all hold a potential risk of upsetting your skin.

The implications can vary hugely – from an annoying irritation to a large area of water blisters across the skin – but where they exist the chances are that the sufferer has some degree of contact dermatitis.

Essentially, the words eczema and dermatitis are one and the same, but the latter is brought on by contact with an element in the external world, while eczema is an internal skin sensitivity.

Though a skin complaint might sound on paper like a relatively mild medical complaint, for those who have it, it can take a huge toll on day-to-day life.

Maureen Brown is a nurse practitioner in the dermatology department of Ipswich Hospital, and she is all too aware of the implications of a skin allergy.

She said: "In some cases people will literally have no choice but to change their job because of an

allergy.

"A hairdresser who discovers allergy to nickel (in the metal scissors) and the chemicals in hair dye is really going to have little option if a comfortable working life is sought.

"The thing about allergy is that you can't cure it. There are no means of desensitising people to the allergen so they individual simply has to avoid it wherever possible."

But before the avoidance can begin, the identifying must take place.

To seek out which substances are causing a person problems Maureen and her team can conduct a patch test over a course of five days which tests the reaction to 35 items.

This is a tried-and-tested approach which gives the clearest indication as to their problem. It can also be made specific to a working environment.

"If we knew that someone was working in manufacturing with certain products there are specific

batteries which can be tested to try and identify the problem substance," Maureen said.

"This can make a huge difference to people's lives. We have one particular success story in which we were able to test 30 people working in a specific business who all showed a reaction to something.

"From our testing we were able to trace that one substance was responsible and the employer was then able to remove the offending chemical from the workplace. That's the power of testing."

Specialists in dermatology claim they are now seeing more and more referrals from GPs for people wanting skin-testing.

While they accept that there are some cases in which people are genuinely in need of this process, they also insist that there is a great number of others for whom no allergy-testing is going to help.

Dermatology specialist Sam Gibbs said: "In particular, we're seeing a great increase in urticaria (hives) and childhood eczema. In these cases people are of the opinion that they need testing to trace the source, where in fact, it's an inflammatory disease and is nothing to do with an allergen at all."

Dr Gibbs admits that allergies can be a very complicated topic to master and also says that there is a modern tendency towards people wanting to think they do have an allergy.

He said: "Allergy is a whole universe. It's not simply one disease and it's a complex and misunderstood area of medicine.

"I believe that there are lots of potentially troublesome substances about nowadays and that the way we live our lives makes allergy more likely.

"Added to that, we do know that there are people with very real and serious allergies that are potentially life-threatening and which must not, under any circumstance, be ignored.

"But I also cynically think there's a trend in people wanting to believe they have an allergy when very often they don't. They would rather think it's something concrete causing the problem – not their life having been very stressful lately."

It might be an infuriating problem for those who suffer it, but Dr Gibbs insists that an allergy like contact dermatitis is actually still very rare among the general population.

Indeed, we might well like to blame something specific for our rashes, itches, blotches and general fatigue. But perhaps we're just going to have to accept that not everything happens for a reason……or at least an allergy-based one.

Weblink

www.eczema.org

www.skincarecampaign.org

ECZEMA (atopic dermatitis): Tends to run in families along with hay fever and asthma. People are born with a tendency to get this type of eczema.

CONTACT DERMATITIS: Caused by something in the outside world which comes into contact with the skin. It may come in to direct contact with the skin or be in the air.