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Friday, August 19, 2022

Skin Allergies in Children – What parents need to know

When a child develops recurrent episodes of itchy rashes involving either the face, body or limbs, one should consider the possibility of a skin allergy.

Skin Allergies In Children

Skin allergies can affect children in all age groups right from infancy to adolescence. In this article we will discuss the basic facts about skin allergies in children.

Q1: When to suspect skin allergy in a child? 

When a child develops recurrent episodes of itchy rashes involving either the face, body or limbs, one should consider the possibility of a skin allergy. However, if the same child also has other symptoms of allergy such as early morning sneezing, wheezing, food allergy, etc., or any of the family members (parents / grandparents) also suffer from allergic symptoms, then an allergy should be strongly suspected  in the child. 

Q2: What are the common presentations of skin allergy in children?

The common presentation include: 

1.Urticaria – Characterised by multiple wheals / hives affecting all parts of the body and often associated with intense itching.

 2.Insect bite allergy – Here, itchy red lesions usually occur only in the exposed areas of upper and lower limbs, which often leaves a black pigmentation on healing.

3.Eczema – In infants, eczema presents as dry itchy red lesions on the cheek, scalp, body and extremities, whereas in older children it usually involves the skin behind the joints such as knees and elbows.

4.Angioedema – Characterised by swelling of eyelids or lips or hands / feet, often associated with severe pain.

5.Contact dermatitis – Occurs due to contact of the skin with various cosmetics, nickel, dyes, detergents, etc.

Q3. What are the causes of skin allergy in a child?

Food allergy can present as allergic skin rashes in young children. The common food causing allergy symptoms include milk, egg, nuts, prawn, crab, shrimp, etc. Sometimes house dust-mite allergy can also cause allergy skin rashes in children. In rare cases, an autoimmune phenomenon has also been observed  in children with skin allergy, particularly with urticaria and angioedema.

Q4. Diagnosis of skin allergy

Diagnosis is clinical and usually done by the appropriate history and clinical examination. However, the identification of allergen responsible for the allergy is very important and  is usually  done by Allergy Skin Testing  and sometimes by Allergy Blood Test. Allergy skin testing is the gold standard in allergy diagnosis and is a simple and safe test done routinely in the allergic clinics by an allergist on an outpatient basis.

Q5. How to treat skin allergy?

The treatment in skin allergy is a two-step approach:  

  1. Pharmacotherapy – Involves symptomatic treatment with anti-allergic medications. It works well but symptoms recur promptly on stopping the drugs 
  2. Allergen avoidance – In skin  allergy, avoidance of allergen will only help in the long-term control of allergic symptoms. However, it is only possible with allergen identification by an Allergy Skin Test.

Conclusion: In children with skin allergies, a 3A  approach is the need of the hour: 

  • Allergist consultation
  •  Allergen identification by allergy skin testing 
  • Allergen avoidance
Dr. N. Suresh DNB (Ped), MRCPCH(UK), MNAMS, PGDAP., Senior Consultant –  General Pediatrics, Paediatric, Pulmonology & Allergy Specialist, Rainbow Children’s Hospital, Guindy, Chennai

Dr. N. Suresh DNB (Ped), MRCPCH(UK), MNAMS, PGDAP.

Senior Consultant –  General Pediatrics, Pediatric Pulmonology& Allergy Specialist 

Rainbow Children’s Hospital, Guindy, Chennai.

24×7 Pediatric Emergency Contact Number – 044-4860 0000

First published on: 27-06-2022 at 12:18:23 pm
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