Skin allergies occur when the immune system overreacts to a substance that contacts the skin or enters the body. This triggers inflammation, itching, redness, and sometimes blistering or swelling.  

• Often associated with asthma, hay fever, and food allergies 
• Common in skin creases: elbows, behind knees, neck, hands

Irritant Contact Dermatitis

• Caused by direct damage to the skin (chemicals, soaps, cleaning agents)  Allergic Contact Dermatitis
• Caused by immune reaction to allergens like: 
  • Nickel (jewelry, belt buckles) 
  • Fragrances and skincare products 
  • Hair dyes 
  • Poison ivy/oak/sumac 
• Rash appears hours to days after exposure 

• Raised, red, itchy welts 
• Can be triggered by foods, medications, infections, heat, cold, or pressure 
• Acute (<6 weeks) or chronic (>6 weeks) 

• Deeper swelling in the skin, lips, eyes, hands, feet 
• Often occurs with hives 
• Severe cases may involve throat swelling (emergency) 

• Rash triggered by medications such as antibiotics, NSAIDs, anticonvulsants 
• Ranging from mild to severe (e.g., Stevens-Johnson Syndrome)

Symptoms

• Itching 
• Redness or discoloration 
• Raised bumps or hives 
• Dry, scaly skin 
• Swelling 
• Blistering or oozing (in severe cases) 
• Burning or stinging sensation

• Detailed history of symptoms, triggers, timing, and exposures 

• Skin prick testing — for hives, eczema triggers, environmental allergens 
• Patch testing — gold standard for allergic contact dermatitis (48–96 hours) 
• Blood tests — IgE testing for suspected allergic triggers 

• Infections 
• Autoimmune skin diseases 
• Psoriasis 
• Rosacea

• Identify allergens or irritants 
• Switch to fragrance-free skincare 
• Avoid nickel jewelry or cover with protectant 
• Use gentle detergents, avoid fabric softeners 
• Wear protective gloves when handling chemicals  

Essential for eczema and chronic dermatitis

• Daily moisturizing with thick creams/ointments 
• Short lukewarm showers 
• Avoid hot water 
• Use hypoallergenic cleansers 
• Consider bleach baths (per provider guidance) 

3.   Medications

• Topical steroids (hydrocortisone to stronger Rx options) 
• Calcineurin inhibitors (Tacrolimus, Pimecrolimus) 
• PDE-4 inhibitor (Crisaborole / Eucrisa) 
• Barrier repair creams 

• Antihistamines (cetirizine, loratadine, fexofenadine) 
• Short courses of oral steroids for evere flares 
• Antibiotics if infection is present 

• Dupilumab (Dupixent) for moderate–severe atopic dermatitis 
• Omalizumab (Xolair) for chronic hives