Symptoms to watch for

Food allergy symptoms can vary widely but typically include:

• Mild to moderate reactions: Hives, minor swelling, and itching or tingling around the mouth, digestive issues, such as stomach pain and vomiting. Small children may become floppy and/or pale.
• Severe reactions: Anaphylaxis may involve difficulty breathing, cough, hoarseness, tightness in the throat, tongue swelling, dizziness, a sudden drop in blood pressure and collapse.

How should parents approach exposure to allergenic foods?

Introducing allergenic foods early, around six months of age BUT not before four months, may prevent the development of food allergies. It’s important to introduce allergenic foods like peanut butter or cooked egg gradually and continue to include them regularly if no adverse reactions occur.

In the past, some people thought it might be better to hold off on allergenic foods even longer- till after 12 months of age- but this is not a recommended approach, as it may actually increase the risk of developing allergies. Parents are advised NOT to avoid exposing their kids to potentially allergenic foods between 6 and 12 months of age, unless there is already known evidence of an allergy.

Seborrhoeic Eczema

• Usually affects the scalp, eyebrows and other parts of the face
• Can be associated with other skin conditions like and psoriasis

Pompholyx

• Affects the hands or feet
• Bumpy itchy skin, usually on the sides of the fingers or toes
• Usually worse when sweating
• Sometimes follows direct contact with nickel
• Can be triggered by stress
• Often no cause found

Photodermatitis

• Occurs as a reaction to the UV light in sunshine
• Characteristically appears only on the area of skin exposed to the sun

Perioral Dermatitis

• Mostly affects women
• White spots and redness around the mouth
• Treatment is with antibiotics (usually applied to the skin directly)

Discoid Eczema

• Also known as Annular or Nummular Eczema
• Scattered patches (often round)
• Cause is unknown

Venous Eczema

• Also known as stasis, gravitational or leg eczema
• Develops in people with swollen legs
• The skin gets darker and itchier as the legs swell

How common is Eczema?

• In Australia approximately 1 in 5 children have Eczema
• Approximately 3% of adults have Eczema

What can I do to make my Eczema better?

Changes to how you wash

• Use a soft towel and pat yourself dry (rather than rubbing)
• Avoid using soaps – try using oily moisturiser instead
• Don’t use bubble bath
• Add unfragranced oils to your bath

Changes to your clothes

• Use sensitive-skin detergents in your washing machine
• Allow only cotton to be in direct contact with your skin wherever possible

Changes to how you moisturise

• Use moisturiser as often as possible, particularly after washing
• Use moisturisers that are unfragranced
• Switch between moisturisers until you find one that works well for you
  • Usually oily moisturisers are more effective but they may not be absorbed as easily
  • You don’t need to buy expensive moisturiser – cheap moisturisers are just as good

Other measures

• Stay well-hydrated
• Install an air humidifier where you live/work/sleep

Commonly used medications

• Antihistamines
  • For itching
• Topical steroid creams & ointments- these should be used at the lowest effective strength as they can cause significant side-effects. They should only be used in addition to the measures described earlier.
• Antibiotics- if skin infection is thought to be playing a part in the Eczema
• “Occlusion dressing”- the practice of applying moisturiser thickly under cotton bandages & gloves to treat eczema in children

• Less-commonly used medications, usually under the guidance of a specialist include:
  • Ultraviolet light therapy
  • Coal tar ointment
  • Immunosuppressant medications

Article Resources

www.allergy.org.au

www.rch.org

How is Scabies diagnosed?

Usually a doctor will be able to recognise the symptoms of scabies and the typical appearance of the rash. If there is doubt, sometimes skin scrapings may be taken, to look at under a microscope.

What is the treatment for Scabies?

• The usual treatment for scabies involves a variety of ointments, creams, and lotions that can be purchased over the counter from a pharmacy.
• The whole body from the neck down needs to be treated- treatment should be applied overnight and can be washed off the following day. Usually it is advised to treat a second time, a week later.
• Antihistamines may be prescribed to treat itch.
• Antibiotic cream or tablets may be prescribed if the doctor thinks the lesions are infected with bacteria.
• Corticosteroid cream may also ease the itch.
• Hot showers or baths should be avoided until the rash is gone, as hot water can make the itch worse.

More aggressive treatment may be needed for severe or widespread scabies. An oral tablet can be prescribed by a doctor to people who:

• don’t see an improvement in symptoms after initial treatment
• have crusted scabies
• have scabies that covers most of the body

How quickly does treatment work?

• For the first week after treatment, it may seem like there’s not much improvement- the rash may even seem a little more irritated.
• After the first week, the symptoms of Scabies should start to settle down, though it is important to note that “post scabies itch” can last up to 4 weeks, even when the scabies mite has been cleared.
• Within about 4 weeks the skin should look and feel normal again- if the rash or itch is still there, further treatment may be required- the skin may still be infested with the Scabies mite.
• If there is bacterial infection of the lesions, topical or oral antibiotics may also be needed to get the rash to clear up. Crusty, inflamed or weeping skin may indicate secondary infection with bacteria such as Staphylococcus.

What else should be done to get rid of Scabies?

Unfortunately, it’s not just a matter of treating the infected person. Close contacts need to be treated too, and efforts need to be made to remove the mite from living spaces, to avoid reinfection (as scabies can last for 3-4 days on surfaces, clothing and bedding):

• Wash clothes, bedclothes and towels in a 50C hot wash, and then place in the dryer on the highest heat setting, ideally for 30 minutes.
• An alternative is to put clothes and other items in bags in the freezer for a few days.
• Thoroughly vacuum-clean carpets, floors, rugs and curtains etc- then discard the vacuum bag if there is one, and/or where possible disinfect the vacuum container and other attachments of the vacuum cleaner.
• Clean surfaces and floors with hot water and bleach

If you have symptoms of Scabies or any other undiagnosed rash, speak to your doctor or pharmacist.

Further Patient Resources:

Scabies. betterhealth.vic.gov.au

Scabies. mshc.org.au

https://www.rch.org.au/kidsinfo/fact_sheets/Scabies_symptoms_and_treatment/

https://dermnetnz.org/topics/scabies/

What are the complications of Chicken Pox?

• Scarring can occur if lesions are very inflamed or are scratched a lot
• The blisters can become infected with bacteria- leading to weeping sores, crusts and/or cellulitis
• Viral pneumonia
• Viral encephalitis (infection of the brain)
• Bleeding disorders can rarely occur
• In rare cases, death can occur

Who should get the Chicken Pox Vaccine?

• The Chicken Pox vaccine is recommended for children as part of routine childhood vaccination
• If a child has missed the vaccine they can get it later, though after the age of 14 two shots (at least a month apart) are required to get an adequate immune response
• If you are not immune to Chicken Pox and someone in your household or close contacts is immunocompromised (a significantly suppressed immune system due to certain illnesses or treatments- see below)
• However, the Chicken Pox vaccine is not safe for everyone – see below

Who should not get the Chicken Pox Vaccine?

As the Chicken Pox Vaccine is “live”, it should not be given to certain people as it may cause harm/ severe infection

• Pregnant women and women who intend to become pregnant within the next month
• People who are immunocompromised (a weakened immune system)- for example, due to chemotherapy, immunosuppressant medication for organ transplant, some cancers, long term steroid treatment, radiation treatment, HIV infection etc. This should be discussed with your doctor, as the advice may vary depend on individual factors.
• Anaphylaxis (severe allergy) to any ingredients in the vaccine
• If unsure, seek medical advice

What is the treatment for urticaria?

• If you know the trigger, avoid it.
• Antihistamines may ease the rash and the itch- these are available over the counter from your pharmacist.
• Avoid anything that makes the rash more prominent – like stress, alcohol, getting too hot or hot spicy food.
• It seems anti-inflammatories can make urticaria worse in some people- so these should be avoided. Paracetamol (Panadol) is still OK.
• Sometimes oral steroid medication (cortisone) is prescribed- but it’s often not very helpful, and there are many possible side effects of this treatment.
• People who have chronic urticaria may need to see an allergy specialist or dermatologist for further advice- sometimes they may try medications which act on the immune system.

Are there any tests for urticaria?

• Tests are not usually needed- as they usually don’t offer any helpful information.
• However, if urticaria goes on for more than 6 weeks, or if a person has other unexplained symptoms apart from the rash (eg fevers, pain or feeling generally unwell), blood tests may be advised.
• If there are symptoms suggestive of Anaphylaxis, further allergy testing will usually be recommended.