Understanding why your skin may riot

My colleague, Keturah, woke up recently with a rash all over her body. She had usedan antibiotic called Augmentin and in barely days, the hives had spread to her face.

“They were very itchy. I quickly saw a skin specialist who prescribed Loratidine, an anti-histamine, and Eurax, a cream to apply on the hives. Thankfully, the intervention worked and I’m back to work with a hive-free face, although I still have red blotches on my arms and breasts,” she confesses.

Dr. Grace Nambatya, the director of the Natural Chemotherapeutics Research Laboratory at the Ministry of Health, also talks about how she battled skin allergy when she was still a student at Makerere University. “It was in 1983, while in my second year. It looked so bad and kept me worried.

There was very little information regarding the condition. The few existing dermatologists were not accessible to ordinary folks like me,” she narrates in her book Management of Eczema through Natural Products.

“I spent all my fi rst salary arrears to secure treatment,” she adds. At one point after taking medicine from a local herbal centre, Nambatya developed a running stomach. But the rashes did not even go away.

Upon completion of her degree in chemistry, she decided to pursue a course that would help her fi nd treatment to her skin allergies as well as help other people in the same predicament.

Like Nambatya and Keturah, sometimes you have no idea what to do when your skin breaks out. You do not even know if it is a reaction from the lotions you are using or the food you ate.

Skin allergies can manifest in many forms, but the common symptoms include itching, red skin, blisters, skin hardening, puffi ness, dry patches and bleeding from scratching. Carol Natukunda explores different allergy manifestations, their causes and diagnosis.

Eczema
Eczema is a Greek word that means “to boil over.” It is an itchy infl ammation of the skin and causes redness of the affected areas, lumps or blisters. “It can affect any part of the body, at any age, though it is more common in children,” says Nambatya.

She explains that it is also common in people who have asthma. It occurs when the skin of an asthmatic’s person comes in contact with a substance he or she is sensitive to.

Dr. Eric Mutahi, a private skin specialist and dermatologist in Kampala, also concurs that eczema is a common disorder which produces red, itchy, “weeping” rashes on the elbows and in the back of the knees as well as the cheeks, neck, wrists and ankles.

Eczema can be managed by avoidance of contact with irritants and use of anti-infl ammatory treatments as prescribed by a doctor.

Contact dermatitis
This is often a result of exposure to an irritant, for instance; chemicals, powders and cleaning agents.

“In which case the removal or protection from this irritant would be an important part of managing that person’s condition compared to someone else with no such history of exposure,” says Nambatya.

Mutahi explains that this rash is also occasionally oozy and affects the parts of the skin which have come in direct contact with the offending substance. Other common examples are reactions to jewelry containing nickel or even lotions and deodorants.

Discoid hives
This non-contagious problem can be triggered by insect bites. It is also linked to a dry and rough skin. Discoid manifests itself in the form of a rash and mainly affects the lower part of the legs, hands and forearms. The rash can be extremely
itchy and uncomfortable and may also cause scaling of the skin.

Mutahi warns that individuals with discoid hives have the capacity to develop additional secondary skin infections or other forms of dermatitis (skin infl ammation). “You get irritated and end up scratching yourself instantly. This exposes the skin to bacterial infections, and the skin condition worsens,” explains Mutahi.

Seborrhoea
Nambatya says this is common in infants and appears in the nappy area and scalp. In adults, it also appears on the scalp and in the nose or sides of the mouth. This is caused by yeast infection.

Other skin allergies
This is caused by the varicose veins. Such veins are swollen, twisted veins which mainly form in the legs or other parts of the body. Mutahi says such veins cause not just blood clots, but also skin ulcers (sores).

“They are painful and itchy,” he observes. Nambatya agrees: “This condition is intensely itchy and can also be found on the hands. Sometimes the blisters are small and sometimes they are large.”

Food allergy
Ever eaten, say, meat, ghee, or milk and your skin all went itchy with rashes all over? You may wonder why the skin would react to something that was just in the stomach. According to experts, food with proteins is the most common allergic component.

“Sometimes, the body’s immune system mistakenly identifi es a protein as harmful. Some proteins or fragments of proteins are resistant to digestion and those that are not broken down in the digestive process are rejected and it manifests in the skin through rashes.

The immune system would, therefore, be kind of alerting you that the protein is harmful,” explains Mutahi.

Diagnosis
Doctors advise that proper evaluation of a rash requires a visit to a doctor or dermatologist so they can know whether it is a fungal or bacterial infection. “For instance, fungus and yeast infections have little to do with hygiene — you might have a clean baby who gets the rash.

You might not be exposed to anything, but you still get the rash,” Mutahi says. “For bacterial infections, antibacterial creams may not be effective. Oral antibiotics may actually be needed.”

Mutahi says the doctor will probably require details of one’s family history to fi nd out if any other relatives have the same problem.

“We may also review your diet to make sure that there are no food allergies involved, or even a drug intake which may affect your skin. We have had cases where we also perform a blood test to fi nd out the underlying causes.”

According to Dr. Nambatya, common medications on the market such as hydrocortisone and betnorvate (betamethasone) creams compromise synthetic steroids that may cause more harm than good.

“We need education on recognition of skin diseases and skin care products, conditioning moisturises, soothers, foods and cleansers to ensure appropriate utilisation.”

Preventive measures
There is evidence that breastfeeding for at least six months, compared with feeding infants formula made with intact cow milk protein, prevents occurrence of skin allergies.

Try to fi nd alternate food sources of essential vitamins and minerals which are less allergenic.

Keep your nails short since there is always a temptation to scratch the skin

Use clothing made up of cotton as it is less sensitive to the skin

Ensure you are knowledgeable on what materials to use, such as jewellery, cosmetics

Ask for expert advice before you embark on any medicine and know
how long you should use it.

Pay attention to children’s hygiene and keep the nappies clean. Avoid unnecessary beating as some children’s skin reacts easily.

Avoid refi ned foods like cookies, cakes and soft drinks. They bring about wrinkles and premature aging l Drink a lot of water to keep your skin hydrated and smooth

Natural cleansing: don’t clog your skin with all sorts ointments and powder all the time. Wash it thoroughly and let it breathe.

Exercise and eat vegetables and fruits for a healthy skin. Spicy foods aggravate allergy