Sensitive Skin

Diagnosis & Treatment

It is important to visit your GP for diagnosis and treatment. The following information in this section is a guide and not intended to replace medical advice.
If you or your children have red, bumpy, scaly, itchy or swollen skin, you may have a skin allergy.  The most common skin allergies are Hives (Urticaria), Angioedema, Eczema (Atopic Dermatitis), Contact Dermatitis.

1. Hives are red, itchy, raised areas of the skin that can range in size and appear anywhere on your body.

2. Angioedema is a swelling of the deeper layers of the skin that often occurs with hives.

3. Eczema is a scaly, itchy rash that often affects the face, elbows and knees.

4. When certain substances come into contact with your skin, they may cause a rash called Contact Dermatitis.

Hives in More Detail

A trigger can be identified in some cases such as:
Infection
Allergies
Environmental temperature changes
Emotional stress
Food
Medication

It usually appears as a series of raised, red bumps that come up within minutes and can resemble mosquito bites or nettle rash. It can be limited to a small area or span large expanses of the body. Sometimes there is swelling of the face and eyes.

The rash can last from minutes to hours but often disappears without a trace within 24 hours.

Hives are usually very itchy which can be a source of much frustration. In chronic cases, the symptoms are often worse in the evenings which can affect quality of sleep. If symptoms are severe it may also affect a child’s ability to carry out simple activities in daily life. Some children and adults may also find the physical appearance distressing.

Most cases of hives get better without treatment and the symptoms can be effectively treated with antihistamines. For long-term hives the treatments aim to relieve symptoms rather than act as a cure. Identifying potential triggers is an important first step though usually a specific cause cannot be found. Available treatments include antihistamines, short courses of steroid tablets and in very severe, chronic cases medications to dampen the body’s immune system (such as ciclosporin) can be beneficial.

Eczema in More Detail

Eczema and dermatitis mean the same thing; inflammation of the skin characterised by redness, swelling, itching and excoriation (scratch marks) in the acute form. In the chronic (persistent) form, regular rubbing of the skin through itching and scratching, leads to thickening or ‘lichenification’, scaling and post-inflammatory darkening of the skin.

There are many different causes for eczema:
Atopic eczema: common in children and related to other allergic conditions such as asthmas and hay fever.
Allergic contact dermatitis: an eczema caused by an allergic reaction to something coming in to contact with the skin (such as a fragrance). This can be identified by means of a patch test.
Irritant contact eczema: an eczema caused by a chemical irritating the skin (such as soap or disinfectants).
Lichen simplex chronicus: a thickened itchy area caused by repeated rubbing and scratching.
Nodular prurigo: similar to lichen simplex, multiple small itchy areas of thickened inflamed skin.

Acute eczema is red with swelling of the skin, sometimes to the point of tiny blisters or vesicles appearing. It is often symmetrically distributed. Chronic eczema that has been rubbed repeatedly might be thickened and darkened.

The key feature of eczema is that it is itchy! This can be a minor distraction or a major feature that interferes with your life. For children it can prevent sleep which causes unhappiness at home and school. The condition can cause redness and thickening of the skin which might affect appearance and confidence.

The treatment of eczema can be divided into three basic strategies depending on severity, namely creams, phototherapy (ultraviolet/sunlight) or systemic medication (oral or injectable drugs).

Creams include emollients, soap substitutes, steroids or tacrolimus.

Phototherapy involves precise doses of ultraviolet light being delivered by a medical UV-machine.

Systemic medications include tablets such as prednisolone, azathioprine, methotrexate and ciclosporin. These powerful drugs are reserved for severe or life-limiting Eczema Lichen Planus.

With any condition, a visit to your GP will be required for diagnosis. Your doctor will examine your skin, ask about your medical and family history and possibly use patch testing if other conditions need to be ruled out.