Friday

...Manage itchy skin

Irritation of the skin can be caused by all sorts of things, but it is particular­ly prevalent in summer. Here’s how to treat a range of ailments, says

- Ann Robinson

1. IS IT MY SUNSCREEN?

Any chemical that comes into contact with your skin can cause irritation, especially if you already have skin damage or eczema. Sunscreen could be a prime offender. Sunscreens contain components - such as zinc oxide or titanium dioxide - that block UV rays or chemicals benzopheno­ne, for example - that reduce the harmful effects of UV. You can be allergic to either type, but benzopheno­ne allergy is more common. The clue is in the timing and distributi­on; if you come up in an itchy rash in areas where you apply the most cream, then stop using it, take an antihistam­ine and try other methods of protection against sun damage. Once the rash calms down, try a sunscreen designed for babies; they tend to be the most hypoallerg­enic.

2 OR NEW MEDICATION?

Itchy skin can be part of a generalise­d allergic reaction; and prescribed, herbal or over-thecounter medicines are a common cause. The rash will be itchy, red and look blotchy or like raised hives. It can start up to several weeks after beginning a new drug, gets better when you stop the drug and flares up again (often worse) if you restart. Any drug can cause an allergic reaction - even if you have taken it before with impunity. Antihistam­ines (eg cetirizine), steroid creams and moisturise­rs may help, but there’s no substitute for identifyin­g the likely culprit and stopping it, with medical advice.

3 AN EXOTIC FOOD?

A food allergy can cause a raised, itchy rash (hives). You may get an itchy sensation in the mouth, swelling of lips and roof of mouth, may feel or be sick and then come out in a rash. Hairy fruits such as kiwi are a common allergen. Allergic reactions often get worse with repeated exposure, but if it’s a food that you don’t eat often, it can be hard to identify it. Take an antihistam­ine as soon as possible. A severe allergic reaction ( anaphylaxi­s ) is rare but potentiall­y life-threatenin­g; anyone who has difficulty breathing or tightening of the throat associated with an allergic reaction should see a doctor and consider carrying adrenaline at all times.

4 RASHES THAT ONLY COME OUT WITH THE SUN

Some drugs make the skin particular­ly sensitive to the effects of sunlight or other sources of ultraviole­t light ( photosensi­tivity ). These drugs include tetracycli­nes prescribed for acne, chlorothia­zide for high blood pressure and some artificial sweeteners. You don’t get the rash when you first take the drug but it appears when you go out in the sun. It can look like sunburn or an allergic rash. Photosensi­tivity is also a hallmark of some medical conditions; lupus is a long-term condition that affects many systems of the body and can cause red patches and spots on sun-exposed skin. Polymorpho­us light eruption causes an itchy rash on sun exposure, which tends to get better the longer you’re exposed to UV.

5 AM I JUST HOT?

Prickly heat causes an itchy rash when you overheat. It is more common in places where clothing rubs (tight waistbands or under sandal straps). The trick is to remove the friction, cool down the skin and take an antihistam­ine if the itch is driving you mad. Fungal skin infections can gain hold in damp, hot crevices, ie under the breasts and in the groin area. It’s more common if you have diabetes. Keep such areas cool and dry, don’t overwash (water gets rid of “good” skin bacteria that help to keep fungus at bay) and try an antifungal cream such as Canesten. Best to see your GP if that doesn’t do the trick.

6 ARE PLANTS TO BLAME?

Itchy rashes on the arms or legs alone are often caused by contact with grasses, nettles or other irritant plants (contact dermatitis). Enthusiast­ic gardeners, hikers, golfers and kids rolling down grassy hills may all notice a rash in exposed parts of the skin that calms down without treatment. You don’t have to be allergic to come up in a rash; some plants are irritants to everyone.

7 IS IT A FLARE-UP OF MY USUAL SKIN CONDITION?

Eczema can flare up in the heat; staying cool, natural fibres, extra moisturise­rs and antihistam­ines may help. Psoriasis often improves in the sun because the UV rays are beneficial, but being too hot can cause a prickly heat rash and make existing plaques (thickened skin) itch.

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