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Skin Allergy

Eczema refers to skin conditions that cause inflammation or irritation of the skin. Atopic dermatitis, the most common form of eczema, involves itchy scaly skin. Patients with atopic dermatitis are more likely to develop environmental allergies and/or asthma.

Atopic dermatitis patients have impairment of the barrier function of their skin. In other words, their skin has small holes in it that let things in that shouldn't get in.


When these allergens get through the holes in skin of patients with atopic dermatitis, they cause inflammation. The skin becomes red and itchy. Patients scratch, making more and larger holes, more allergens get in, and the rash gets worse. The fluid below the skin may leak out, making the eczematous skin wet and oozy. Bacteria love wet skin, and a secondary infection may develop.


Patients with difficult to treat or severe atopic dermatitis or eczema in Sterling, Lansdowne, and Purcellville should have skin allergy testing to see what environmental or food allergies may be associated. Food allergies can be associated with eczema in up to 30% of children.  Skin allergy testing can be done at our office to determine if one of these allergies are contributing to your (your child’s) eczema or skin allergies in Sterling, Leesburg, and Purcellville.


Contact Dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. There are two kinds of contact dermatitis: irritant or allergic. Irritant reactions commonly result from soaps , detergents, fabric softeners, solvents, or other chemicals.

Allergic contact dermatitis commonly results from contact with adhesives, topical antibiotics, ingredients in many personal products and cosmetics, fabrics and clothing, fragrances in perfumes, soaps, and moisturizers, nail polish, hair dyes, nickel or other metals, poison ivy and other plants, and rubber, latex gloves or shoes.
The allergic contact dermatitis reaction is delayed, with the rash appearing more than a day after exposure. The rash may have red bumps that may form moist, weeping blisters and become scaly, raw, or thickened

Patch Testing for Contact Dermatitis

Patch testing is a method used to determine which allergen is causing contact dermatitis. Patch testing in Sterling, Leesburg, and Purcellville requires more than one office visit and will be done by a specialist with the experience and skill to interpret the results correctly. Tiny quantities of common allergens placed in individual square chambers are applied to the upper back. They are kept in place with special hypoallergenic adhesive tape. The patches stay in place undisturbed for at least 48 hours. After removal, the allergist will interpret the results and determine if additional readings are needed in the subsequent days.

If the cause is determined by patch testing, then detailed educational information will be provided to you about the ingredient, where it is found, what products contain it, and what alternatives can be used instead.

Hives are pink or pale swellings that appear as welts, and can occur on any part of the skin. Each individual hive typically lasts minutes to hours before fading away, leaving no trace. New hives can continue to develop as old ones fade away. They can vary in size from a few millimeters to inches, and can join together to form larger swellings. Hives are typically itchy, but may occasionally burn.


Hives are produced by blood plasma leaking through tiny gaps between cells lining small blood vessels in the skin.  Natural chemicals called histamines are released from allergy cells which lie along the blood vessels in the skin. Histamine produces the itching, swelling, and red color of the hives. Scratching the skin can result in further release of histamine that worsen the signs and symptoms of hives.


Hives are very common, and approximately 15–25% of the population will have an episode in their lifetime. They typically go away within a few days to weeks, but occasionally can continue for years.  Chronic hives are those that last or recur more than 6 weeks and occur in approximately 30% of hives patients. In these cases, bloodwork may be ordered to look for systemic diseases  that can be associated with chronic hives in Sterling, Lansdowne, and Purcellville

Definitive treatment of hives-45698.webp

Angioedema is a deeper swelling underneath the skin, that usually affects the eyelids, lips, or tongue. Approximately 40% of patients with hives also have angioedema.  In a smaller number, approximately 10%, angioedema is present without hives. Sometimes it may be life-threatening if swelling occurs in the throat or if it accompanies trouble breathing.  Hereditary angioedema should be considered if there is a family history and blood work can identify a protein deficiency in these inherited cases

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