Allergy

Dear Dr. Jen,

I have an allergy on my foot. It has been bothering me for a few months. I went to see an allergy doctor at the hospital and I was given some anti-itch cream along with prednisone steroid.  It was better for a while but now it has returned.  Is there something else you can recommend?

Izzy

Dear Izzy,

Itchy, red rashes on the foot may be a number of things aside from allergy.  Contact dermatitis due to allergy from some footwear is regularly treated with anti-itch creams with some antihistamines.  But if using the offending footwear persists, then the allergy will definitely recur.

If there has been no use of the offending shoe, other things can be considered, like fungal infection, eczema or bacterial infection.  Definitive confirmation for allergy would be to do a biopsy.  Since some patient may deem this too invasive, you can also do patch testing which is totally painless and quick to perform, no needles involved.  Scrapings sent to the laboratory can help rule out fungal or bacterial presence. Sometimes, fungus or bacterial presence delays healing and will need to be addressed first before the allergy medications are given.

Oral steroids like prednisone might not be warranted at this point.  You can explore other treatment options with your nearest PDS dermatologist like local or topical steroid treatment, paired with some antihistamines.

Dear Dr. Jen,

My eyebrows keep getting red and flaky.  I use some Chinese cream on it once in a while and it does help.  But now I noticed the same flaking on the sides of my nose.  Is this an allergy or a fungal infection?  I’m not sure if I should continue using the Chinese cream.

Fe

Dear Fe,

Seborrheic dermatitis manifests as redness and dry skin on the eyebrows, cheeks, ears, behind the ears, scalp and even on the back and chest areas.  While seborrhea is genetic and can be present your whole life long, there are measures that you can adopt to ensure it stays controlled.

First of all, you must identify the factors that trigger your flare-up. Is it the temperature (too hot or too cold)?  Are you stressed and sleeping less? Does it get aggravated after exercise or physical activity? Once you have identified which are your triggers, the trick is to avoid the triggers.

Apply cool water or cool cloth to the affected areas if exercise or heat exacerbates the flaking and redness.  If cold temperature triggers it, using cover-ups at work and adjusting the air-con temperature in the room at night may also help. Using non-steroidal anti-inflammatory creams on a daily basis may help prevent frequent flare-ups.  If the triggers cannot be avoided, make sure to keep a jar of anti-inflammatories nearby and use as needed.  Sometimes, when there are some yeasts present on the eyebrow area, anti-fungal creams will also come in handy. 

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with the Perpetual Succour Hospital (PSH). Information on PDS is at www.pds.org.ph. Questions or concerns regarding the skin may be sent by text to 0932 857 7070 or emailed to [email protected]; or coursed thru The Freeman – (032) 2531276, or thru PSH – (032) 2338620 and 2325929. Inquiries will be forwarded to Dr. Tan.