Skin Allergies In Children – What parents need to know?

Q1: When to suspect skin allergy in a child? 

When a child develops recurrent episodes of itchy rashes involving either face, body or limbs  one should consider the possibility of skin allergy in the child. However, if the same child also has other symptoms of allergy such as early morning sneezing, wheezing, food allergy etc., or any of the family members (Parents / grandparents) also suffer from allergic symptoms  then allergy should be strongly suspected  in the child. 

Q2: What are the common presentations of skin allergy in children?

The common presentation includes 

1.Urticaria – Characterised by multiple wheals / hives affecting all parts of the body and often associated with intense itching.

 2.Insect bite allergy – Here itchy red lesion usually occurs only in the exposed areas of upper and lower limbs, which often leaves a black pigmentation on healing.

3.Eczema – In infants eczema presents as dry itchy red lesions on cheek, scalp, body and extremities  whereas in older children it usually involves, the skin behind the joints such as knees, elbows.

4.Angioedema – Characterised by swelling of eyelids or lips or hands / feet   often associated severe with pain.

5.Contact dermatitis – Occurs due to contact of the skin with various cosmetics, nickel, dyes , detergents etc.

Q3.What are the causes of skin allergy in child?

Food allergy can present as  allergic skin rashes in young children. The common food causing allergy symptom include milk, egg, nuts, prawn, crab, shrimp etc. Sometimes house dust-mite allergy can also cause allergy skin rashes in children. Rarely autoimmune phenomenon has also been observed  in children with skin allergy  particularly with  urticaria and angioedema .

Q4.Diagnosis of skin allergy

Diagnosis skin allergy is clinical and usually done by the appropriate history and clinical examination. However, the identification of allergen responsible for the allergy is very important and  is usually  done by Allergy skin  testing  and sometimes by Allergy Blood test. Allergy skin testing is the gold standard  test in allergy diagnosis and  is a simple and safe test done routinely done  in the allergic clinics by Allergist as outpatient basis.

Q5.How to treat skin allergy?

The treatment in skin allergy is a two step approach  

1. Pharmacotherapy – Involves symptomatic treatment with anti-allergic medications. It works well but symptoms recur promptly on stopping the drugs .
2. Allergen avoidance – In skin  allergy  avoidance of allergen will only help in the long term control of allergic symptoms. However It is only possible with allergen  identification by Allergy skin test.

Conclusion : In children with skin allergies 3A  approach is the need of the hour 

• Allergist consultation
•  Allergen identification by allergy skin testing 
• Allergen avoidance

Dr. N. Suresh DNB (Ped), MRCPCH(UK), MNAMS, PGDAP., Senior Consultant –  General Pediatrics, Pediatric, Pulmonology& Allergy Specialist, Rainbow Children’s Hospital, Guindy, Chennai

Dr. N. Suresh DNB (Ped), MRCPCH(UK), MNAMS, PGDAP.

Senior Consultant –  General Pediatrics, Pediatric Pulmonology& Allergy Specialist 

Rainbow Children’s Hospital, Guindy, Chennai.

24×7 Pediatric Emergency Contact Number – 044-4860 0000