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Dr. Hive, need ideas on dd15's hives


Susan in TN
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Dd is struggling with some severe hives (again) and/or eczema breakout, particularly on her face.  She started an incredibly strict elimination/gluten-dairy-nut-etc- free/nightshade-free diet last week to see if she could find foods that give her reactions and only eats chicken, ground beef, rice (white rice, rice cakes, rice hot cereal, Rice Dream Original Enriched rice milk, gluten free Rice Chex, DeBoles rice pasta), pears, raspberries, blackberries, organic unsulfured blackstrap molasses, sweet potatoes, cauliflower, broccoli, organic apple cider vinegar, iceburg and romaine lettuce, olive oil, salt and pepper, and that's about all I can think of right now.  She stopped eating the berries 3 or 4 days ago.

 

On Sunday morning she put some CeraVe cream on her face because her skin was dry and her face got quite red (from the cream, we are assuming).  She washed it off (with plain water) the best she could but her skin didn't improve and this morning the patches on her face are even more red and puffy than two days ago.  (She has used CeraVe in the past with no reactions). 

 

I wonder if I should advise her to stop the elimination diet since her skin is far worse now than it was before she started.  She had allergy testing a few months ago which was not terribly helpful since she tested as not allergic to foods that we know give her reactions (hives) consistently.  I'm assuming she doesn't have a true allergy to these things, only an extreme sensitivity.

 

Her reactions consist of hives (or eczema?) lately on her face, but also behind knees and elbows, etc, and sometimes an "itchy mouth and lips" feeling with certain foods. She is getting frustrated and afraid to eat ANYTHING since maybe something(s) on her very strict diet may be making things worse.  We would appreciate any ideas you have!

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Hives is more red rashy.  Eczema is more dry scaly.  Which is it?  Or is it a combination?  Given the locations, face, behind knees and elbows, that sounds very much like eczema.  Have you been to a doctor/allergist to get some Protopic ointment for that?  It's prescription, but it's nonsteroid and does a great job at getting rid of the eczema, and it can be safely used on the face, unlike steroid creams.  

 

I would keep a food diary and see what reactions follow what foods.  Like what did she just eat with the itchy mouth and lips?  If you keep a food diary, you'll know.

 

What food do you know that give her hives constantly?  (you mentioned that in your post).  It might help us to make suggestions.

 

 

 

 

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Hives is more red rashy.  Eczema is more dry scaly.  Which is it?  Or is it a combination?  Given the locations, face, behind knees and elbows, that sounds very much like eczema.  Have you been to a doctor/allergist to get some Protopic ointment for that?  It's prescription, but it's nonsteroid and does a great job at getting rid of the eczema, and it can be safely used on the face, unlike steroid creams.  

 

She has both - eczema outbreaks on occasion but now hives more severely.  We are mainly looking for the hives culprits - sometimes they come out in red puffy spots, but just this week they are large puffy red patches.  She has been to the dermatologist many times and has also seen an allergist and gone through testing.

 

I would keep a food diary and see what reactions follow what foods.  Like what did she just eat with the itchy mouth and lips?  If you keep a food diary, you'll know.

 

We've done the food diary and she avoids the foods that give her reactions.  Foods that make her mouth itchy include fresh apples (peel), bananas, strawberries, peppers, tomatoes, carrots fresh pineapple - several fresh fruits and vegetables - none of them cause a problem when cooked.  We are mainly looking for a culprit hiding in the foods she is currently eating.

 

What food do you know that give her hives constantly?  (you mentioned that in your post).  It might help us to make suggestions.

 

Citrus and chocolate.

 

 

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I would also start looking at things other than food. My oldest has a constant problem with hives and needs a daily zyrtec to control them and another med added in for the summer. Hers are mostly due to heat but there are other environmental causes as well. None of hers have been caused by foods.

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Are you sure it's food causing the problem?

 

I saw an environmental dermatologist (in NYC, not sure how common they are)

 

I am so allergic to gold they wrote about me in a medical journal.

 

Hmmmm.  Do you think an allergy like this could not have any symptoms and then just start popping up in a (seemingly) random fashion?  Dd's "face hives" have only been showing up over the past 6 months.  They haven't been constant, and not caused by the usual (food) suspects which dd stays away from.  She doesn't wear makeup.

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I would also start looking at things other than food. My oldest has a constant problem with hives and needs a daily zyrtec to control them and another med added in for the summer. Hers are mostly due to heat but there are other environmental causes as well. None of hers have been caused by foods.

 

You know, this past April, dd broke out in hives on a camping trip when she went into very cold lake water.  The hives were everywhere the water touched her (not on face, neck, or shoulders) within just a few minutes.  I will have to look into heat, too.

 

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Hmmmm.  Do you think an allergy like this could not have any symptoms and then just start popping up in a (seemingly) random fashion?  Dd's "face hives" have only been showing up over the past 6 months.  They haven't been constant, and not caused by the usual (food) suspects which dd stays away from.  She doesn't wear makeup.

 

yes. I started breaking out in hives every day for months around the time when I was 15. I was just allergic to "something:"  Took allergy meds every day for a long time.

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Hmm, strange. 

 

My cousin had horrible eczema for many years. They finally figured out it was caused by a very strong sensitivity allergy to citrus, and thus also citric acid. 

 

Citric acid is in Ev.er.y.thi.ng. When my aunt put her on a strict diet avoiding everything with citric acid, she improved dramatically.

 

Your dd has hives caused by citrus, which would lead me to believe citric acid might be problematic, but that very strict diet doesn't seem to be much of a culprit for hidden citric acid. :huh: . . .Which leaves me with no ideas.  :confused1:

 

:grouphug: to you and your dd, though. I hope you can get her some relief. That is no fun at all.

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I'm also wondering if yeast could be a factor.  Any of that white rice stuff could really feed yeast.  If she is not doing a probiotic of any kind, I would consider adding that.  My own allergies/food sensitivities are not totally gone, but less oppressive when I think in terms of not feeding yeast.  Sugar is a big no no. 

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Based on all the above info, I agree that it's probably environmental in some way.  Yea, you can let your daughter eat again!  

 

My mom gets hives on her face if she gets hot from working in the house or the yard.  Just another random thing to add to the conversation.

 

Best of luck!  

 

Oh, another question:  Does Benadryl or Zyrtec help?  Maybe start taking Zyrtec daily?

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Yes, some people get hives, etc. from hot and cold.

 

This might be out there, but is she eating organic stuff? Are you cleaning the fruits and veggies with white vinegar or something more than plain water? Pesticide residue makes my husband break out around his mouth. In his case, washing really well is all he needs. I am pretty sure that berries are one of the worst culprits for pesticides.

 

Are any of the foods she's eating regularly on the elimination diet new to her (or new at this frequency)?

 

If yeast is behind it (and the areas you are describing are yeast prone), it can get worse before it gets better--I've done a diet that is similar, and I felt terrible for a while. Is she taking a probiotic? Has she tried Lotrimin cream (generic is fine too). Yeast can manifest in your mouth (thrush). Does she take a steroid inhaler? You can get thrush from those, but I don't know exactly how that would feel. I would be worried about the funny feeling in her mouth since that could mean food allergies. Some people with pollen allergies have to stay away from certain fruits and veggies if related plants are blooming outside (chamomile is related to ragweed, for instance, and I think some people have to avoid melons during ragweed season as well).

 

For relief, she might try clay baths or Epsom salt baths.

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Wow - thanks for the ideas! Yeast is a possibility - she is eating a lot of rice which we have had on occasion, but in general she doesn't eat a ton of starches and she has stopped eating yogurt and homemade sauerkraut, too.

 

The fruits are not organic - dh has the same issue with the fresh fruits and veggies. I will check on that.

 

I don't see citric acid as an ingredient in anything dd is eating, but maybe I haven't checked everything. That's something to keep in mind definitely.

 

One thing I notice is that several of the rice foods are made with brown rice (the rice pasta and rice milk) and we normally only eat white rice because dh has had reactions from brown rice before. And molasses is not something she has had much of in the past (it was on the list of "safe" foods, so we chose it for the vitamins and iron).

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