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Dr. Hive - help me stop this allergic reaction


athena1277
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A little over a month ago, I started itching around my armpits.  Over the course of several days, it spread down my arms to the bend of my elbows.  There was no visible rash, but the itch got so bad I finally went to urgent care.  (I don’t have a primary care doctor.). The nurse practitioner I very quickly decided that it was an allergic reaction to my deodorant and gave my 6 days of prednisone.  I felt like it got rid of it about 90%.  After the 6 days (plus new deodorant), it started coming back, but this time there was a visible rash on my upper arms.  Went back to urgent care.  I saw a different nurse practitioner who took a little more time with me, but came to the same conclusion as the first.  I got a steroid shot and a dose pack.  She said it doesn’t seem like something I ate that I’m allergic to because it’s only on my arms.  I very rarely ever change soaps, detergents, etc. because dh has bad allergies that are often triggered by scents.

I feel  like  whatever it is is coming back.  Again.  I have an appointment with a primary care doctor, but as a new patient, I can’t be seen for 3 weeks.  I know I may need to see an allergist, but who knows how long I would have to wait as a new patient.  What can I do?  Aveeno lotion and Benadryl help, but I can’t live on Benadryl forever.  And I’m not sold on the deodorant allergy either.  Help, please!

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Well, unfortunately, if you've developed an allergy to deodorant you're going to have to stop using it if you want to stop reacting to it. In previous threads some people have talked about success using Milk of Magnesia as a deodorant - one you get used to it.

Maybe it isn't a depositante allergy? You said you weren't sold on that. Your description really sounds like it, but do you think it might be something else specifically?

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Instead of Benadryl, you might consider Zyrtec.  It's a 24-hour antihistamine.  It shouldn't make you drowsy the way Benadryl can. 

Do you usually use an antiperspirant or a deodorant?  Different ingredients.  I would assume you are reacting to whatever the common ingredients are in the ones you've tried, and then find something else.  Most antiperspirants have aluminum; if antiperspirants are what you have been using, maybe you should try a product that's deodorant only.

 

 

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9 minutes ago, SusanC said:

Well, unfortunately, if you've developed an allergy to deodorant you're going to have to stop using it if you want to stop reacting to it. In previous threads some people have talked about success using Milk of Magnesia as a deodorant - one you get used to it.

Maybe it isn't a depositante allergy? You said you weren't sold on that. Your description really sounds like it, but do you think it might be something else specifically?

No idea what else it might be.  Both nps just seemed too quick to decide that was the problem.  I felt like they were in a hurry to move on to the next patient and didn’t really consider all possibilities.  But maybe there wasn’t.  I don’t know.

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Just now, klmama said:

Instead of Benadryl, you might consider Zyrtec.  It's a 24-hour antihistamine.  It shouldn't make you drowsy the way Benadryl can. 

Do you usually use an antiperspirant or a deodorant?  Different ingredients.  I would assume you are reacting to whatever the common ingredients are in the ones you've tried, and then find something else.  Most antiperspirants have aluminum; if antiperspirants are what you have been using, maybe you should try a product that's deodorant only.

 

 

Already on Zyrtec.  I take it daily for seasonal allergies.  

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Have you changed soaps lately?  Do you take long or very hot baths or showers?

The areas you are mentioning are pretty thin, sensitive skin.  I would be inclined to suspect some kind skin sensitivity that is partially cumulative, and in which if you are 'triggered' you are more sensitive to lots of things that don't normally bother you.  I would suggest taking 12 hour allegra during the day and benedryl at night for at least 2-3 weeks straight, and also getting a very sensitive skin friendly moisturizer like Curel and some strong cortisone cream.  After a shower or bath, put the cortisone onto all of the sensitive areas, slather the Curel on top of and around it, and repeat this application every 12 hours (but not with another shower.)  Also, try to avoid long soaks and very hot water when cleaning.  If you have changed soaps or shampoos lately, change back.  You want to minimize the irritants can that contribute to this.

If you try this for a while and it doesn't work but it does seem to be helping, you can take that info to a doctor to get stronger than OTC cortisone to try, or another ointment that is stronger yet.  I'll bet this will work for you.

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36 minutes ago, athena1277 said:

I tried, but only lasted a day.  No deodorant just feels icky to me.

It takes the body a while to get used to no deodorant, but it will and you will stop stinking. I quit in college after an allergic reaction. If I am stinky due to hormones (just a bit of the month) I might use a wash cloth and soap to clean up mid-day or a little hand sanitizer after showering. The allergic reaction isn't worth it, especially since allergic reactions that are ignored tend to get worse.

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I had a mystery rash in the same area, and it was awful and itchy. I eventually put straight apple cider vinegar on it (the raw, unpasteurized kind), and relief was immediate! I had to keep putting it on when the itch returned. After a couple days, it was finally gone. I think it may have been a yeast thing, maybe brought on by sweating, or maybe nicking with a razor, who knows. Could be worth a try since ACV only costs a couple dollars. You can also try it diluted in water and see if that works, and make it stronger if it doesn't. Hope you get relief soon!

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Just on an off chance, can you check your deodorant for tocopherol acetate? This is the vitamin E additive that they use in a lot of cosmetics. My DD is allergic to it and we have to be very careful. Also, she's had a similar rash from when her friend was spraying Febreeze in a room, although that started on her face. Since Febreeze doesn't have ingredients listed, we can't really know if tocopherol was the cause, but it could have been. 

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5 minutes ago, SamanthaCarter said:

Just on an off chance, can you check your deodorant for tocopherol acetate? This is the vitamin E additive that they use in a lot of cosmetics. My DD is allergic to it and we have to be very careful. Also, she's had a similar rash from when her friend was spraying Febreeze in a room, although that started on her face. Since Febreeze doesn't have ingredients listed, we can't really know if tocopherol was the cause, but it could have been. 

If you call the company, they can let you know if tocopherol is one of the ingredients in Febreeze.  I believe that it is required by law that they give you the information if you ask about a specific ingredient.

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Try using some anti fungal cream. Like for athletes foot. I have several times gotten uncontrollable itching in my arm pits, and it turned out to be yeast. Some people have an allergic reaction to yeast beyond the normal discomfort, which would explain the spreading rash. If it is yeast you'll get some relief in 24 hours most likely. 

It's just a warm, moist environment. 

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41 minutes ago, Ktgrok said:

Try using some anti fungal cream. Like for athletes foot. I have several times gotten uncontrollable itching in my arm pits, and it turned out to be yeast. Some people have an allergic reaction to yeast beyond the normal discomfort, which would explain the spreading rash. If it is yeast you'll get some relief in 24 hours most likely. 

It's just a warm, moist environment. 

I was just about to suggest this.  

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If it's yeast/fungal, it should get worse with cortisone cream and possibly better with an anti-fungal. 

I have a lot of unexplained itching and have to take multiple antihistamines a day. I get itchy on my shoulders sometimes if I eat something that triggers it (but I have had extensive testing and am not actually food allergic). I sometimes also get crazy bad itching down the front of my shins. 

If my skin gets dry, that can trigger the other kind of itching. I also recommend Vanicream products. I've used only the lotions so far, but I really like them.

I use milk of magnesia for deodorant, and it works quite well. I put it in a little screwtop container, and I try to let it get just a big thick before I use it--if I have to open a new bottle, I often leave the cap off it to let it thicken. It's easier to get an adequate amount applied when it's creamier.

Regarding the quote below, my experience with most practitioners (aside from allergists who want actual data) is that they always feel like they know what is causing an allergic type of reaction but that you, who live in your body, are pretty much always wrong, lol! Ditto for migraine triggers--they are sure it's this but not that.

If you continue to have problems, I think an allergist or dermatologist is your next best bet.

3 hours ago, athena1277 said:

No idea what else it might be.  Both nps just seemed too quick to decide that was the problem.  I felt like they were in a hurry to move on to the next patient and didn’t really consider all possibilities.  But maybe there wasn’t.  I don’t know.

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I could have written a very similar post three years ago. The clinician I saw didn’t say that it was caused by deodorant, just that it was a “flare” and would happen occasionally. 

I never have seen anyone who solved the problem, but I end up back at urgent care or a dermatologist a couple of times a year and am prescribed steroids, shots and steroid creams. 
 

I gave up deodorant when it first happened and other posters are correct, once you get used to that it’s no big deal. However, it didn’t solve the problem, I still get random rashes that start in my armpits and and move down in my arms.

 

When it’s bad, diphenhydramine works best and other antihistamines are better than nothing during the day. Prescription creams and hydrocortisone creams work well, but you have to be careful not to over use them.

 

Good luck getting answers! In my case, we moved to another state right before this all started happening, so I think it’s environmental, but I don’t know what it is or how to get anyone to believe me.

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I started reacting to the aluminum in deoderants years ago. If you try a health food store, you can find all kinds of alternative products that won't have it and might still be fragrance free or very lightly scented. My dh uses products from there and if he applies it in the morning, the scent is gone by evening when he gets home anyway. Tea Tree oil products work particularly nicely.

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Pepcid AC is actually an antihistamine and can be safely combined with Zyrtec and Benadryl for added relief. 

You might try a low-histamine diet for a while. I develop hives from heat, sunlight, and stress and at my worst, I found that high-histamine foods were the extra "push" that overloaded my system and caused me to break out.

My hives started on my inner arms, opposite my elbows, and behind my knees. These seem to me to be similar places to underarms--perhaps it isn't your deodorant. 

I know it's horrible! I hope you are able to find relief quickly.

Edited by MercyA
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Lots of allergies here. Of course you should talk to a doctor and an allergist and quite possibly an dermatologist but I would suspect some kind of allergy, could be deodorant, soap of some kind, fabric softener or any number of things. It doesn't have to be a change in any of these for an allergy to form. Sometimes allergies can suddenly appear from a product you have used for many years. It could be a slight change in the formulation of the product that didn't agree with you or your immune system overreacting for some reason. My allergist also has me on daily Zyrtec but I can also take Benedryl in addition to the daily Zyrtec and one additional dose of Zyrtec per day for allergies that breakthrough. If none of that helps, he wants me to come in. If you are having active allergy problems, allergists can usually work you in pretty quickly, even if you are a new patient.

If you are absolutely positive that it isn't an allergy, my next thought as other's mentioned would be fungal skin infection. It can look a lot like an allergic reaction but harder to make it go away. There are lots of different anti-fungal creams with different main ingredients. The creams with the main ingredient tolnaftate have worked the best for us. We have also started cleaning the affected area with chlorhexadine based surgical scrub like Hibiclens. You can buy it in most pharmacies or big box stores with a pharmacy. It seems expensive but a little goes a long long way. When a fungal infection is really red and angry, we wash it daily with chlorhexadine soap and then apply the tolnaftate cream. Once it starts going away, we back down the chlorhexadine wash to once a week but keep doing the cream daily. It really seems to help. Especially with the itchiness. The thing about fungal infections though it that it can take a long long time for them to completely go away. Like weeks and sometimes months to eradicate the fungus completely. So we keep it clean and medicated until the skin is completely clear of the rash and then we usually do a couple of days more with the cream even after it seems to be gone. 

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