Managing Recurring Allergic Dermatitis and Dyshidrotic Eczema

Recurrent allergic dermatitis and dyshidrotic eczema?

Hello Doctor, I suspect that my allergy source is from riding my bicycle past a factory on July 12, where there was a large amount of sand and gravel.
That evening after riding, I noticed itching on my neck, and the rash gradually increased day by day.
By July 15, I had widespread red rashes on both arms.
On July 19, I sought medical attention and was diagnosed with allergic dermatitis on my arms and neck.
The doctor prescribed Prednisolone and Fexofenadine, which I took from July 19 to July 21, along with topical ointments.
I saw significant improvement, but I stopped using the ointment and taking medication after a few days.
On the evening of July 25, I resumed taking traditional Chinese medicine, but in the last couple of days, I've noticed an increase in the red rashes on my arms again.
I would like to ask: 1.
Could the worsening be due to hot weather or sun exposure? 2.
Will resuming traditional Chinese medicine have any effects? Could the traditional Chinese medicine itself be a source of the allergy? 3.
Are there other possible causes? (I haven't ridden my bicycle since that day.) My feet were diagnosed with fungal pompholyx; could this be athlete's foot? The prescribed ointment is clotrimazole.
Can I stop using it once the peeling is gone? However, I've recently developed small blisters on the soles of my feet again.
How long should I continue applying the ointment before I can stop? Thank you, Doctor, for your attention.

Jia, 20~29 year old female. Ask Date: 2021/07/27

Dr. Wu Yuxin reply Dermatology

There are skin issues, but without visible lesions, it is difficult to determine the problem, and I cannot provide any recommendations.
If it is very bothersome, please seek medical attention as soon as possible.

Reply Date: 2021/07/27

More Info

Managing recurring allergic dermatitis and dyshidrotic eczema can be quite challenging, especially when you are exposed to potential allergens or irritants in your environment. Based on your description, it seems that your skin condition has been exacerbated by several factors, including environmental exposure and possibly the use of traditional Chinese medicine. Let's address your concerns one by one.

1. Weather and Sun Exposure: Yes, hot weather and sun exposure can indeed worsen allergic dermatitis and dyshidrotic eczema. Heat can lead to sweating, which may irritate the skin and exacerbate itching and inflammation. Additionally, UV exposure can cause skin irritation, especially if your skin is already compromised. It's advisable to wear protective clothing and use sunscreen specifically formulated for sensitive skin when outdoors. Keeping your skin cool and dry can help minimize flare-ups.

2. Impact of Traditional Chinese Medicine: While traditional Chinese medicine (TCM) can be beneficial for some individuals, it is essential to be cautious. Certain herbs or ingredients in TCM can potentially act as allergens or interact with other medications you are taking. If you suspect that the TCM might be contributing to your skin issues, it would be wise to consult with a healthcare professional familiar with both Western and Eastern medicine. They can help determine if any components of the TCM are causing your symptoms.

3. Other Potential Causes: Besides environmental factors and TCM, other causes for your recurring dermatitis could include stress, dietary changes, or even changes in your skincare routine. Stress can significantly impact skin health, leading to flare-ups of conditions like eczema. Keeping a diary of your symptoms, including what you eat, your activities, and any products you use, can help identify triggers.

Regarding your foot condition diagnosed as tinea pedis (commonly known as athlete's foot), it is essential to follow the treatment plan prescribed by your healthcare provider. Clotrimazole is an antifungal medication that should be applied as directed, typically for at least two weeks after the symptoms have resolved to ensure the infection is fully cleared. If you notice new blisters or worsening symptoms, it may indicate that the infection is still present or that there is a secondary infection. In such cases, it is crucial to follow up with your healthcare provider for further evaluation.

In summary, managing your skin conditions involves a combination of avoiding known triggers, adhering to prescribed treatments, and maintaining a good skincare routine. Regularly moisturizing your skin can help prevent dryness and irritation, which are common in conditions like eczema. Additionally, consider using hypoallergenic products that are free from fragrances and harsh chemicals.

If your symptoms persist or worsen, it is essential to seek medical advice promptly. A dermatologist can provide tailored treatment options, including topical steroids or other medications, to help manage your symptoms effectively. Remember, skin conditions can be complex, and a comprehensive approach is often necessary for effective management.

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