Blog that contains real life struggles of those suffering from allergic contact dermatitis

Unmask the facts- the truth behind “fragrance free”

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Original Article:

Scheinman PL. Exposing covert fragrance chemicals. Am J Contact Dermat. 2001;12(4):225‐228. doi:10.1053/ajcd.2001.28697

Reviewed by Jalal Maghfour and Dr. Alina Goldenberg

Fragrances are widely used in personal care products, cosmetics, medicaments, and foods within the US. Fragrances are responsible for many cases of allergic contact dermatitis, leading it to be perceived as a significant public health problem. 

We aim to provide an overview of fragrance chemicals and how knowledge of fragrance elements can shape patient outcomes.

Patch testing continues to be the gold standard for the diagnosis of fragrance sensitization. Patch test commonly include fragrance mix (FM) and balsam of Peru. FM, which includes cinnamic aldehyde, cinnamic alcohol, eugenol, isoeugenol, hydroxycitronellal geraniol, oak moss absolute, and alpha-amyl cinnamic aldehyde,  is highly ubiquitous worldwide with an estimated sensitization prevalence of 11%.  

While patch testing can detect 70 to 80% of fragrance elements, false negative reactions to FM may occur. Hence, it is important to conduct an expanded series of fragrance chemicals if the suspicion for an allergy is high. This is of clinical importance since identification of the exact etiology may guide disease management and empowers patients to take control over their own health.

Although being aware of fragrance allergy is important, many products that are labeled as “fragrance-free” are not truly free of chemical fragrance. For instance, benzyl alcohol is often used as a preservative but it is also considered a fragrance agent. However, because benzyl alcohol has a dual function, companies can legally label a product as “fragrance-free”. This makes it challenging for sensitized patients to avoid certain “fragrance-free” products.  Hence, knowledge of various products by clinicians can be vital for patient care. Historically, plant and animal ingredients were the main extracts used in making fragrance. It is therefore important to note that a patient who is allergic to a fragrance agent in a product may also react to the same ingredient found in plants and flowers.  

Sensitization to an allergen is necessary for elicitation to occur in which the rash of ACD is present. Initial sensitization usually requires a higher dose of the chemical allergen. However, if a fragrance is applied to skin areas with high absorption capacity such as face, genitals, and traumatized areas (shaving, post-surgical sites, excoriated lesions of atopic dermatitis/eczema), a lower dose is may be necessary to sensitize an individual. It is noteworthy that for sensitized individuals subsequent exposure of a lower dose of the allergen may be enough to elicit a cutaneous eruption. Hence, in addition to removing fragrances from commonly used products, public policy should also focus on reducing the levels of fragrance use to prevent reactions in sensitized individuals.

Contact Dermatitis Awareness Ribbon

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Announcing the Contact Dermatitis Awareness Ribbon:

On March 19, 2016 a Montessori Teacher and a Customer Service Representative, two mothers with children suffering with allergic contact dermatitis, joined together to start a patient-centered outreach group on Facebook called “Eczema, Contact Dermatitis and Patch Testing Alliance”. Currently, this 1,925 member focus group is providing educational resources to sufferers of allergic contact dermatitis worldwide.

As the eve of the anniversary of the group approached the lead administrator (Misha Bertolino, MA) raised the question, Why is there not a contact dermatitis awareness ribbon?

**Contact dermatitis costs a reported $1,529 million/year in medical costs!

**Contact dermatitis is the 8th most costly skin disease!

**Contact dermatitis is preventable!

 

The Contact Dermatitis Awareness Ribbon is indeed very much needed!

In a collaborative effort, the Eczema, Contact Dermatitis and Patch Test alliance along with artist Janna Vassantachart, MD, logistician Chandler Rundle, BS, practicing contact dermatitis specialists, and global advocates – the orchid (eczema) and teal (allergy) contact dermatitis awareness ribbon has become a reality.

This symbol can be worn to show support and solidarity for the millions of people who suffer from this disease.  In alignment with these symbols, our mission at the Dermatitis Academy is to educate the public, the medical providers, the manufacturers and the legislators on ACD, while cultivating a community of support for those impacted by this disease.

With early diagnosis, education, and intervention, we HOPE for a future where allergic contact dermatitis can be controlled by remission or prevention.

Please visit the Dermatitis Academy to learn more about allergic contact dermatitis, allergens, and patch testing and to download the Contact Dermatitis Awareness Ribbon.

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Amanda’s Allergic Contact Dermatitis Story – My ACD story

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Amandasstory

“My MI/MCI story by Amanda B.

In April of 2013, I began struggling with sleep. Friends suggested I go on Hormone Replacement Therapy, and my doctor, who knew nothing about hormones, suggested I visit a gynecologist for HRT. She also offered me sleeping pills. Not wanting either alternative, I chose to hope for the best and tough it out. But months and months later, I still wasn’t sleeping, and my thoughts and feelings began to become affected. The day before Thanksgiving, my only surviving family member and sibling was admitted into the hospital 2,000 miles away. She passed away on December 11 and I was unable to attend her funeral.  My college-aged children were home and I pressured myself into preparing elaborate holiday feasts. My business, which is in full swing during the holidays, was demanding my attention. I say all of this so you can understand that I was on overload, to say the least. I fully believe that my sensitization to MI/MCI was due in large part to stress, the fact that I wasn’t handling my stress well, and my use of denial (“it will all get better”).

That Christmastime, I began experiencing itchy rashes on the back of my hands. I was at a loss as to what was causing it. I booked a January appointment with a dermatologist and they kind of shrugged, gave me a preliminary diagnosis of dyshidrotic eczema (although the presentation of my rashes was irregular for that diagnosis), gave me some very strong ointment, and sent me on my way. I read the package insert of the medication and was alarmed at how they stated it could interfere with the adrenals. I used it sparingly, and it worked.

I kept having these sorts of breakouts on my hands, but then later in 2014, I began breaking out on my face, chest and arms. These blisters were horrible. As the rash on my face was in a butterfly shape, the dermatologist tested me for Lupus, which was negative. No indication on their part as to what could be causing the rashes. More corticosteroids.

Finally in early 2015, after a facial caused my lips to flare, I insisted we get to the bottom of the problem. The dermatologist suggested a patch test to determine if I had contact allergies. She administered the TRUE test and I reacted quite strongly, and only to isothiazolinone. Not one person in the office could pronounce it, and not one person talked with me about Allergic Contact Dermatitis (ACD). They handed me a printout from the TRUE test and said, “this is what the problem is.” I immediately talked with the aesthetician who had given me the facial. She began looking on her phone right away. The first site she went to was Wikipedia, and then she went to Facebook. She found the MI group and I immediately began following. To date, these MI support groups have provided me with nearly 100% of my education on ACD.

Like everyone else with ACD, the allergy ruled my life at first (and it still does, for the most part, but I have a safe home now, and I know how to live with the diagnosis). I spent a great deal of time focusing on how to keep out of a flare. I am a jewelry artist and am exposed to chemicals on a regular basis, but it was cleaning out my basement this past winter that caused a huge flare that I couldn’t seem to heal. Although I have prescriptions for various corticosteroids, I try to use them sparingly, even to wean myself off of them, because they are known for thinning the skin, and the ingredients are absorbed into the bloodstream. So during this particular flare, I began using natural salves that were absolutely lovely (in my opinion). But something wasn’t right. I would use corticosteroids one night, the natural salves another night, and I kept flaring. There was no MI/MCI in any of the products I was using. So back to the dermatologist. She had mentioned that there was a specialist about an hour and a half away who could patch test me on a larger scale if I needed it, so I said, “it’s time”. Fortunately, I have medical insurance that would pay for it.

In April of 2016, I had my appointment and was given 129 patches on my back. The results were that I had developed sensitivities to some of the ingredients in the natural salves I had been using. My new allergens include Fragrance II, Propolis, the botanicals neroli and lemongrass, as well as ethylhexylglycerin and dodecyl gallate. I was told to avoid all fragrances, all botanical oils and beeswax, in addition to MI/MCI.

Now I use very little on my skin, as I fear that I will become sensitized to more allergens. Something that I feel has been missing in all of this is patient education about how to heal a flare once you get one. And that education for the medical community in this arena is sorely lacking. I know that doctors become highly specialized and it may be impossible for them all to know about ACD, but it seems to me that dermatologists ought to be able to patch test a patient sooner than later.   I think that most of us ACD sufferers are out there floundering with no idea of diagnosis and treatment. I am grateful that Dermatitis Academy exists now to help us all through this maze!”

My Allergic Contact Dermatitis (ACD) Story is a portion of the Dermatitis Academy Blog that highlights real life, user submitted, allergic contact dermatitis journeys in an attempt to provide awareness and encouragement regarding this crippling disease.

Infographic by Peter Gust

Claire's Story

Parent’s Speak Out About Allergic Contact Dermatitis and Patch Testing

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Claire's Story

It Just Kept Coming Back

“From a very early age, my daughter had eczema. Hers was a very mild case; sometimes she would get small patches on the back of her knee or on her wrists, other times her skin was perfectly clear. Each night that she had a bath, I made sure to fully moisturize her skin in order to protect it and if needed I would put a small amount of hydrocortisone on affected areas. This usually did the trick and her skin stayed pretty healthy looking. I didn’t want my daughter to suffer from itchy and uncomfortable skin…and I certainly wasn’t going to let that happen. After all it was my job as a mother to keep my child healthy, comfortable and happy. Her skin was great for about 10 years, with a few manageable flares every so often.

 

As time passed and as my daughter entered upper elementary school, her skin gradually became worse. I continued to treat her skin with the same moisturizer and hydrocortisone cream. Sometimes it would get a little better, but then it would come back worse than the previous flare. She also became much more uncomfortable, it seemed like she was always scratching herself. I noticed more and more scratch marks each day she woke up.   We were doing everything that had been suggested…frequent lukewarm baths, pat dry, hydrocortisone, moisturize, a cool temperature in the bedroom, cotton pj’s, and we kept her fingernails short. Still, it got worse.

 

At one point we had to go to the pediatrician because the backs of her knees were weeping…and it happened seemingly overnight. She was given antibiotic ointment, oral antibiotics, and a new steroid to help calm everything down. Once it calmed down we went back to the same skin care routine.

 

The condition of her skin continued to decline. The areas around her eyes became dry and scaly at times. It was frustrating trying to apply makeup for dance recitals, as the flakes were so much more visible with her makeup on. Her shins became unmanageable. She literally couldn’t sit still with out scratching or rubbing her legs, back, arms, neck or face. It drove me crazy and I drove her crazy as I told her over and over to stop scratching. She knew she shouldn’t scratch but the itch was unbearable. We had so many battles about her skin…it was seriously affecting our relationship and many nights ended in tears for both of us.

 

When we first went to see the dermatologist she looked at her skin and asked us questions about what we had been doing to treat the eczema. She said that an injected steroid would help calm things down, so we opted for that. She also prescribed a stronger steroid and a topical immunosuppressant cream for her eyes. She assured us that we were ok to use the steroid cream, and offered advice on tapering down, and which strength of steroid to use on different areas of skin depending on severity of the condition.

 

Her skin cleared nicely after the shot and the stronger topical steroid. The topical immunosuppressant seemed to work temporarily, but the skin always returned to a flaky and inflamed condition without it. Eventually, the rest of her skin was back to its previous state, and getting worse by the day.

 

At the next dermatologist appointment, the doctor looked at the condition of the skin and said, “Did you ever have her patch tested?”. I had not heard of patch testing and didn’t know anything about it. She went on to explain that it is a test that can diagnose allergies to substances that she might be coming into contact with that are responsible for creating her dermatitis. She gave me the name of local dermatologist that performs patch testing. We left from the appointment with a few new samples of products, the same treatment plan, and the name of the contact dermatologist.

 

Did I schedule the patch testing right away? No, I did not. (Looking back I wish I would have dialed that number as soon as we had left that appointment) I thought, “We’ll give it a little more time to see if it clears up.” All the while my daughter was miserable. As I was putting her steroid cream on one night she said, “Mom, are you sure this is making it better?” My quiet and uncertain response was, “It’s supposed to.”

 

Finally, mid summer, we scheduled a patch test consultation. We met with a nurse practitioner who was under the guidance of the contact dermatologist. She explained the patch test procedure and what my daughter could and couldn’t have as far as topical and oral medications, and also explained the need to limit sun exposure prior to and during patch testing. The dermatologist joined our meeting later and asked us questions about when her condition started, asked if we had trouble with her ears as they had been pierced, and just general questions about possible exposure to allergens.   We scheduled my daughter’s patch testing for the week before she would return to school.   It would take one full week with four appointments to complete the test, as our insurance required half of the patches to be applied the first day, and half applied at the second appointment, two days later.

 

I assumed my daughter would want to hang out around the house during patch testing. After all, she was a middle schooler, a vulnerable age for so many girls in regards to appearance. But no, she put on her dance leotard with her patches showing and went to her studio for dance class. She explained to everyone what the patches were and was able to make jokes and laugh about it with her friends.

 

At our third patch test appointment when both sets of patches had been removed, the doctor indicated that he thought that he would be able to give us some helpful information at the final appointment on Monday. When we got the results at the final appointment, we learned that she was allergic to 10 substances! Nickel, Propylene Glycol, Methylisothiazolinone, Parabens, BHT, Oleamidopropyl Dimethylamine, Lanolin, Octyl Gallate, Bronopol, and Decyl Glucoside. Some of these had elicited stronger reactions than others, but the doctor felt that they were all clinically relevant.

 

It turns out that many of the substances that she was allergic to were ingredients in the moisturizers, steroid creams, and the topical immunosuppressant cream that we had been using. The very things that we were using to treat her eczema were making it worse! It was explained to us that no one is born allergic to these substances, but through exposure one becomes allergic. So, not only were these ingredients making her skin worse – these substances were in fact responsible for creating the allergic contact dermatitis that my daughter was suffering from. The seemingly hypoallergenic and safe products that I was using on my daughter’s skin, from the time she was a baby, created this nightmare of a condition. When this revelation had time to sink in, I became deeply saddened and outraged.

 

As I came to grips with all of this new information I began to remove her allergen containing products from our lives and replaced them with “safe for my daughter” products.   I learned that in order for my daughter’s skin to have the best chance for healing, we needed to completely avoid all exposure to the substances that she tested allergic to. We changed out personal and household products, eliminating every product that contained her allergens. I changed my products as well so that there wouldn’t be risk of exposure to her from a product that I had used on myself.

 

As we evaluated every possible place of exposure, my daughter informed me that one of her teachers at school was using an automatic air freshener in the classroom. Air fresheners contain all sorts of contact allergens…and in my daughter’s case, propylene glycol and methyliosthiazolinone would be the worst offenders in this kind of product. She didn’t want me to talk with her teacher about it, as the air freshener was one of the things that he was known for, and he was a popular teacher with the students. I told her that I had to, and it that it was the school’s obligation to provide a safe environment for ALL of the students. I e-mailed her school counselor and she responded with a phone call within an hour of receiving the email. She understood the situation at hand, and immediately suggested to get a 504 plan in place.

 

At the 504 meeting, I brought my daughter’s binder containing all of the papers we had received at her patch testing appointment. I also showed the teachers and counselors pictures of allergic contact dermatitis reactions. I explained that some of these chemicals are in aerosols and cleaning supplies commonly used at school and at home. The teacher who had the automatic air freshener in the classroom looked up ingredient listings for the household wipes and other cleaning products used at school.   It was eye opening for him to see the prevalence of these chemicals in products.   As a result of this meeting the educational team had a better understanding of allergic contact dermatitis and they all agreed a 504 plan would be appropriate. We ended up with a comprehensive plan at the end of the meeting. The teachers would use a simple dilute bleach/water solution and paper towels to sanitize and clean desks. The head cafeteria worker would investigate the cafeteria cleaning supplies and report back to us. And the teachers were ecstatic about this one: “Scent Free Zone” signs would hang on the walls of the halls and classrooms in my daughter’s wing of the building. The teachers were excited about the possibility of the elimination of body spray being applied by the boys in the locker hallways.   The teachers were very accommodating and I couldn’t have been more pleased with their response.

Before/After…

beforeclaire after

Through continued avoidance of my daughter’s contact allergens, and with time allowed for healing, her skin looks better than it has in many years, and more importantly, she is more comfortable than she has been in many years. I realize now the significance of that one simple question that our dermatologist asked: “Did you ever have her patch tested?”  If she hadn’t mentioned patch testing, my daughter would likely still be suffering today. Patch testing, diagnosis, and removal of allergens has been the key to my daughter’s recovery.”

 

  • By Misha B.
  • Infographic by Peter Gust

 

Parents Speak Out About Allergic Contact Dermatitis (ACD) is a special category in the Dermatitis Academy Blog where passionate parents reveal a personal look their family’s journey in dealing with ACD and the role of the patch testing.

 

Please visit our home page HERE for more information on allergic contact dermatitis. Please share this post in order to create awareness for this seldom considered, but highly relevant disease process.

Remington's Story

Remington’s Story – Parents Speak Out About Allergic Contact Dermatitis – Benefits of Being Patch Tested

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Remington's Story

“Is that contagious? A question we have been asked throughout my son’s life.  I am sure many people with skin issues have heard frequently!  Our son is just shy of three years old and has been battling a skin issue since he was a few months old.  Once he turned a year old his skin began to get worse. As months continued it even worsened, soon it was to the point that we could not take him out. Doctor appointments weekly sometimes multiple doctors appoints in a week. Specialist after specialist nothing was working.  He was diagnosed with eczema at just 6 months old. We were first prescribed over the counter medications. But as he continued to get worse something else needed to be done. Once he reached a year old we were sent to an Allergist. They performed a skin prick test on his back. They found him to be mildly allergic to dog. The allergist changed up his medication yet again.”

Remington's story

“As the months rolled by he was not getting better, if anything he was getting worse. We were finally sent to a dermatologist. There they performed a blood test on him to find allergies.  Yet nothing came back positive except for dog.  They continued to treat him as if he had “eczema” at one point he was on three different steroid creams. We would rotate Zyrtec, Benadryl and Attarax just to try and relive his itch. Our nights became nightmares are sleep became nonexistent. There were endless hours of tears. Nothing we did would work. NOTHING! We were hospitalized for 5 days. He also had a staph skin infection. Even the bleach baths weren’t working at this point. Our son was prescribed prednisolone so many times in 6 months that he reached his peak for oral steroids and the doctors would not prescribe him them again. I honestly felt like I was feeding my child medications for no reason. The flare ups became worse and lasted longer. It was truly a nightmare! Once we reached the max limit on oral steroids his dermatologist decided that it was time to start an immune-suppressant.  This was something we were completely against. We felt his immune system was already weak and we were not willing to go this route. We wanted a second opinion. We changed his pediatrician; we needed a new set of eyes.”

“The new pediatrician did a complete blood work profile on him. His live vaccinations titers came back as if they were not existent.  He was given a booster then had his levels checked a few weeks later. They came back normal, so the route of having an auto immune disease was out. Still getting new creams and ointments nothing was working. At this point we said we are done with steroids. We went all-natural. We were doing herbs and using only coconut oil on his skin. It seemed to be working but then it was infection after infection. After 4 months or so he wasn’t improving. He was one of his worst flare ups we had to go back to the dermatologist. We couldn’t put it off anymore we had to give it a try, we had to give our child some type of relief. We did it. We put him on cyclosporine. He was going for blood work weekly to start. This medication is used in transplant patient and monitoring of kidneys and liver function are needed while on this medication, his levels needed to be checked frequently. At first it seemed promising he seemed to be doing slightly better. We thought we were seeing the light at the end of a DARK tunnel. But then it hit, yup you guessed it – another flare up. This time worse than the last. He was at the doctors 3 times in a week. Eight different medications – it was heartbreaking. What am I doing wrong; I asked myself this question so many times. I didn’t understand why wasn’t anything working. I knew something I was wrong I knew this wasn’t just “eczema” I knew it was more!”

“He was on cyclosporine for about three months; usually this clears up something with eczemas fairly quickly, but not us. That’s when I decided it’s time for another set of eyes. I contacted at Children’s Hospital which was three hours from us. I scheduled and appointment but it was 6 months out. Our pediatrician called them on our behalf because he wanted him to be seen as soon as possible. We got in the next week! As soon as we got in the room the dermatologist looked at him and said has he ever been patch tested for contact allergens, he needs to be patch tested. She knew right away he had a contact dermatitis rather than atopic dermatitis. We had the patch testing done. Mind you we have to drive a total of 6 plus hours there and back, but we went through with it. We NEEDED answers. Leaving that doctor appointment I felt a sense of surety, I honestly felt like we were achieving some. I felt a sense of relief. My husband took our son back down on Friday. We had his final read on Monday. GUESS WHAT – our son tested positive for 3 different allergens. He was positive for propylene glycol, compositae (asterace), and sesquiterpene lactone. Finally we got answers, because he was patch tested! So the reasons the all-natural route did not work was because it had sunflower base in it (sunflowers are in the Composite family and contain sesquiterpene lactones).

He is allergic to florals and herbal things. The reason the cyclosporine did not work may have been because it contained PG, but also because he was unknowingly being exposed to his allergens. Also two of the steroids as well as moisturizers he used contained PG. After he was patch tested, we had to clean out our house. I went home and got rid of everything. If it smelled it was removed to prevent further damaging his skin. I love the scentsy smelly things, but they were gone, no if and or buts! I went through all the cleaning supplies I had checked every label. We took him off all medications and ointments. We put him on an ointment free from PG. We had a game plan. Within a week we could see a difference. It was amazing. We are now on a normal bed time routine. We actually get sleep, it is a miracle. His hands, feet and face still have healing to do but it is manageable and I know we can do it. If it wasn’t for Patch Testing, I don’t know where we would be right now. Patch testing has truly given my son the gift of being able to be a child again!”

 

  • by Travis & Jessica Musser
  • Infographic by Peter Gust

 

Parents Speak Out About Allergic Contact Dermatitis (ACD) is a special category in the Dermatitis Academy Blog where passionate parents reveal a personal look their family’s journey in dealing with ACD and the benefits of being patch tested.

 

Please visit our home page HERE for more information on allergic contact dermatitis. Please share this post in order to create awareness for this seldom considered, but highly relevant disease process.

francinenew

A Serious ‘Tipping Point’ – Demand for allergic contact dermatitis specialists by sufferers far exceeds supply

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francinenew

 

This is Francine’s story, written from the perspective of her allergic contact dermatitis provider (contact dermatologist), Dr. Sharon Jacob.  Together the patient and provider worked together to properly evaluate her through patch testing which gave Francine her life back by helping to resolve her allergic contact dermatitis.

Anger, sheer anger, “How can we have to wait 11 months to see the doctor? Tell her my son is suffering, tell her I can not live seeing my child live like this.”

I would like to introduce you to Francine.* She was an ex-cosmetic fragrance counter worker, who had to quit her job because of rashes. She came referred from her 4th dermatologist who wanted to start cyclosporine (an immunosuppressive medicine used to prevent transplant rejection) but she couldn’t afford the medication.   I looked into her eyes, her eyelids so inflamed they were peeling back.  She was suffering from allergic contact dermatitis.   She asked “can you get me better?” I humbly said, “I am surely going to try”, and swore to myself that I would not take hope from this patient.

 

We patch tested her to balsam of Peru (BOP) and the individual BOP components and confirmed she was highly allergic to cinnamate derivatives and benzyl alcohol. Unfortunately, her current topical medication contained benzyl alcohol. (1) We instituted avoidance and she dramatically improved. She told me “Patch testing gave me my life back”. Three months later she ‘cheated with a cinnamon bun at the mall and had a severe flare that led her back to my office.   We reviewed that avoidance is the permanent treatment for allergic contact dermatitis.

Before:

before

After:

after

Five minutes later, I looked into the eyes of the next patient’s distraught father. He raised his voice at me, frustrated that they had to wait so long. “We just can’t understand why you just couldn’t put our son in. Look at him, he has worsened waiting for you. Look at him”. Do I tell them I haven’t regularly eaten lunch in 3 years, do I tell them that this epidemic has caused me to cut routine sleep out of my daily life. No.

 

“I am sorry”, I say, “I am here to help, but anger fills the room. We do the evaluation to determine if patch testing is appropriate and then I tell them we will schedule their patch test appointment. “What, you are going to make me wait again?” “What is wrong with you?” I explain we do custom tailored patch tests and we now have to make them by hand for their son. Dad points at the nurse who has come in to tell me that the next roomed patient is now delayed, and we have three walk-ins in the waiting room pleading to be seen. I gently ask the nurse to tell the next patient I will be right there. Dad takes his son by the hand and storms out. I am beside myself. The desperate child looks back at me with sorrowful eyes (the first deliberate-eye contact of the appointment) – my heart breaks.

 

There are days when the graduates’ hugs are far more needed by me, than by them. (Graduates are the people who have learned their allergens, avoided them, regained control of their lives becoming rash free and informed.)

 

Unfortunately, it was the ‘same’ story every 30 minutes of my contact dermatitis work life. Nickel, balsam of Peru, formaldehyde, methylchloroisothiazolinone, cocamidopropyle betaine… yes there are also new emerging allergens, but if formaldehyde has been on Bonneville’s bad list for over 80 years, why are we not doing something about it? The answer was not to keep seeing the 1000s, but to reach the millions.

 

We formed the Dermatitis AcademyTM to reach the patients, reach the providers and grow hope in reaching the legislators. www.dermatitisacademy.com

 

The unmet need – supply and demand:

 

How many tertiary care centers in the US are dedicated primarily to patch testing? Now that is a good question!

 

The largest multicenter group of 15 dermatologists, the North American Contact Dermatitis Group tested 4,238 patients in 2011-2012 cycle, ~280 per provider). (2)

 

An estimated 60% of the members of the American Contact Dermatitis Society (ACDS) do comprehensive patch testing. In dermatology private practice, 83% of practitioners patch test fewer than 5 patients/month.   (3,4) Guestimating (and a likely overestimate) 150 centers nationally patch testing 50% of the time estimates 280 x 150 = 42,000 patients potentially being tested each year. If 80 million people are suffering with contact dermatitis (the prevalence rates are believed to be 24,400 cases per 100,000 individuals/yr) and only 42k are being provided with patch testing, then there is a huge unmet need for the diagnostic evaluation of allergic contact dermatitis. This deficit leads to high morbidity (conditions difficult to live with) and huge direct and indirect expenses (associated with allergic contact dermatitis) to the health care system (in the Billions). (5)

 

This best multi-faceted solution to the burden of skin disease caused by allergic contact dermatitis is routed in appropriate patch testing, appropriate access to properly trained providers, outreach in education for prevention and evidence-based safety regulation in manufacturing.

 

 

1) Jacob SE. Ciclosporin emulsion a novel treatment for benzyl alcohol associated eyelid dermatitis. Contact Dermatitis. 2008. 58: 169-170.

2) Warshaw EM, Moore JB, Nelson D. Patch-testing practices of ACDS members: a cross-sectional Survey. Am J Contact Dermatol 14:5-11, 2003

3). Scheman A. et al. Patch Testing An Underutilized Modality. Arch Dermatol 140: 1529-30, 2004

4) Warshaw EM, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015 Jan-Feb;26(1):49-59.

5) Bickens DR, et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006 Sep;55(3):490-500.

 

*names changed to protect the patient

helens story

What do hair dyes & cosmetic cream preservatives have to do with hip replacements anyway?

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helens story

For Helen D., resident of Miami, Florida, the relationship is too close to home. Helen suffers from a disease called allergic contact dermatitis (ACD), which is an allergy to chemicals in the environment. It is a preventable and (through avoidance) treatable disease, yet many people suffer for decades. Others are treated with oral or injected steroids, such as prednisone. While this may make the dermatitis resolve, it is all too great a reality that it returns as the medicine wears off, requiring further treatment. These treatments are not without side effects, and serious ones at that! Steroids can damage the eyes, raise blood pressure, induce diabetes, and even destroy bones. So why not just see the doctor and get cured? It should be that easy, but it can be difficult to diagnose without the appropriate testing tools and expert evaluation.

 

Helen’s Story

“I have had sensitive skin and allergies “all my life” and have taken allergy medication and shots. I experienced eczema and even had numerous skin cancers removed. To top it off, I am a breast cancer survivor of thirteen years, so I have had my share of medical issues to deal with in my fifty-seven years.

 

Nothing, however, prepared me for the experience I would be thrust into in February 2003. I was prescribed a well-known statin drug, and after a few days of taking it my face began to itch and rash. On the fifth day I woke up looking like a monster with a bright red, swollen, and indescribably itchy face. I called the General Practitioner who had prescribed the medication and was informed they could not fit me in. I informed them I WAS coming in, and when they saw my face, I was sure they WOULD see me. When the medical assistant slid open the glass door into the patient waiting room, his eyes widened in disbelief with a hint of horror; a look I was to see many times over the next few years from those who witnessed me in a major flareup or saw my “show and tell” photos I took to all appointments for the next two years. The doctor gave me a shot of cortisone and a prescription for a prednisone dose-pack. Over the next few days, the red, swollen and itchy skin was replaced by parched skin that had the consistency of sandpaper and then miraculously turned into clear, fresh dewy looking smooth skin, thanks to steroids.

 

Thus began a two-year sentence of tortuous skin eruptions and an emotional roller coaster ride. I experienced severe flare-ups, often several times a week. The flare-ups would begin with an itchy face and very rough skin. Then the skin would begin to feel raw and burned, and most ointments or creams felt like pouring alcohol on an open wound. The next phase was peeling, parchment-dry, sandpaper skin that no cream, moisturizer or diaper ointment alleviated. One dermatologist prescribed a soothing mask of fresh cold yogurt followed by Crisco, which provided short-term relief. Several times I was given antibiotics when the inflamed skin became secondarily infected. Despite vast quantities of Benadryl, prescription antihistamines and creams, nothing helped except steroids.

 

I began my long journey seeking help within the medical community, first seeing my allergist. After seeing my inflamed face, sometimes with bright red circles around my eyes several times, the doctor diagnosed ”allergic contact dermatitis” or ACD,not hives as I had assumed. This was my first introduction to the name of this hideous disease. By March, I had seen my dermatologist and allergist several times and found an endocrinologist, who after many tests, told me I had a compromised immune system, a sluggish adrenal system, and was possibly pre-auto-immune though did not test positive. He put me on a regimen of 10 mg of Medrol (prednisone) for three months and told me it was dangerous to be on longer than this and would also make me gain weight (how true!).

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After I was off the prednisone for the appropriate time, my allergist performed a T.R.U.E. Test® (Allergen Patch Test) test, which yielded no results. Perhaps this was because a medical assistant, uneducated in proper patch test reading techniques, administered the test. Also, I was never told to come back on Friday, after the assistant removed the patch on Wednesday. I was still in the dark about what was causing my flare-ups, which continued week after week.

 

I never knew when I accepted a social invitation, if I would really be able to attend. I missed numerous days at the office, hiding my face or seeing doctors. After many months, I let more and more friends and colleagues see me in a flare up. Often I would burst into tears upon waking up in a full fledged flare up, knowing the impending cycle to come over the next four or five days.

 

My second allergist also administered a T.R.U.E. Test® (Allergen Patch Test) in August 2003 and discovered I was very reactive to a common preservative, Methylchloroisothiazolinone/ Methylisothiazolinone (MCI/MI). Knowing I was highly allergic to MCI/MI was a big help, as I could begin to examine everything in my medicine cabinet and extensive arsenal of makeup, hair and skin products. I eliminated products and carefully scrutinized all product labels before buying. I read the long list of ingredients on products looking for Methylchloroisothiazolinone or synonyms for MCI/MI.

 

Sounds fairly simple, but not so fast! I discovered by trial and error and my own amateur investigative work that MCI/MI is in most liquid fabric softeners and some liquid soaps. The ingredients are not listed on these products for competitive purposes. I had begun to notice that every time I went on a business trip and stayed in a hotel, I started to flare up by the second or third day. The dreaded itchy rash returned on my face often accompanied by swollen eyes, a portent of a full flare up to come.I carried “melt in your mouth” children’s Benadryl and would copiously pop them in my mouth at the first sign, to no avail. I carried tinted glasses,so when my eyes began to swell, I could cover them and still help ‘man’ the vendor booth for the company I partially own. When the flare up was bad, I would often call a doctor to get a prescription for a steroid dose pack to alleviate the problem and allow me to finish the trip sans major flare up. Then in August of 2003, we bought a vacation condo. The realtor left a big basket of cleaning products which included liquid fabric softener, something I do not use at home. Lo and behold, after two nights sleeping on the sheets and pillowcase, I began a flare up. This was one of the countless times I racked my brain to figure out what I was using that was “different” or “new” and the liquid fabric softener light bulb lit up!

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It was then I discovered that finding product ingredients when they are not listed on the product is not a simple task! The ingredients are not on company web sites and you must put in a request, either in writing or by email and eventually be contacted. You will NOT be provided with a list of ingredients, but will be told IF the substance you ask about is in the product. MCI/MI is in liquid fabric softeners (not sheets) from three major manufacturers I checked with. This is typical of the sleuth work that the patient must go through to eliminate known allergens!

 

Over eighteen agonizing months, I saw six dermatologists, three allergists and continued to see my endocrinologist searching for answers. I spent thousands of dollars on my portion of numerous medical tests, untold amounts of creams, OTC medications or supplements, acupuncture, products and devices, including an electric hand-held anti-itch device ordered from the Internet. Amazingly, the anti-itch device for $49.99 actually did provide some temporary relief! I switched to organic pest control in my house in an attempt to rid my life of unnecessary chemicals, and began eating organic food whenever possible. I went to a medical intuitive who told me my adrenal system was not working well but gave no good path to recovery. I even tried drinking fresh aloe to cleanse my immune system. At this point, if someone told me rubbing monkey dung on my face would solve the problem, I would have tried this too!

 

I was on corticosteroids for a 3-month period in 2003, a one-month period in 2004, had at least three cortisone shots and many dose packs. I vaguely knew they had a potential to be dangerous, but desperation and agony usually preceded my requests for this relief. I also knew people with asthma took Prednisone for years.

 

At some point during my odyssey, I realized via my Internet research that I needed extended patch testing. First I started asking the allergists and the six dermatologists, including one at the Cleveland Clinic, hoping they could either administer the extended patch test, or would know someone (anywhere!) who did. Nada! One allergist had provided the name of a doctor in NYC, whom I was unable to contact. After several months, I printed out a long list of Miami dermatologists from my insurance company web site and began phoning to ask if they performed extended patch testing. Most of the appointment schedulers did not have a clue as to what I was talking about, and I usually had to hold for a nurse, or be called back. Many phone calls later; I eventually hit pay dirt when I called the University of Miami Dermatology Group. The scheduler happened to ask a nurse in the presence of a resident. I was given the name of a contact dermatologist at the University of Pennsylvania. This contact became vital to my eventual diagnosis!

 

Coincidentally, or by the grace of God, I had a vendor show coming up in Philadelphia three weeks after getting the doctor’s name. It’s amazing what begging can do. The scheduler actually took pity on me when I told her my situation and fit me in May 2004, a full fifteen months after my first bad flare up.

 

In Philadelphia, The UPenn Contact Dermatologist was very compassionate, saying I must get help as my quality of life was suffering. What an understatement, but at last I had found someone who truly related to my plight! The doctor said he could perform tests in Philadelphia, but I might be more interested in a doctor on the west coast of Florida  and I eventually got a blessed appointment for August 4, 2004 in Ft. Myers, Florida.

 

On a Monday eighteen months after my first bad flare-up, the doctor administered an extended patch test and 206 ingredients were positioned on my back next to identifying numbers and covered with tape. I could not get my back wet for the five-day test duration. On Wednesday, the patches were removed for the first reading and I returned Friday for the second reading. Finally! I was given an extensive list of allergens and directions for following an “avoidance” regimen. Allergens included Bacitracin, Goldsodiumthiosulfate (Gold), Nickel, Fragrance Mixture, Methylchloroisothiazolinone (MCI/MI); Bromonitropropane Diol; Paraphenylenediamine Mix (Black Rubber) PPD; Dermatophagoides mix (Pteronyssinus/Pharinae) – house dust mites. Later, Tetracaine, 2.5 Diaminotoluene Sulfate and Ammonium Persulfate would be added to this list.

 

Gone was my gold jewelry, replaced by platinum, or silver or stainless steel tested for nickel content. No more hair color, as hair dye contains PPD, one of my major allergens. I changed many personal products including my laundry detergent, my toothpaste and looked for “fragrancefree” products that did not contain my allergens. The flare-ups did not entirely go away, but subsided immensely! On a follow up visit, several months later, I gave my doctor a big hug, telling him he had given me my life back!

 

My sixth dermatologist informed me in December 2004 that thankfully, Miami now had a dermatologist specializing in allergic contact dermatitis! This was my introduction to Sharon Jacob, MD, Assistant Professor of Clinical Dermatology at the University of Miami, who has been so important in my diagnosis, education and understanding of Allergic Contact Dermatitis. Ironically, that resident in clinic who directed me to the UPenn doctor in the first place had been Dr. Jacob. A marvelous touch of fate provided the help I so desperately needed.

 

Through Dr. Jacob, I am still learning new ways to avoid allergens each and every day. I learned additional products to avoid. I learned I needed to purge all products from my life that were not “fragrance free.” I had not been strict about “fragrance free”, and consequently when I got serious, I eliminated a large shopping bag full of products from my home. I learned the term “unscented”means yet another chemical has been added to the product to mask the scent. Read product labels and you will see chemicals upon chemicals upon chemicals.

 

Chemicals have proliferated in our society at an alarming rate. PPD (Paraphenylenediamine) is a good example. Per Dr. Sharon Jacob,“many temporary tattoo artists mix PPD with ‘natural’ henna to give it a brown-black color and to accelerate the fixing time of a temporary henna tattoo. Henna use/tattoos are a growing fad in the under 18-year-old population, as parents generally permit this type of tattooing. Furthermore, occupational and environmental exposures are diverse, as it is also present in black rubber, scuba gear, photographic developers, printing inks, and textile & fur dyes. Important also is the notable cross reactions PPD has with other compounds with para position benzene rings (para-amino benzoic acid (PABA), as in sunscreens, sulfonamides, sulphonylureas, azo dyes for clothing, and ester anesthetics). Because this allergen is on the rise, with new exposures entering the American cultural arena, it has been nominated for 2005 allergen of the year.”

 

Dr. Jacob also sternly warned me about the dangers of over-use of steroids, as I still had big flare ups when I stayed in hotels and had a prescription for a few more dose packs I would use in desperation.

 

Sadly Dr. Jacob’s warning came too late! I started having right leg pain around the middle of January 2005. I had just taken a yoga class, so I attributed the pain to a pulled muscle or tendon. The pain worsened, causing me to limp part of the time and have pain every morning. I saw two orthopedics in the beginning of February and one began the process of x-rays,bone scans and MRI’s.By the beginning of March,I was also having pain on my left side, walking with a cane, in lots of pain at night and severe pain in the morning. I still attributed this to a soft tissue injury, and went into major SHOCK when I was given my diagnosis in mid March 2005.

 

My Diagnosis –bilateral Osteonecrosis or Avascular Necrosis. Loss of blood supply to the bone or increased pressure within the bone causes the blood vessels to narrow; making it hard for the vessels to deliver enough blood to the bone cells and the bone literally necroses or dies.

 

My Probable Cause –off and on corticosteroid use for a two-year period.

 

My Treatment – complete hip replacement or hip decompression surgery for both hips!

 

I am now using crutches or painfully lurching around on a walker and seeking the best orthopedic surgeon to perform my needed surgery and treatment. When the pain is not too bad, I work on the computer from my house, as going into the office is difficult. Friends take me grocery shopping and my over-stressed husband is trying to run a business and take care of chores he never even dreamed of in the past.

 

In the 19th century, miners carried canaries in small wooden cages down into the mines. The little garden-variety songbirds served as sentinels for miners, warning them by dying or falling off their perch when toxic fumes were in the mineshaft. The cheerful birds were extra sensitive to poisonous gases, so they’d react to them well before the miners, who would then quickly evacuate. People like me with chemical sensitivities have sometimes been referred to as this century’s canaries. What is the proliferation of chemical additives in foods and products doing to our children, our environment and ourselves? Perhaps it is time to heed the warnings of the canaries!

 

My current orthopedic condition was AVOIDABLE and is a human medical tragedy I will have to make the best of. I am telling my story to prevent someone else from going through what I have, and what I face in the next year. There is a serious lack of education regarding ACD by lay people, doctors, and medical personnel. There is a serious lack of knowledge of the side effects of prednisone. And finally, there is a major lack of access to the patch testing modality. Had the majority of my allergens been diagnosed within the first six months, I would not have taken steroids for two years and would not be facing extensive surgery and orthopedic treatment. This did not need to happen to me and should not happen to anyone else.”

 

My Allergic Contact Dermatitis (ACD) Story is a portion of the Dermatitis Academy Blog that highlights real life, user submitted, allergic contact dermatitis journeys in an attempt to provide awareness and encouragement regarding this crippling disease.

 

For more info on allergic contact dermatitis or how to get tested (patch tested), please visit our home page here.

Infographic by Peter Gust

Owen’s Story – Parents Speak Out About Allergic Contact Dermatitis and Patch Testing

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“My name is Lisa. As a sufferer of contact dermatitis (triggers still unknown) and the mother of a child with contact dermatitis (confirmed by patch testing), I’m a strong proponent of thorough, accurate patch testing available to all. First, as a preface, my 9 year old son (Owen), is allergic to corn by both ingestion and upon contact. He has been since birth, though the contact part began later at age 3.5 years. I feel it necessary to mention, in addition to and in reference to the discussion of contact dermatitis, because many food-allergic children also have contact dermatitis and eczema problems. Additionally, the corn allergy has and still makes deciphering his skin issues complicated.

Corn is in almost everything (food, health/ beauty aids, adhesives, preservatives, etc.) or used in the packaging of many things. As an example, the plastic coating on cheese is often dusted with corn starch to keep cheese from sticking to the plastic. Since Owen reacts differently to pure corn and its 110+ names (preservatives/derivatives), we blamed all skin/eczema issues on corn for the first 3-4 yrs of his life. Granted, corn allergy was still rare 10 years ago and is still not a common food allergy, though it is gaining momentum quickly.

Getting the corn allergy diagnosis was difficult enough without adding contact dermatitis to his on-going list of medical concerns . Our first Allergist kept saying he only had eczema because “textbook” hives don’t manifest with any of Owen’s food allergies unless he eats/ touches pure corn meal. His corn rashes were simply odd. We finally found 1 of only 3 Allergists in the St. Louis, Missouri (USA) area with experience in corn allergy, allowing us to move on to deciphering numerous skin issues which didn’t go away after removing hidden corn from his diet /personal care items. The learning curve was tremendous. It took almost 3 yrs because corn is used literally everywhere.

Gradually, we slowly learned all Owen’s corn exposure variations. Some derivatives only cause a certain type of rash. Some make him hurt all over, in addition to showing the rash. Some cause severe itching but no rash. Some cause full-blown hives. Some cause blisters upon contact. Some are GI/intestinal/skin-rash all at once. He never had “textbook” eczema, for which I’m grateful, though it would have made things easier for diagnosing purposes.

Again, the reason I provide so much food-allergy information above is because many food-allergic children also have skin problems. However, many kids with eczema can eat anything with no skin manifestations, thus giving rise to much confusion and frustration. There is a great deal of misinformation available referencing the overlap of food allergy and contact dermatitis.

Our problem is some of these weird rashes were on Owen’s face, hands, and bottom. Some of these were noticeable and led to other kids teasing or asking about his face and hands. Or it hurt, as was the case with his bottom, whenever it touched a toilet seat. The raised rash that itched on his bottom would often burn, and it was always where the ring of the toilet seat touched his skin. What pushed us over the edge was at age 8 (March of 2015), Owen developed perioral dermatitis on his face. This condition is unusual except in 20-yr old-ish girls or pre-pubescent boys (with or without other skin issues). The usual medications didn’t help though. Certain medications actually made it worse. Others made it burn, dry, or crack. Nothing made sense or cleared it completely for months.

We finally got lucky with a 3rd attempted antibiotic, plus 2 topical medications, though it was still a very slow process of healing. However, we are lucky enough our Dermatologist is located in one of only 2-3 practices in St. Louis to offer detailed patch testing. Once we cleared Owen’s face (a process taking 4 months, forcing him to go to school regardless of how bad it looked), our Dermatologist and I agreed he’d had too many strange rashes to keep thinking it everything was corn-related. She also thought he’d dealt with enough in his young life and wanted him to avoid more heartache, as she was suspecting more would pop up if we didn’t investigate further.

Luckily, during this mess, Owen had a long virus & missed 7 days of school. While out of school, his dry, cracked hands (which had come and went all winter) healed completely. However, after just 1 day back at school the redness, dryness, and burning returned. This told me the school soap had to be a trigger. His Dermatologist already knew about his hand problem from one of our 2-week check-ups for his perioral dermatitis treatment, so we immediately scheduled patch testing, knowing we had another piece of HIS personal skin puzzle.

I do not have the chemical names of all 6 allergens he tested positive to, but 2 of them are in the Glucoside family, and 2 of them are in the Paraben group. He also is allergic to 2 metals: Nickel and Copper. At the time the test results were given to me, I remember being shocked it was only 6 positive patches. Why wasn’t there more to explain all of his strange rashes? Then I read where those 6 occur—-Nickel is very common. However, he wore active pants most days instead of jeans, thus we rarely saw rashes that low on his torso. Then I learned the two glucosides are common in almost every soap/shampoo/personal care product I had in my home. The two parabens are common in many lotions, even the lotion our Dermatologist had prescribed for us to use on his face while it was so dry/cracked from the perioral dermatitis occurrence/treatment period. She felt horrible about that, as it had to have slowed the healing process, possibly even exacerbating the problem. In retrospect, we both think his face was struggling to heal because we were constantly putting his allergens on it three times a day.

Fast forward one month. We switched all products to those known to be allergen-free for Owen. He took his own soap to school in a pocket each day. He used his own soap at home, & we even clean his bathroom with safe products that won’t irritate his bottom. We have a strict rule in our house about what to use to clean toilet seats! After all was done, our Dermatologist said Owen changed the way she views contact dermatitis & eczema, especially non-textbook, strange manifestations of eczema. She said part of the problem is there are 200+ ashes considered “eczema”. It’s not just one thing and is often a “catch-all” term for the unknown rashes.

Therefore, she now thinks every child with any atopy (allergy) issues and combined skin problems of any sort, or contact dermatitis, and/or even “textbook” eczema (because of the food allergy overlap) should be patch tested to see if the products supposedly treating the skin is actually making it worse. Even if there is no history of food allergy or contact allergy, she thinks patch testing could provide knowledge of skin allergens parents would have no way of knowing might be making matters worse. This tailors the treatment to each child’s personal skin/atopy profile. It’s very likely some day-to-day products could be causing the weird rashes that aren’t consistent between children, as skin problems are extremely individual. In summary, thorough patch testing could provide answers many of us have been seeking for years.

—-Lisa Williams (Mother to Owen Williams, 9 yr old son); Written on March 27, 2016″

Infographic by Peter Gust

 

Parents Speak Out About Allergic Contact Dermatitis (ACD) is a special category in the Dermatitis Academy Blog where passionate parents reveal a personal look their family’s journey in dealing with ACD and the role of patch testing.

 

Please visit our home page HERE for more information on allergic contact dermatitis and patch testing. Please share this post in order to create awareness for this seldom considered, but highly relevant disease process.

My ACD story...

Propylene Glycol Struggle – My Allergic Contact Dermatitis Story

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My ACD story...

User allergic contact dermatitis story submitted on 2/23/16:

“I was diagnosed with my propylene glycol (PG)/polyethylene glycol (PEG) allergy by patch testing in April 2014.  My skin problems, however, go back to June 2013 when I was misdiagnosed with “postmenopausal atrophic vaginitis”.  In reality, I believe I was reacting to an over-the-counter lubricating “warming gel” containing PG that inflamed the sensitive vaginal area.

 

During a four month period, my ob/gyn prescribed three different topical estrogens for me (Premarin, Estrace, Vagifem), all containing PG or PEG, in an attempt to restore lubrication to the area.  While using the Vagifem tablet (PEG), I began to bleed and an endometrial biopsy was performed.  The results came back negative and I decided to discontinue the estrogen and seek out a new dermatologist to help clear up my red, irritated skin.  This new specialist diagnosed me as having “lichen simplex chronicus” (thickened skin as a result of chronic itching and scratching), even though I told her my skin DID NOT itch and I WAS NOT scratching it!  This dermatologist prescribed a very strong topical steroid compound–Clobetisol Propionate with zinc oxide.  Clobetisol Propionate is another PEG medicine.  Over a four month span, my skin improved very little, but I was told it “takes a while for the steroid to thin out the thickened skin.”

 

Finally, at the end of February 2014, I suffered a tremendous allergic reaction.  My entire body felt sick and my skin was red and swollen with pus-filled blisters.  This reaction was caused, I later found out, by a mistake by the compounding pharmacy that was making the Clobetisol Propionate compound.  Instead of using the CP OINTMENT, as was prescribed, they used CP CREAM which contained twice as much of the glycols!  Following this allergic reaction, I consulted a new dermatologist who put me on Prednisone and recommended that chemical patch testing be done.  Several weeks later, I was given the NAC-80 (North American 80 Comprehensive Series).  I reacted positively to only PG, nickel and gold.  (Nickel and gold, however, do not give me significant problems).  These results helped me to get my life back again!  Avoiding propylene glycol is a daunting task, but at least I know what I’m dealing with now.  To me, it is unfathomable why doctors would wait so long to recommend patch testing when their treatments are not working.  It is needless suffering for the patient.”

 

My Allergic Contact Dermatitis (ACD) Story is a portion of the Dermatitis Academy Blog that highlights real life, user submitted, allergic contact dermatitis journeys in an attempt to provide awareness and encouragement regarding this crippling disease.

 

For more info on allergic contact dermatitis or how to get tested (patch tested), please visit our home page here.

Infographic by Peter Gust