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Why Benedryl isn’t the Optimal choice for Allergic Swelling

I have been seeing a lot more cases of swelling, or the medical term is angioedema over the past month. Angioedema can be easily treated and reversed with the proper medication- but Benedryl is not the best choice. Why? Angioedema involves the swelling of the deeper soft tissue in the body and antihistamines, such as Benedryl,  Claritin, Allegra or Zyrtec don’t have the ability to fully reverse this type of inflammation.

The location of the swelling should help your doctor determine if the cause of your angioedema is allergic, or due to another medical condition. For example, swelling of the lips, face or eyelids in many cases is due to an allergic trigger. One of the most common causes of angioedema in these locations is a food allergy. I typically hear a story where a patient has eaten at a restaurant(many times an Asian restaurant with various sauces) and within an hour the allergic reaction involves the lips or tongue, but can also affect the face or eyelids- think of Will Smith after he ate peanut in the movie Hitch.  For these type of allergic reactions that are not obvious, food allergy testing through the blood or simple, non-invasive skin tests can provide the answer to prevent future reactions. Another common cause of swelling in these areas can be a contact dermatitis allergy. This is where a person touches a product that gets transfered from the fingers to the face and can trigger intense swelling. A recent example I just saw in the office was a woman who started coloring her hair to get the grey out. She put the home product of hair color on her scalp on Friday, and by Sunday her eyelids were swollen so badly she could hardly see! This is an example of what we call a delayed allergic reaction- meaning, the allergic swelling doesn’t take full effect until 48 hours after the application. My office does skin patch testing which is safe to determine which chemical in the product caused the reaction. The other main cause of angioedema can be medications themselves. I have seen in my New York allergy practice several cases where common drugs like Aspirin or Advil have caused the reaction. Another well-known cause of facial or neck angioedema can be from the blood pressure medications called ACE-inhibitors. This class includes popular medications, such as Diovan.

The non-allergic causes of angioedema can be Hereditary Angioedema. This can be a dangerous cause of recurrent swelling involving the respiratory tract an cause asphyxiation. It also can be confused with Irritable Bowel Syndrome or Appendicitis, because the stomach pain can be very severe. There are specific blood tests that can be ordered called complement proteins which can diagnose if you have this disorder. The good news is that there is a replacement medication to prevent these attacks today. Non-allergic causes of swelling can be infectious and require antibiotics or autoimmune, such as in inflammatory arthritis.

To go back to my title: “Why Benedryl isn’t the best choice for Allergic Swelling?”: the answer is that oral cortisone in short courses can quickly reverse the deep swelling and make you look normal again. This a safe option because in most cases it is not needed long-term- and for that the key is a complete medical evaluation to determine the cause. I hope if Will Smith reads this article he will remember not to drink the Benedry but call his doctor for some cortisone.

Anaphylaxis (Allergic Shock): What anyone with a food allergy needs to know

Salads with multiple toppings can cause unexpected allergic reactionsThe medical name for allergic shock is anaphylaxis (ana-filaxis) and it can be a deadly form of allergic reaction. Anaphylaxis used to be most commonly associated with bee stings but today, food allergies are a much more common cause of this serious reaction. Read the rest of this entry »

Peanut Allergy: Exciting breakthroughs in diagnostic testing and treatment!

Peanut allergies can now be successfully treated.During my last 20 years as an allergist, the only advice I could offer to patients with a history of peanut allergies was to avoid peanuts and peanut products. Now, some new research has come out that may end our frustrations! Here’s what’s new: Read the rest of this entry »

Cat or dog allergies don’t have to end badly… Allergy drops can help!

Cat and dog allergies

This past week the American Academy of Allergy, Asthma and Immunology had their annual meeting in Boston. The Academy estimates that 40 to 50 million Americans suffer from asthma or allergic diseases. Asthma rates alone have more than tripled in 25 years, now affecting 22 million people. A recent article USA Today article titled, “Allergies triggered by ‘things we love’ are rising,” suggests that pets may be having an increased effect on out allergies. It is estimated that 90% of homes have significant levels of dog and cat hair – even in those homes that don’t have a pet! How can that be? Pet dander is easily transfered from pet owner’s clothing to other places they visit. Studies done in Scandinavia and here in the USA have shown that school children without pets still had a measurable amount of pet dander in their home, transferred to them at school from classmates with pets at home.

Read the rest of this entry »

Halloween and Candy Allergies: We are ready to help you take the fear out this fun holiday

trick or treating can be allergy-free

CBS News ran a story today about problems children have with food allergies, particularly tree nuts and peanuts, when they go trick-or-treating on Halloween, and how to take precautions against a reaction.

In our NYC Allergy practice, I see a lot of kids with food allergies, but I have not found a case where a child couldn’t participate in this fun Halloween event if some reasonable ground rules are set before the fun of collecting candy begins. Read the rest of this entry »

Ouch! I just got my Flu shot…. but here’s 5 reasons I’m glad I did:

Flu shot!In my New York City office, I’ve noticed several patients are developing upper respiratory infections – nothing severe, as this is common in October and November with the change in weather. In many cases, I just prescribed nasal sprays, only a few patients required antibiotics for bronchitis or sinusitis. But this reminded me that flu season is just around the corner… and this is the optimal time to get your flu shot. Read the rest of this entry »

Mosquito Allergy: Sometimes more than just a nuisance

mosquito repellent coilsMore water means more mosquitoes

I’ve noticed that everyone lately is complaining about Mosquito bites. It seems Hurricane Irene brought with her more than just damaging floods. The excess water everywhere is a breeding ground for mosquitoes. Normally, mosquitoes wouldn’t be a major topic of discussion, but with West Nile virus being reported in our area, Read the rest of this entry »

Hurricane Irene and Its Effect on Allergies

hurricanes effect on mold allergiesIt’s amazing what a difference a day makes.The past two days were ominous with the winds blowing and the Hurricane swirling, and today we had the picture perfect day for weather. The good news for most of the east coast is that Hurricane Irene caused less damage than expected, but that may be of little solace to those of you who are cleaning up the debris from fallen trees (I lost my favorite big oak tree in my backyard) and wading through the water damage from the flooding. Read the rest of this entry »

Am I really Allergic to Penicillin? Can I be tested? Does it matter? Yes or No, Yes and Yes!

Allergists New YorkWhen I take a medical history on patients that come to my office in New York or Long Island for various allergic problems, I always review their drug allergy history. A large portion of my patients that have a history of a childhood reaction to Penicillin, and have avoided using this antibiotic for decades because they were told they could have a severe reaction if used again. The truth is that many of these patients probably no longer are allergic to Penicillin and are avoiding its use without cause. Read the rest of this entry »

Sunscreen Allergy and New FDA Labeling

NYC AllergistA lot of attention has been focused over the past week on the new guidelines of sunscreen labeling. Current SPF ratings for sunscreens only reflect the protection against UVB light, which determines how long a person can be in the sun before burning. The higher the rating, the longer a person can stay in the sun. The new guidelines, which will take place over the next 12 months, will require sunscreen labels to be more clear.

Here are a few key points: Read the rest of this entry »

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Allergy Relief
Why Benedryl isn’t the Optimal choice for Allergic Swelling

I have been seeing a lot more cases of swelling, or the medical term is angioedema over the past month. Angioedema can be easily treated and… read more

Anaphylaxis (Allergic Shock): What anyone with a food allergy needs to know

The medical name for allergic shock is anaphylaxis (ana-filaxis) and it can be a deadly form of allergic reaction. Anaphylaxis used to be most commonly associated… read more

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