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Dark Skin Discoloration

There are dark skin discoloration disorders that we can effectively treat with homeopathy, traditional pharmaceuticals, surgery, and other non-traditional techniques and many conditions whose symptoms also include dark skin discoloration that are the result of significant advanced disease processes. This article focuses on those conditions whose treatments have known efficacy. To begin, the agent within the skin that provides coloring is melanin.

This color agent stimulates production of skin changing coloring in the epidermal and dermal layers of our skin. This pigment also protects the skin from sun exposure. Persons with darker skin have more melanin then persons with lighter skin but all skin needs oxygenation, lubrication, protection, and maintenance.
There are specific dark skin discoloration conditions listed below that have diagnosis and treatment of these conditions included.

Ultraviolet Rays & Sun

Types of Discoloration

Age spots, birthmarks, freckles, and pigmented moles, or nevi may result from aging skin. Additional melanin in the fascia activated by our genetics, continued unprotected, exposure to ultraviolet light, tanning and light machines can damage these layers causing specific dark skin discoloration. Although the sun’s ultraviolet rays provide our bodies with the ability to create Vitamin D, essential for our healthy homeostasis, the average individual only requires approximately 12 minutes of this exposure for sufficient production of Vitamin D. When this ultraviolet light contacts the skin, melanin reacts to protect our bodies and changes color.

This color change can cause burning or tanning of the skin but long-term effects can result in age spots, fine lines or wrinkles, aging the skin prematurely. Freckles and other types of hyperpigmentation, or accelerated melanin production in the fascia may also occur from long- term ultraviolet light exposure. Regular and extended tanning and light machine exposure beyond the body’s ability to produce melanin may also result in a higher risk of skin cancer and sun poisoning.

Persons born in arid areas in the world have additional melanin production to protect them from exposure to those rays for longer periods; however, persons of European American descent with lighter skin have less genetic protection from sun exposure. Tanning facilities are just as harmful for the layers of our skin as the sun’s rays in that these tools emit ultraviolet rays, hence the need for eye protection.

Diagnosis and Treatment

A Wood’s Lamp uses ultraviolet black light that does not damage the skin. You do not look directly into the light though for assured protection. This examination detects excessive discoloration as well as dry patches resulting from poor hydration. The lamp used in cosmetic facilities, can provide individuals with the opportunity to remain proactive in treating dark skin discoloration and damage. The Wood’s Lamp test often takes place in a dark room in a dermatologist’s office. The lamp, positioned four to five inches from the skin, exposes the epidermal layer of the skin discoloration for treatment. Specific proactive treatments include limiting exposure to ultraviolet rays, lubricating the skin with tanning protection lotions or homeopathic options such as green tea, black tea gel, tomatoes, and broccoli extract.

Homeopathic options have organic ingredients that maybe less harmful to the body than over-the-counter sunscreen protection products. Green tea is high in polyphenols that are believed to provide protection from ultraviolet or UV radiation.

The side effects of green tea in high doses are caffeine’s effect on the body in that caffeine can be absorbed into the skin in small amounts. Ingesting the green tea also, helps protect the body from sun exposure but caffeine can accelerate the body’s metabolism producing raised blood pressure in persons with uncontrolled hypertension.

Black tea gel, recently examined in the International Journal of Cosmetic Science (Dec. 2007) applied the gel to the skin of six subjects while exposed to artificial UV light. The study found that the skin was unaffected by the ultraviolet rays for four hours of sun exposure. This black tea gel may also allow for the absorption of small amounts of caffeine within the body so person sensitive to these effects may need to try alternative solutions.

Broccoli extract is rich in an antioxidant called sulphoraphane that studies have shown to protect against redness and inflammation caused by UV exposure. The sulphoraphane is absorbed into the body’s cells and protects against UV damage three days after application.

(Talalay et al) These anti-cancer fighting agents as well as tomatoes, high in carotenoids, appear to provide the body with natural sun protection. Over-the-counter, pharmaceutical sunscreen with 30+-sun protection is recommended by WebMD.com. The site indicates that products over 30+ do not offer much more protection. When purchasing a product look for water/sweat resistance with titanium dioxide and zinc oxide as well as a chemical called avobenzone recommended for curbing sun exposure to the skin. When using these sunscreen products look for a “broad-spectrum” coverage from UVA and UVB rays. Some consumers may have allergic reactions to these products resulting in skin irritation or rashes. It is best to apply any product to the inner arm prior to application to determine any adverse affects on the body.

Melasma

Types, Definition, & Alternative Names

Melasma or Chlosma-mask of pregnancy is a tan or dark skin discoloration, commonly occurring in pregnant women who are taking oral or patch contraceptives or hormone replacement therapy pharmaceuticals. This skin discoloration is also prevalent in men and women of Native American decent, German, Russian and Jewish Descent. The symptoms are dark, irregular areas found on the upper cheek, nose, lips, and forehead; they develop gradually, and do not cause any other symptoms.

Melanin production, as previously discussed, is stimulated by the hormones estrogen and progesterone, in this instance. Women of lighter skin are more susceptible when in regions of intense sun exposure. In the latter case, genetics are a major factor in developing melasma. Some rare causes of melasma result from allergic reactions to medications and cosmetics.

Diagnosis and Treatment

Melasma like sun exposure is diagnosed with the Wood’s Lamp as well as visual examination. However, melasma appears to disappear spontaneously over several months after childbirth or the cessation of oral contraceptives or hormone replacement therapy. Treatment consists of accelerating the fading of the discolored areas. Although hydroquinone, a skin bleaching ingredient, was banned in the U.S. in 2006, this topical product is common in Asian and African markets as well as the United States in an over-the-counter cream containing 2% or less of hydroquinone.

The ban developed from greater concentrations of HQ applied to the skin causing burning and permanent discoloration. Hydroquinone, is dispensed in 2 to 4% ratios to control its reaction to the skin. The chemical HQ inhibits an enzyme that produces melanin. However, HQ is not recommended for use while pregnant. In addition, a facial or chemical peel with alpha hydroxyacids is an effective accelerant. In instances of genetic predomination of dark skin discoloration, laser treatment has been effective.

If the melasma has moved deeper into the layers of skin, dermal, a Fraxel laser can reduce the appearance of the discolorations. For any of these treatments strict avoidance of sunlight is mandated because additional sun exposure can stimulate melanin production despite pharmaceutical or laser intervention. Another common temporary treatment is cosmetics that can reduce the appearance of melasma

Classic Kaposi Sarcoma

Types, Definition, & Alternative Names

Classic Kaposi Sarcoma or KS can occur in older people of the Mediterranean, Eastern European, and Middle Eastern descent and is more common in men than women. Individuals usually have several dark patches on the legs, ankles, or soles of the feet. These lesions do not grow quickly or develop as often. Classic Kaposi Sarcoma is an immune system disorder that can be affected by age. The KS is a herpes virus infection that is endemic to the human population and can hide and reoccur in the body because of stress, illness, poor dietary healthy, and UV exposure and vitamin deficiency.

There is classic and epidemic KS; the latter common in the United States is AIDS-related KS. The skin discoloration symptoms are similar in both classic and epidemic KS but epidemic Kaposi Sarcoma is a symptom of a serious immune deficiency that invades and shuts down other organs in the body.

Diagnosis and Treatment

Diagnosis for classic KS usually occurs with skin biopsy and blood testing for IL- 1 beta protein found in persons with herpes virus infections, (J Immunol. 1992 Jul.). The treatment includes gene transcription therapy with growth factors. These growth factors, naturally synthesized homeopathy, signal polypeptides to bind cell receptors from allowing continued lesion growth. There are no known side effects of this procedure. Electromagnetic signals have also been known to disrupt cell growth and are radio frequencies administered specifically to pinpoint particular cell growth. The patient is treated for several months with these growth factor signals.

Treatment of the HIV related KS consists of antiretroviral therapy resulting in fewer cases of epidemic KS. In countries where this therapy is not available AIDS patients with epidemic KS quickly advances and causes death in six months.

Hyperpigmentation

Types, Definition, & Alternative Names

When hyperpigmentation occurs in women with darker skin tones it is often from acne inflammation, scratches or abrasions, insect bites and over exposure to the sun. Women of color will see skin discoloration around the joint, knees and elbows as well as the eyes. This discoloration can remain long after the outbreak. These color changes from acne called post-inflammatory hyperpigmentation, are more common than scarring but may take years to disappear. They appear to be more common in persons of Hispanic, Middle Eastern and African American descent but can occur in Caucasian persons as well.

Diagnosis and Treatment

As mentioned earlier, visual examination is a typical diagnosis tool but it is best to contact a dermatologist for persistent or reoccurring acne at its onset. Chemical peels, microdermabrasion, and topical skin treatment options are recommended. Chemical peels remove the epidermal or outer layer of the skin. This technique is excellent because there is less risk and less recovery time however, several peels may be required to alter the discoloration and it can be painful.

Microdermabrasion uses aluminum oxide crystals as an abrasive element to the skin and is preferred because it is a painless. This technique often requires up to 15 treatments to remove hyperpigmentation so it can be an expensive procedure. Many topical pharmaceutical skin products have the hydroquinone-bleaching agent as previously described, that will lessen the appearance of dark discoloration. Homeopathic treatments such as aloe, vitamin E, rose oil, and lemon balm are also effective at lessening the appearance of dark discolorations but both pharmaceutical and homeopathic products can cause allergic reactions in the sensitive skin areas on and around the face.

Acanthosis Nigricans

Types, Definition, & Alternative Names

Hyperpigmentation or increased melanin production in men and women of color can leave dark blemishes and patches on the neck, armpit, under the breast, and in skin creases. These skin changes may appear over months or years and occasionally cause itching or pruritis. Its onset can occur at any age and is prevalent in persons with darker skin. This hyperpigmentation also known as acanthosis nigricans can be a sign of too much insulin production in the body.

Diabetes or obesity can cause this over production of insulin to trigger melanin production in skin cells. Acanthosis nigricans may also be genetic and can be activated from too much niacin, oral contraceptive use, and hormone level changes.

Diagnosis and Treatment

Since this condition can be a symptom of type 2 diabetes and obesity your doctor or naturopath may require testing for fasting blood sugar and insulin production. There is no specific treatment for acanthosis nigricans; however, improved diet and life style changes may encourage these skin changes to fade without treatment. Dietary changes as well as weight loss can alter the body’s excess insulin production. Products containing vitamin A, such as the pharmaceuticals and over-the-counter remedies containing HQ, as mentioned previously can aid in treatment but can cause allergic skin reaction.

Homeopathic vitamin A supplements and fish oil can be effective in reducing the appearance of dark skin discolorations as well with fewer side effects. Topical creams of vitamin E, Aloe, lemon balm, rosemary and lavender can ease pruritis and encourage patch fading.

Vitamin Deficiency

Types, Definition, & Alternative Names

Vitamin and mineral deficiencies within the body can cause brown skin discoloration, darkening of the skin-folds around the elbows and knees, red and brown skin discolorations that later may ulcerate as well as warts and moles.

Some of the vitamin deficiency culprits include vitamin E, C, A, B12, Niacin, Manganese, Calcium, Zinc, and Folic Acid. These deficiencies have no age, race, or ethnic boundaries in that most of our vitamin and mineral supplement is derived from our foods. Countries who have less access to fruits and vegetables may be more prone to these deficiencies. For most people, vitamin and mineral deficiency results from poor food choices, the body’s inability to absorb certain nutrients from foods and pharmaceuticals that may block the body’s absorption of vitamins and minerals.

Diagnosis and Treatment

Diagnosis generally consists of blood work by your doctor or analysis of the iris, tongue, fingernails and skin of your homeopath. Treatment must include dietary foods that contain the needed vitamins and minerals. It may also require the additional boost of daily multi-vitamins and general immune system builders such as Echinacea, Acai fruits or teas and grape seed extract. Vitamin A should be taken in moderation as it may slow the absorption of other vitamins and minerals.

Some homeopathic doctors and holistic physicians may prescribe injections for extreme vitamin or mineral deficiencies. Many common fruits, nuts, legumes, fish, as well as other animal byproducts can provide the body with sufficient vitamins to cease the production of melanin in the body. As previously mentioned however, interim topical creams and cosmetic tinctures may lessen the appearance of these dark skin discolorations until our body absorbs a sufficient amount of minerals and vitamins. Cosmetic and homeopathic body creams may be infused with the needed essential vitamins and then applied to the skin to enhance the effect of the mineral and vitamin intake.

References

WebMd
Mayo Clinic

Halitosis, or bad breath, is a combination of the Latin word halitus meaning “breath” and the Greek suffix “osis” which means “afflicted with” or “condition.” The word itself was actually coined by Listerine in 1921 as part of an advertising campaign. It is not a modern affliction but one that can actually be traced back as early as 1550 BC. Early Roman records speak of a man who made his goat gargle with rosewater because of its fetid breath.

Halitosis describes any breath odor that is disagreeable, offensive or unpleasant. The term halitosis in used to describe a foul odor that may be noticeably present as an afflicted individual exhales. The smell may be from the mouth cavity or some underlying condition. In the case of 90% of the people, the odor is caused in the mouth.

Social Problems

Probably the worst effect of having halitosis, or bad breath, is the social and personal ramifications that may leave an individual feeling embarrassed or socially inept. A small percentage of people can have a chronic case of bad breath, which is more serious, and resulting symptoms of stress and depression may occur. Therefore, there are two types of halitosis, transient and chronic.

Halitosis is caused by what is referred to as volatile compounds (VCS) which are caused by anaerobic bacteria that are accumulating in moist areas of the mouth, the surface of the tongue, between the teeth, the back of the molars and below the surface of the gum line.

The tongue is considered a breeding ground for anaerobic bacteria because of the uneven surface. The results of this bacterial growth is a fetid smell caused by smelly compounds and fatty acids. The area of the tongue most likely to be the culprit is on the posterior dorsum of the tongue. This area of the tongue, towards the back of the mouth, is generally poorly cleaned in daily hygiene and bacterial populations can thrive there.

Underlying Conditions

Some conditions or artificial situations such as medication can lead to the propagation of VCS in the mouth.

Halitosis as a Symptom of Causal Conditions

• Alcoholism
• Bronchitis
• Diabetes
• Emphysema
• Gall Bladder Disease
• Herpes
• Liver Failure or Cirrhosis
• Obesity
• Pneumonia
• Sinusitis
• Tonsillitis
• Tumors
• Viral Infections

Halitosis as a Result of Medication

• Anti-Depressants
• Anti-Parkinson’s
• Anti-Psychotics
• Antihistamines
• Choral Hydrate
• Decongestants
• DMSO
• Narcotics

Symptoms of Halitosis

For the majority of people, halitosis is caused by poor oral hygiene, periodontal disease, gingivitis, gum disease, accumulation of food between the teeth or the eating of certain foods and drinks, such as cheese, garlic, onion and orange juice. Tobacco products can also cause bad breath. These types of transitory halitosis last between 48 to 72 hours. Other causes may be dentures, heavy metal accumulations, alcohol-based mouthwashes or a lack of Vitamin B or zinc.

Morning breath is another form of transitory halitosis and is caused by an accumulation of a thin coating on the tongue, teeth, gums and throat that has not been properly cleaned away. The sleep cycle actually mimics an anaerobic situation because saliva production is reduced and the surfaces of the mouth are susceptible to the formation of bacteria and VCS. Individuals who suffer either chronic or transitory halitosis may experience dry mouth, a sour or metallic taste, postnasal drip, or a white or yellow film on the tongue.

Misdiagnosis

Some individuals who think they are dealing with halitosis may be presenting with a symptom of a condition or disease. These types of malodorous smells should be brought to the attention of a health professional.

• Fecal breath odor typically accompanies an intestinal or gastrointestinal obstruction.
• Fruity breath odor is a side product of respiratory elimination of excess acetone.
• Ammonia breath odor or “fishy” breath is common in end-stage renal failure.
• Musty, sweet breath odor occurs with severe liver disease such as hepatic encephalopathy.

Diagnosis

The diagnosis of halitosis can be made by either a physician or a dentist. These healthcare professional will take a patient’s history and perform a physical or oral examination. Special consideration may be given to geriatric, pediatric or conditional pointers in the examination and diagnosis.

Treatment

While some healthcare professionals may recommend additional teeth brushing as a way to combat halitosis, others will contraindicate that process and state that brushing the teeth too often creates dry mouth, which in turn make the halitosis worse. Their recommendation is that brushing the teeth is limited to twice daily and saliva stimulation be increased to combat the condition.

Preventative oral care can decrease the incidence of halitosis. Cavities should be filled and periodontal procedures, such as scaling and planing, should be performed to reduce bacteria on the surfaces of the teeth and gingival cavities of the mouth. Additionally attention must be paid to the tongue. Many professionals recommend tongue scraping as a way of decreasing the odor of halitosis.

There are special techniques and equipment employed to help forestall the progression of halitosis or possibly halt it all togethe. A halimeter is a portable monitor that test for VCS or sulfur emission that may be used to determine causal effect. However, this monitor is not sufficient to test for all types of VCS. Gas chromatography is a more effective measure by a method of digitally measuring molecular levels of VCS. The BANA test is a directed means of measuring an enzyme present in bacteria populations, which results in halitosis.

Although these technologies have proven helpful, the best diagnostic test is the sniffing and scoring of the type and level of the odor. This is done by trained individuals and is assessed on a six-point intensity scale.

Home Care

The majority of healthcare professionals recommend the following methods for combating halitosis.

• Gently clean the surface of the tongue twice daily using either a tongue cleaner or tongue brush/scraper. Brushing a small amount of antibacterial tongue gel onto the surface of the tongue may help inhibit the growth of odor-causing bacteria.
• Chewing sugarless gum aids in the production of saliva and the saliva in turn helps cut down halitosis. Chewing gum is an excellent means of combating halitosis, especially when the mouth is dry or normal oral hygiene is not possible.
• Gargle before bedtime with the appropriate mouthwash. Mouthwashes and toothpastes can sometime counteract the efficacy of each other so it is advisable not to use mouthwash directly after brushing the teeth.
• Maintain regular dental visits. Teeth-cleaning, regular prevention and treatment of cavities is essential in eliminating the cause of bad breath.
• Floss regularly. Flossing eliminates bacterial growth and plaque that can accumulate in the interspaces of teeth.
• Dentures wearers should properly clean and store their dentures when not in use.

Self Diagnosis

Methods of self-diagnosis are to lick the back of the wrist, let it dry for a period of two to five minutes and then smell the wrist. If a malodorous smell is still detected, the person is at risk for bad breath. Another method is to scrape the back of the tongue with an inverted teaspoon and smell the resulting residue on the spoon. Most halitosis sufferers cannot detect their own breath smells and women have a more keen sense of smell than men do. If no odor is detected, a family member or friend may be pressed into service to help ascertain the existence of odor.

Diet

The elimination of certain foods may be beneficial in reducing bad breath. Foods high in sugar create a breeding ground for bacteria in the back of the throat. Acidic foods create the same type of environment for bacteria on the tongue. A reduction of high-fat foods, excessive amounts of meat. exotic spices and dairy products may be all that is needed to eliminate the bad breath.

A high number of transitory halitosis may occur when a person eats garlic, onions, and spices, such as curry. Blue cheese, Camembert, Roquefort and Limburger cheeses, canned tuna and anchovies and highly spiced deli meats should be avoided. These products can be smelled for up to 24 hours after ingestion.

Caffeinated beverages like coffee and tea are both very acidic and a change to clear water or organic peppermint teas may suffice in eliminating the halitosis.

Natural Treatments

There are a great deal of natural, home remedies that may be utilized in reducing or eliminating bad breath.

Food and Drink

• Chew mint leaves, basil or parsley for refreshment and cleansing of the breath.
• Drink a cup of hot unsweetened tea.
• Chew sunflowers seed at meals with a glass of water.
• Increase daily intake of water.
• Chew cloves or cardamom seeds after meals.
• A daily addition of yogurt for six weeks may eliminate the source of the bacteria.
• Drink either pineapple juice or a glass of water with the juice of a half of a lemon added.
• Eat apples. Apples can help freshen the breath.
• Coriander, rosemary, thyme, wintergreen, cinnamon bark, fennel or anise seeds can be slowly chewed as a breath freshener.
• Drink a glass of water with a teaspoon of apple cider vinegar mixed in before meals.

Other Home Remedies

• Before brushing, rinse mouth with hydrogen peroxide.
• Gargle with a mixture of baking soda and water.
• Gargle with warm salt water. An additional salt technique is to brush the tongue and teeth with sea salt at bedtime. Regular salt may lead to bloating. If an individual has issues with water retention, there are light salt formulations that can be substituted.
• Clean your toothbrush daily and replace it every month.

ESSENTIALS OILS
Tea Tree oil is a powerful disinfectant with antiseptic compounds. It can be found either in a tea tree enhanced toothpaste or an individual can simply put a few drops of the oil directly on their toothbrush, either alone or with regular toothpaste.

Natural gums with essentials oil of spearmint and peppermint are available in health food stores. It makes fresh breath easier to maintain while oral hygiene supplies are not available.

Lavender oil can be used as a gargle. A simple wash can be made with 4 ounces of water with 10 drops of lavender oil added. Lavender helps neutralize the odors.

Symptoms

A vitamin deficiency could be the cause of halitosis. A lack of Vitamin B can be corrected with 50 mg of niacinimide with meals. Supplemental high potency B complex and 50 mg of B6 daily can also be taken to help eliminate the problem. Vitamin C of 1,000 mg a day will help flush bacteria and mucus from the system.

A deficiency in zinc has been linked to halitosis. However, a daily zinc dosage of 30 to 60 mg should not be taken for more than ten days without a physician’s supervision. Zinc can potentially interfere with the absorption of copper.

Ayurvedic Treatments

There are traditional ayurvedic treatments available for the treatment of bad breath. Practitioners encourage the eating of areca nut and betel leaf as a remedy for bad breath. However, the betel nut can stain the teeth bright red when chewed. The Ayurvedic treatment of halitosis is aimed at treating and correcting the known cause for this condition. Skilled practitioners may treat dental hygiene issues as an outward manifestation of an internal condition. Infections of the gastro-intestinal and respiratory tracts may be treated with distilled tinctures and mouthwashes as well as powders and pastes.

Symptoms

Practitioners of acupuncture believe that halitosis is an imbalance in the body. The traditional Chinese medicine believes that bad breath is a sign of “Stomach Heat” which is an imbalance of the digestive system. As the name would suggest, stomach heat is too much heat in the stomach. This imbalance causes bad breath, gum disease, frontal headaches and mouth ulcers.

As is most treatments of acupuncture, extremely thin needles are inserted into various parts of the body to balance the yin and yang of creation and release blocked energy of the Qi force.

Myths and Misconceptions

A list of ineffective home remedies was released by the American Academy of Periodontology. While they may bring temporary relief, they do not remove the cause of the bad breath. These remedies are to be avoided.

• Alcohol-based mouthwashes.
• Sugary gums and chewing tobacco.
• Vodka martinis and sour mash whiskey. They are a drying agent for the mouth.
• Do not rinse the mouth out with kerosene.
• Tongue piercing increases the production of bacteria on the tongue.
• Colonic or gastric washes.

Mouthwashes

Favorite and recognizable mouthwashes may not be the best remedy for the individual with bad breath. Alcohol-based mouthwashes like Scope and Listerine can contribute to dryness of the mouth and actually acerbate the halitosis. It is recommended that all mouthwashes containing dyes be avoided.

Look for these ingredients in a mouthwash. If cetylpyridium chloride, zinc, sodium chloride or chlorine dioxide is listed on the label, these elements may act as an antibacterial agent that controls anaerobic bacteria in the mouth. Natural mouthwashes will generally contain essential oils for the control and retardation of anaerobic bacteria. In addition, a new water-oil two-phase mouthwash has proven effective in reducing bad breath in clinical studies.

Summary

While halitosis can be embarrassing, it is important to remember that the human body is engineered to recoil from certain smells because it detects some diseases and infectious conditions by this fashion. There is no shame in seeking help and resolution with an issue that may make an individual feel rejected or alone. Many of the remedies for halitosis are easy to obtain and simple to perform.

Earache is a common medical condition that causes the swelling and inflammation of the structures that makeup the ear. These structures include the tympanic membrane, external auditory canal and the middle ear. Although very common in children, earaches can occur in adults resulting in pain, fever and irritability.

An earache can also be a symptom of an infectious disorder or disease. Although not every ear pain is a reason for concern, it’s best to see a physician as self diagnosing and treatment can be dangerous if there is more harmful underlying condition. An acute ear infection is typically caused by an outer ear infection (external otitis) or middle ear infection (otitis media) while a reoccurring ear ache can be a symptom of a larger problem.

Types of Ear Infections

There are three main types of ear infections that can occur in humans. These are the otitis extern, otitis media and bullous myringitis.

• Otitis Externa: The otitis externa is a type of skin infection that affects the outer ear canal. This type of ear infection is typically the result of swimming, commonly known as ‘swimmers ear’.
• Otitis Media: Otitis media is a type of infection that occurs in the middle ear and the eardrum. This type of ear infection is typically seen in infants and adults but can rarely occur in older children and adults.
• Bullous Myringitis: Bullous myringitis is a type of infection that affects the ear drum. This type of ear infection is typically the result of trauma to the ear or a localized infection.

Symptoms

Each of the three mentioned types of earache conditions come with their own set of common signs and symptoms. Diagnosing the symptoms early on in the infection and visiting a physician for treatment can help to cure the infection before it becomes worse or damaging to ones hearing.

Symptoms of Otitis Externa Include:

• Earache that develops gradually verses overnight onset of pain and discomfort
• Mild itchiness sometimes accompanied by pain
• Worsening of the pain when the upper rim (helix) of the ear is touched or pulled
• Mild or severe loss of hearing
• Buzzing or ringing sound in the ear
• Feeling of stuffiness or block in the ear
• Swelling or inflammation of the inner and/or outer ear
• Thick drainage that comes from the helix and ear canal

Symptoms of Otitis Media Include:

• Irritability, whining, fussing or crying in infants and children
• Partial or complete loss of hearing
• Feeling of blocked or plugged ear
• Buzzing or ringing sound in the ear
• Fever or pain
• Discharge that appears when the eardrum ruptures
• Diarrhea or vomiting
• Lack of appetite or poor feeding in infants
• Unable to sleep or rest

Symptoms of Bullous Myringitis Include:

• Pain in the ear
• Fever
• Partial or full loss of hearing
• Bloody discharge that appears from the ear canal

Causes

Finding the cause of an earache will allow your physician to find the proper diagnosis and treatment fairly quickly. Causes of an earache can differ depending on your age, activity level and environmental factors.

Causes of Otitis Externa Include:

• Trapped moisture or fluid in the ear canal (example: swimmers ear)
• Minor trauma or scrape to the skin covering the ear canal (example: the tip of a cotton swab or small object can break the skin, allowing bacteria to enter)

Causes of Otitis Media Include:

• Bacterial or viral infection caused by a cold or upper respiratory infection which prevents normal fluid drainage from the middle ear
• Allergies
• Exposure to second hand smoke
• Infants can get an ear infection if fed while laying flat
• Family history of earaches or ear infections
• Abnormal anatomy of the neck or head

Causes of Bullous Myringitis Include:

• Trauma to the ear caused by a blow or inserted object
• Localized infection
• Pressure due to flying in an airplane or diving
• Exposure to a load sound or noise

Risk Factors

Eliminating or maintaining risk factors that can lead to an earache can help reduce the number of infections that occur. Age plays a major role in ear infections with over two-thirds of children experiencing an earache before they turn three. Boys are also more likely to experience earaches than girls. This is because infants and small children have ear structures that are still growing. As they age, their ears will enlarge and their immune systems will strengthen, fighting off these common childhood infections.

Risk Factors of an Earache Include:

• Allergies can cause inflammation in the ears that block airways
• Children exposed to other children (such as in a daycare) as respiratory infections can spread easily
• Exposure to second hand smoke can lead to acute earaches
• Bottle fed infants have a higher risk of acquiring an ear infection
• The use of pacifiers as a risk due to the production of saliva that leads to the spread of bacteria
• Obesity has been found in connection to otitis media

Prevention Tips

The prevention of earaches and ear infections can help to reduce the number that occurs each year, especially to infants and young children. Follow these simple prevention method to help stop earaches.

Prevention Tips for Otitis Externa Include:

• Gently dry the ears after swimming or when the ears come in contact with water
• Shake the head to remove any excess water
• Hold a hair dryer on low to dry out the inside ear canal (the hair dryer should be held at least 12 inches away from the ear)
• Wear earplugs while swimming
• Avoid putting your ears beneath the water line while in a bath tub
• Do not insert any objects into the ear besides q-tips (example: paper clip, fingernails, bobby pins, etc.)
• Avoid cleaning the ears frequently as they are mostly self-cleaning
• Removal of wax-buildup in the ears should be done by a professional under an otoscope
• Allow a health professional to remove any insects or other foreign objects that may have become stuck inside the ear

Prevention Tips for Otitis Media Include:

• Avoid children’s exposure to other children and adults with colds or upper respiratory infections
• Do not bottle feed an infant in a lying or flat position
• Consider breast feeding verses bottle feeding for a reduced risk of ear infections
• Do not allow a child to use a pacifier after six months of age
• Avoid exposure to secondhand smoke
• Keep children’s immunizations updated, especially for influenza

Prevention Tips for Bullous Myringitis Include:

• Avoid standing in front of speakers or other noises that give out loud sounds
• Be cautious while playing physical contact sports or activities to avoid a blow to the ear
• Wear earplugs or chew gum while flying in an airplane to help reduce the risk of your ears “popping”

Test and Diagnosis Considerations

If you think you may have an earache or ear infection, it’s essential that you visit a physician before the condition worsens. Diagnosis of an earache consists of taking a patient’s medical history, an examination of the ear and surrounding areas and various laboratory and hearing tests may be performed.

Use of Otoscope for Diagnosis of an Earache:

Otitis Externa: An otoscope can be used to diagnosis otitis externa as the ear canal will appear inflamed and swollen. Thick discharge may be present and the insertion of the scope into the canal will cause pain to the patient.

Otitis Media: An otoscope can be used to diagnosis otitis media as the physician examines the ear drum. Fluid bubbles and air may be present inside the ear drum and it may look red and inflamed.

Bullous Myringitis: An otoscope can be used to diagnosis bullous myringitis by inserting the scope to examine the ear drum. Small blisters filled with fluid may be present.

Hearing Tests for Diagnosis of an Earache

Hearing tests may be recommended for patients who have had reoccurring earaches or ear infections. They may also be used for children with a speech delay as this can be connected to an earache. During a typical hearing test, the patient may wear a pair of headphones and listen to various tone depths. If they are unable to hear some or all of the tones, they may have an ear infection.

Laboratory Tests for Diagnosis of an Earache

Drainage samples from the infected area are sometimes sent to the hospital laboratory to check for signs of bacteria. Laboratory tests are not typical for ear infection patients and are reserved for those individuals who do not respond to other treatments.

Treatment Options

The treatment of earaches commonly requires the use of antibiotics of self care remedies. Occasionally, a patient may need a surgical procedure performed to completely cure the damage done by an ear infection or ear trauma.

Home Self-Care for Earaches

Although ear infections should be diagnosed and treated by a physician, the uncomfortable symptoms caused by the infection can be treated at home. The use of over the counter pain relievers such as ibuprofen or acetaminophen can be used to reduce pain accompanied by the earache. A warm compress can also be placed against the infected area to help with pain control.

Medical Treatment for Otitis Externa

The majority of cases of otitis externa are cured with the use of prescribed eardrops for a period of seven to ten days. These eardrops contain a steroid and antibiotic to fight off infection and reduce inflammation and swelling in the ear. The drops are placed in the ear while the individual in lying on their side. The patient should remain on their side for a minimum of five minutes to allow the drops to enter the ear canal. An oral antibiotic may also be prescribed to keep the infection under control through treatment. During the treatment, the ear canal should be kept completely dry. Ear plugs should be worn for bathing, showering and swimming during this time.

Medical Treatment for Otitis Media

There are several treatments available for otitis media. Oral antibiotics are typically given to adults who acquire the condition for quick treatment. Observation is usually the only treatment needed for infants and children as most cases of otitis media in children will treat itself over a period of one to two weeks. For more severe cases of otitis media in children, follow up care may be needed resulting in antibiotics to cure the ear infection. Over the counter pain medications may be recommended to reduce the pain accompanied by the earache. A humidifier may also be used to moisten the air.

Medical Treatment for Bullous Myringitis

Treatment for bullous myringtis may include ear drops, oral antibiotics and symptom related pain medications. Bullous myringtis earaches usually resolve themselves in one to two days of treatment. It’s important not to stop the treatment before all the antibiotics are taken as the infection may still be present even if the symptoms are gone. A follow up may be recommended as well as a hearing test if symptoms do not subside. Your physician may refer more severe cases to an ear, nose and throat specialist for future examination.

One of the most terrifying injuries that can happen to a person involves suffering from amnesia. Imagine losing your entire memory, all of your life’s happiness and all of the pain; or imagine not knowing who your family is, or even who you are. Amnesia can affect anyone, at any age and at any point in his or her lives. Amnesia can be either the loss of short term memories or long term memories; or in some cases, even both. In addition, patients may have difficulties imagining what their futures may hold, as they may not be able to recall the plans or dreams they had before the onset of the amnesia. In general, there are two main forms of amnesia: Anterograde Amnesia and Retrograde Amnesia. A patient can suffer from either form, or in the worst cases, both forms.

Anterograde Amnesia

With Anterograde Amnesia, the patient loses the ability to create and retain new memories after the incident that caused the onset of the amnesia. This can also lead to difficulties recalling events that have happened in the most recent past, while memories of their distant past and long term events remain in place. Anterograde Amnesia remains somewhat of a mystery to physicians and neurologists, as the process of retaining exact memories is not yet widely known.

It is believed that there are two main causes of Anterograde Amnesia: drug or alcohol induced or as the result of a traumatic brain injury; however the condition has also been known to be the result of an emotional disorder or a shocking event. In one of the most common forms of Anterograde Amnesia, alcohol induced blackouts, studies have shown that with rapid increases in the blood alcohol concentration within a short period of time can severely impair the brain’s ability to transfer the short term memories into long term memories for storage and the ability to later retrieve them; this is what happens when you hear someone discussing how they are unable to recall the events of the night before.

Drugs and Alcohol Consumption

By drinking large amounts of alcohol either in a short period of time or on an empty stomach, one can have difficulty remembering the events of the time frame in which they were intoxicated, however once they have reached sobriety, their ability to create and retain long term memories is restored in full.

In addition to rapid alcohol consumption, using drugs that are considered benzodiazepines including midazolam, flunitrazepam, triazolam, nimetazepam and temazepam are known to have profound effects on one’s memory functions.

Similar to the effects of rapid increases in blood alcohol concentration, taking an excess of these drugs can impair the brain’s ability to create short term memories and transfer them into long term memories. In cases where the amnesia is either drug or alcohol induced, the patient can easily recover from it, usually after waking from their induced state.

Retrograde Amnesia

Individuals suffering from Retrograde Amnesia are often found to be unable to recall events that took place before the amnesia set in. In the majority of cases, Retrograde Amnesia is caused by a traumatic brain injury, possibly resulting from a fall or a car accident.

Those who suffer from Retrograde Amnesia can recover their lost memories, although some of the memories that one would had closest to the onset of the amnesia may never be fully restored. It has been described as feeling like the hours leading up to the onset of the amnesia feel more like a dream than actual reality. Currently there is no cure for Retrograde Amnesia, although doing activities designed to “jog” one’s memory may help them remember some skills or events, but not their entire life before the onset.

Types of Memory

There are two types of memory that are most likely to be affected by amnesia: procedural memory, which is the ability to remember how to do certain skills such as tying your shoes or driving a car; the other, declarative memory, is the part of the memory that retains information regarding events that have happened in one’s life. It is also the part of the memory that retains information learned in school, such as history.

Types of Amnesia

Post-traumatic amnesia is commonly described as a confused state as the immediate result of a traumatic brain injury. During an instance of post-traumatic amnesia, the individual is unable to recall events that happened after their injury took place. They may not know their name, where they are or when in time it is. While they are suffering from the effects, new memories cannot be stored. Once they begin to regain their memory, the post-traumatic amnesia is considered to have resolved itself.

Psychogenic amnesia, which is more commonly referred to as dissociative or functional amnesia, is diagnosed when one has the presence of retrograde amnesia but does not have the presence of anterograde amnesia. Individuals suffering from psychogenic amnesia cannot remember things about themselves like their own identity, but they are able to retain new information and perform daily functions as they normally would. At times, individuals can lose the ability to read or write, and will have to re-learn these skills.

Repressed Memory & Childhood Amnesia

Repressed memory is a form of amnesia where an individual is unable to recall the events that are traumatic or stressful in an individual’s life. For example, a rape victim may subconsciously block out the circumstances surrounding their attack.

While the memory is stored in a person’s long term memory, the psychological defense mechanisms in their brain will not allow them to remember it. The patient will still have the ability to learn new information, and as time passes, they may begin to recover all or some parts of the memory they had previously blocked out.

Childhood amnesia, also referred to as infantile amnesia, is best described as the inability to remember events from a person’s own childhood. This can refer to traumatic events or even just remembering activities or vacations taken with one’s family. The majority of patients have reported having difficulties remember events that occurred from birth to the age of four years.

Alternative Names

Both Anterograde Amnesia and Retrograde Amnesia are most commonly referred to as either basic amnesia or memory loss.

Additional Causes

In addition to head trauma and drug interaction, amnesia can also be a result of surgeries performed on the brain. At times neurosurgeons may have to remove a part of the brain in order to prevent or treat a more serious disease, or the parts of the brain can become damaged during surgeries. An individual suffering from a brain tumor that needs to be removed runs the risk of having one of the parts of the brain that is a part of the memory process either damaged or removed, causing either Anterograde or Retrograde Amnesia.

Symptoms

The easiest symptom of amnesia to recognize is memory loss; whether it is only a part of the memory or total loss, or whether it is a temporary setback or a more permanent loss. Individuals may also show difficulty in retaining new memories and information. One may also experience false recollections of events, at times inventing memories or confusing multiple events with one another. In addition, an individual who is suffering form amnesia can experience neurological problems including tremors and seizures, as well as appear confused or disoriented.

Risk Factors

If one has experienced certain injuries or events, they may be at a higher risk for amnesia. These include, but are not limited to, brain surgery and trauma or injury to the head; abusing alcohol and strokes or seizures. And while an individual can live with amnesia, the complications from dealing with it can impact ones daily life. Being unable to recall specific memories can lead to problems in social settings, at work or school and at home.

Some may never recover their lost memories. And those with the most severe cases of amnesia may require constant supervision or be required to live in an extended care home where they can be monitored, as even completing the smallest tasks can become impossible to do.

Prevention Tips

Unfortunately, it can be impossible at times to completely prevent amnesia. No one can predict when they may experience a traumatic injury such as a car accident; or when they may fall victim to a vicious attack such as a rape. However, the following tips are recommended to decrease your chances of suffering from amnesia in the event of an accident: wearing a helmet if participating in dangerous sports or bicycling; wearing your seat belt when in an automobile; avoiding the excessive use of drugs or alcohol.

For those who have a head injury, make sure to get treatment as soon as possible after the incident. And if one feels that they are suffering from a brain aneurysm or a stroke, seek medical attention immediately.

Treatment

The treatment of amnesia will vary depending on the type and cause of amnesia, as well as how each individual person’s body reacts to the cause. One treatment for those who are suffering from amnesia as the result of a traumatic event is cognitive rehabilitation.

The individual would need to be surrounded by love and support, as well as counseling to overcome what happened to them, although recalling such memories can do more harm than good. Psychotherapy and hypnosis is another option, as it can aid in recovering the lost memories. In the case of drug or alcohol abuse, emotional support as well as counseling to determine the root cause of their addiction is needed.

If the amnesia is caused by a condition that affects the brain such as an injury or Alzheimer’s, the treatment will be much more medically based. In the case of physical damage to the brain caused by injury, it may very well be impossible to treat with anything other than time and/or therapy.

Some patients find that they recovered their memory once the brain has had time to adapt to the trauma, while others have unfortunately found the loss to be permanent.

Treating Alzheimers & Living with Amnesia

In the case of a disease such as Alzheimer’s, the best course of treatment for amnesia is to attempt to prevent any additional memory loss. What is gone will most likely never return as an individual advances through the stages of the disease.

There are prescription options that an individual can take that work to either protect the brain itself or slow down the rate at which the memory is lost. However, as with most prescriptions, side effects can be significant and may include nausea and vomiting, loss of ability to sleep and loss of appetite. In most instances, the drugs merely slow down the inevitable.

While living with amnesia is not the best scenario for anyone, as medical technology advances doctors may be able to determine a more specific root cause of the disease, and in turn come up with a cure. But in the meantime, being there and supporting those who are dealing with amnesia and helping to restore their precious memories is a key part of helping those who are living with the disease do just that: Live.

Allergies, estimated to afflict one out of every five Americans, are abnormal reactions to normally harmless substances in the environment called allergens. Upon exposure to an allergen, the body’s immune system mistakenly identifies it as a threat and takes defensive action against the presumed invader. The immune system’s inappropriate attempt to protect the body gives rise to allergy symptoms, which can affect multiple organ systems and which range from the mild to the life threatening.

Symptoms

Allergy symptoms vary according to the nature of the allergen and the way in which it encounters the body, and can be roughly divided into three categories that are defined by the manner in which an allergen enters the body.

Airborne Allergens

Airborne allergens like dust, pollen and pet hair travel through the air and come into direct contact with the eyes, nose, throat, sinuses and lungs. This contact gives rise to a constellation of symptoms including sneezing, nasal irritation, itching and watery eyes and runny nose. Allergic rhinitis, commonly known as hay fever, falls into this category, with symptoms that occur seasonally or year round in response to various pollens and spores emitted by trees, grasses and weeds. Pet allergies can be triggered both by airborne exposure and by contact, and the airborne component causes many of the same symptoms as hay fever. Animal fur is not the culprit. Instead, symptoms are caused by exposure to minute flakes of skin, or dander, shed by the animal.

Many of the symptoms associated with airborne allergens, while uncomfortable, are relatively mild, but serious symptoms do occur. Severe symptoms can begin with wheezing and shortness of breath and escalate to full-blown asthma attacks and difficulty breathing caused by swelling of the throat.

Ingested Allergens

Food, medication and insect stings are all capable of producing allergic reactions.

Food allergies can cause stomach pain, vomiting, diarrhea and itching or swelling of the skin. As digestion progresses, symptoms may spread from one organ system to another, beginning with itching in the mouth as the food is taken in, followed by pain, vomiting or other abdominal symptoms as the food moves through the system. As digestion continues, food is broken down and its components are released into the bloodstream. In this way, allergens may be released into the blood and transported throughout the body.

Since the dissemination of the allergen is so widespread, symptoms can affect the skin in the form of hives or eczema, the digestive system itself or the circulatory system as a whole. In the last case, the result can be anaphylaxis, a sudden drop in blood pressure than can be fatal if not treated immediately.

Medications and insect stings give rise to allergy symptoms that can simultaneously affect several organ systems. Symptoms can appear immediately upon exposure or their onset can be delayed. They may include itching or hives, difficulty breathing, swelling of the tongue or throat, stomach pain, vomiting and cramps, all symptoms of anaphylaxis. Loss of consciousness and coma may occur as the reaction continues. Symptoms may appear to be diminishing, only to return in force even if there has been no subsequent exposure to the allergen.

Contact Allergens

Allergic reactions can occur when the skin is exposed to certain substances, including poisonous plants, latex and animal saliva.

Symptoms resulting from contact exposure most often begin with itching and redness of the skin at the point of contact, followed by the development of a rash, blisters or hives. Symptoms of exposure to poisonous plants generally subside after a week or two, but may persist in particularly sensitive individuals for up to 30 days. While uncomfortable, symptoms do not generally become more serious, although infection can occur at the affected site. However, serious respiratory symptoms can result from the inhalation of smoke from burning poisonous plants like poison ivy or poison oak. This mode of exposure usually necessitates extensive medical treatment.

Latex allergy chiefly occurs among health care workers, where symptoms of exposure are typically limited to a localized rash or irritation called contact dermatitis. More serious symptoms, including anaphylactic reactions, can occur following abdominal surgery and medical and dental procedures that expose patients’ mucous membranes to latex gloves.

Causes

Once the immune system marshals its defenses, all allergies follow the same physiological pattern regardless of the allergen involved.

• First,  person is exposed to an allergen through the skin, the respiratory system or the digestive system, and the immune system identifies the allergen as a threat.
• This initial exposure does not cause any allergic symptoms, but sets the immune system to work against the invader.
• Certain white blood cells begin to produce an antibody called Immunoglobulin E, or IgE, whose job it is to bind the allergen.
• IgE circulates throughout the body and attaches itself to mast cells, which play a key role in the inflammatory process and are rich in histamine.
• At this point, the immune system has been sensitized to the particular allergen.
• The next time the immune system encounters the allergen, it binds the allergen and the mast cells release histamine and a broad arsenal of other chemicals that produce inflammation.
• This time around, the release of those inflammatory agents, known collectively as “mediators,” results in symptoms.

Whether symptoms are localized or general depends on the specific allergen and the person involved, and whether an allergic reaction is mild or severe depends to some extent on the extent and suddenness of the release of mediators. The presence of great numbers of mast cells in the respiratory and digestive tracts explains the frequent occurrence of allergy symptoms in those locations.

Risk Factors

While the physiological causes of allergy are well understood and relatively straightforward, risk factors involve a complex interaction of genetics, environment and individual history and susceptibility.

Heredity

Heredity plays a strong role in the probability that a person will be subject to allergies. Children in families where both parents are allergic have at least a 60% chance of having allergies. Such children are more likely to be sensitive to more allergens and to have allergies that are more severe than children who do not have an allergic parent. In general, this genetic predisposition does not translate into the inheritance of sensitivity to a specific allergen, but studies of identical twins have found a 70% likelihood that the twins will suffer from the same allergies.

In children, the incidence of allergy is higher in boys, although this imbalance tends to disappear in adults.

Racial and ethnic factors have also received some attention from researchers, particularly in light of the higher distribution of asthma in the African American population, but results have been inconclusive, especially because of the difficulty of separating environmental and genetic influences.

Environment

Almost by definition, the environment is a risk factor for allergy. After all, allergies do not exist without allergens and allergens come from the environment, whether in the form of pollen, food, medicine, pet dander or poison ivy. Some environmental risk factors are not as self-evident.

Public health researchers have noted a number of epidemiological trends that suggest a broad environmental basis for the development of allergies.

• In the Western world, the incidence of allergies has approximately tripled between 1980 and 2010.
• Allergies are much more common in the industrialized world than in the developing world.
• Immigrants from the developing world to the industrialized world show a greater risk of allergy, and that risk grows along with their time in the industrialized world.
• Children in larger families are less likely to develop allergies than those in smaller families.

The generally accepted explanation for these trends, the “hygiene hypothesis,” holds that the immune system benefits from exposure to a wide variety of irritants and bacteria and thus becomes more tolerant of foreign substances. In the absence of that kind of stimulation, the immune system is more likely to react to a normally harmless substance like pollen.

Other environmental factors contribute to the risk of developing allergies, chiefly by serving as irritants. The likelihood of allergic reactions, especially in children, increases with exposure to air pollution and tobacco smoke.

Personal Factors

Some risk factors are associated with a person’s individual history or with other medical conditions.

A person who has been exposed to allergens in childhood is more like to develop allergies in later life, and more likely to react to the allergen to which the child was exposed. Continued exposure to known allergens increases the risk that a person will become allergic to them.

Frequent ear, nose and throat infections in childhood also correlate with increased allergy risk, as does treatment in early childhood with broad-spectrum antibiotics and the use of antibacterial cleaning products in the home. There is also evidence that infants who are breast-fed and are not given cow’s milk or solid foods for the first six months of life are less prone to allergies later.

Among medical conditions, the presence of nasal polyps, asthma and skin sensitivity are all conditions that correlate with the development of allergies. People with high levels of IgE in the bloodstream are also more likely to develop allergies.

Prevention

Allergy prevention begins with avoiding exposure to the substances that trigger allergic reactions. Therefore, preventive strategies vary according to the allergens and irritants involved.

Pollen and Mold

• Close windows at home and in the car.
• Avoid outdoor activity in the early morning and late afternoon, when pollen counts are high.
• Use air conditioning to filter pollens from the air, and change filters regularly.
• Keep indoor spaces ventilated in order to cut down on moisture.
• Hard surfaces are easier to clean and less conducive to mold growth, so avoid rugs and carpets, especially in the kitchen and bath.
• Keep indoor plants to a minimum, as they can provide homes for mold.
• Avoid drying clothes outdoors where they tend to accumulate pollen.

Pet Dander

• Limit or eliminate the pet’s access to bedrooms.
• Wash the pet frequently, in order to remove dander and pollens that can collect on the pet’s fur.
• Use air filtration machines, either central systems or room units, preferably with HEPA filters.
• Foods
• Read food labels and question restaurant staff about ingredients.
• Learn to recognize early symptoms, since allergic reactions to food can happen quickly and may require immediate intervention.
• Introduce solid foods to infants gradually, beginning when the child is at least six months old.

Poisonous Plants

• Learn to identify plants that produce allergic reactions.
• Wear gloves and long pants and sleeves when encountering potentially poisonous plants.
• Avoid burning plant materials, especially if any are suspect.
• Medications
• Be sure to inform health care providers of any known allergies and of any family history of medication allergies.
• Wear a medical alert bracelet that identifies the allergy if you cannot communicate.

Diagnosis

The two medically accepted avenues of diagnosis are skin testing and blood testing, although a vast array of unproven and generally invalid methods competes with the established diagnostic tools.

Skin Testing

In skin testing, the back or arm is pricked with a metal or plastic device that makes a series of tiny punctures in the skin. Small amounts of the proteins associated with suspected allergens are applied to the skin and mapped according to their placement. If an allergy to the particular substance is present, the individual site will redden or develop a hive. Skin testing has demonstrated a high degree of diagnostic accuracy in all areas except for food allergies, where blood testing provides results more clearly related to specific allergens.

Blood Testing

Blood testing is more complicated and expensive than skin testing, but is sometimes preferred for patients who have had severe anaphylaxis as well as for patients who have recently taken antihistamines or who have diseases of the skin. It does allow for greater accuracy in pinpointing food allergies.

In blood testing, a small amount of blood is drawn and analyzed for the presence of IgE antibodies that are specific to a particular allergen. High levels of allergen-specific IgE antibodies indicate the likelihood of an allergic reaction to the allergen.

Unproven Tests

Unproven tests greatly outnumber the two tests that have proven medical validity. These procedures include measurement of changes in the electrical resistance of the skin, changes in muscle strength on exposure to a suspected allergen and changes in pulse rate after eating a suspected allergenic food. Other unconfirmed methods are the microscopic examination of blood cells in contact with an allergen and the analysis of samples of hair and tissues for trace amounts of chemicals alleged to be toxic. No evidence supports the ability of these tests to provide any benefit to the patient, diagnostic or otherwise.

Treatment

Prevention is the first line of allergy defense, but it is impossible to prevent all exposure to allergens, especially to allergens like pollen that are ubiquitous in the environment. There are many available treatment options, from home remedies to sophisticated immunotherapy, and modern treatments have proven to be extremely effective.

Over-the-counter Medications

Antihistamines – As their name suggests, antihistamines work by blocking histamine receptors in the body. They have a long history of use in treating allergy symptoms and can be taken when needed for relief of sneezing, runny nose and watery eyes. Early antihistamines were known to cause drowsiness, but there are now drugs available, including loratadine, that provide relief without the troublesome side effect, Antihistamines are available as pills, liquids and nasal sprays and as eye drops can help treat itchy eyes.

Decongestants – Decongestants shrink blood vessels and swollen tissues in the nose, helping to decrease their tendency to produce fluid. Although they can be taken as needed in response to symptoms, long term use of decongestants as nasal sprays can lead to a worsening of symptoms once the decongestant is stopped. They tend to raise blood pressure and may be contraindicated in people with hypertension. Decongestants are available as pills, nasal sprays and eye drops, and by prescription in combination with other allergy medications.

Combined medicines – Medicines are also available that combine two different active ingredients. Most commonly, these consist of an antihistamine and a decongestant, although other preparations combine allergy medicines with pain medications, asthma medications or other ingredients.

Prescription Medications

Bronchodilators – Bronchodilators work by opening the airways in the lungs and allowing mucus to move more freely. They are used to treat the symptoms of asthma and come in short-acting forms for immediate relief and long-acting forms that last for up to 12 hours. Bronchodilators can raise blood pressure and increase the pulse rate. They are available as inhalers, as they must be inhaled into the lungs in order to be effective.

Leukotriene modifiers – Leukotrienes are produced by the immune system and contribute to inflammation in allergies and asthma. Leukotriene modifiers suppress their production. Side effects are uncommon, mainly involving stomach upset or pain, but the medication must be taken daily in order to have the desired effect. Leukotriene modifiers are only taken orally.

Mast cell stabilizers – Mast cells are the histamine-rich cells to which IgE attaches in the allergic process, and stabilizer drugs prevent the cells from releasing histamine. They may also have some anti-inflammatory effects and are useful in preventing asthma symptoms. In allergy treatment, they are used as a preventive medication taken prior to exposure to a known allergen. Mast cell stabilizers may take up to a month to reach full therapeutic potential. They can be taken orally or used as inhalers or nasal sprays.

Steroids – Steroids chiefly act by suppressing inflammation and are among the most versatile of allergy medicines. They relieve asthma symptoms, as well as nasal congestion, runny nose and sneezing. Steroidal creams can be applied to the skin to treat symptoms caused by contact with allergens. Side effects of steroids are as varied as their uses and include high blood pressure and weight gain in the short term and cataracts, diabetes and muscle weakness in long-term use. Steroids are available as pills, nasal sprays, eye drops and topical creams. When taken orally, steroids are generally prescribed as a course of treatment lasting at least several days, but they are also effective when used as needed.

Epinephrine – Epinephrine, also known as adrenaline, is used as an emergency treatment for anaphylaxis. It is injected immediately upon the appearance of anaphylaxis symptoms, including itching, swelling of the mouth or tongue, trouble breathing and nausea. Side effects can include hypertension, heart palpitations, racing pulse, anxiety and headache, but none of these side effects contraindicates the use of epinephrine in a potentially deadly onset of anaphylaxis. Epinephrine is only available in injectable form and comes in a small syringe containing a premeasured dose. The EpiPen is perhaps the best-known brand. A variation that includes a second dose, the Twinject, is designed to manage the relatively common situation in which symptoms of anaphylaxis have subsided only to reappear several minutes later.

Immunotherapy

Immunotherapy does not cure allergies, but it is the closest medicine has yet come to providing permanent relief.

Immunotherapy consists of a series of injections given in the upper arm for a period of several years. Initial treatment is given once or twice per week and, if successful after the first several months, once or twice per month for the duration of treatment. The shots consist of gradually increasing doses of a specific allergen in the hope that the patient will become desensitized and develop something akin to immunity to the allergen used.

Immunotherapy has proven to be a safe and effective treatment for allergic asthma and for allergies to pollen, pet dander, molds and insect bites. It is not considered an effective treatment for food allergies. Side effects are rare, although there is a small risk of a severe reaction to the allergen injected.

Other delivery methods have been used with some success outside the United States, including oral and intranasal administration of the dose of allergen. In addition, attempts have been made to shorten the time necessary to build up to a maintenance dose by reducing the interval between allergen exposures to as little as several hours. This strategy is used only in a hospital setting as it entails greater risk of a severe reaction to the allergen.

Home and Herbal Remedies

Home treatments are capable of relieving a number of allergy symptoms. For nasal congestion and symptoms of hay fever, nasal irrigation washes irritants from the nose and sinuses. A bulb syringe or neti pot can be used to introduce a saline solution to the nose.

For insect stings, aloe vera or a paste of water and baking soda can relieve pain and itching at the site of the sting.

Many herbal remedies have been proposed as allergy treatments, including goldenseal, stinging nettle and butterbur. Although a comprehensive 2006 Mayo Clinic study of herbal and other nontraditional approaches found little evidence of their efficacy, two recent European studies of butterbur concluded that it is as effective as an oral antihistamine in alleviating hay fever symptoms, and that it does so without causing drowsiness.

Unproven Remedies

Alternative therapies like homeopathy, kinesiology, naturopathy and probiotics find little support in the medical literature and have not been shown to be effective when studied individually.

Acupuncture stands out as the one exception to those disappointing results, although its promise derives from two small studies. The first showed an improvement in hay fever symptoms in all 26 of the patients studied, and did not report any side effects or adverse reactions. The second study involved 76 patients and reported that two sessions of acupuncture eliminated symptoms in over half of those participating.

Resources

CDC.Gov
EverydayHealth.Com
MayoClinic.Com