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November 19, 2014
Allergic to Allergy Medications: When the Cure Causes
Atlanta—Medications used for allergies are intended to relieve the symptoms, not produce different—and sometimes severe—allegic reactions.
a Flare Up Yet that is what happens more often than pharmacists and other health professionals suspect, according to a presentation recently at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Atlanta. Among the medications that can cause allergic responses are topical corticosteroids; antibiotics such as bacitracin and neomycin found in ointments and adhesive bandages; topical anesthetics such as in lip balm; and antifungals. “Allergy to a topical corticosteroid may not be evident right away because its job is to bring down inflammation,” said Luz Fonacier, MD, of Winthrop University Hospital in Mineola, NY, and the State University of New York at Stony Brook, adding that an allergy to a medication should be suspected if the rash doesn’t improve, actually worsens or initially improves but then flares up. As many as 5% of all dermatitis patients could have an allergy to topical corticosteroids, Fonacier added. Certain areas of the body, including the ears, lower extremities and body folds, are more likely to demonstrate allergic reactions to medications, according to the presentation. That also is the case with preexisting dermatoses such as chronic venous insufficiency, chronic otitis externa, postoperative wounds, and chronic eczematous conditions. Such allergies also can show up with occlusive dressings and transdermal medications. The presentation also pointed out that some patients could be allergic to lanolin, which is present in many medicinal compounds, and that thimerosal, a preservative used in topical medications, cosmetics, contact lens solutions, and vaccines, also could cause reactions. For most topical medications, a patch test can be done to determine if the patient is reacting to the actual drug component, the preservatives, the fragrance, or the delivery system of the drug. “It’s surprising that the main medications used to relieve allergies can cause new allergies, or worsen already existing allergies,” added allergist Sami Bahna, MD, ACAAI past president and presenter. “They are, therefore, rarely suspected.” |
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